In an effort to lower hospital length of stay, several initiatives have been implemented. Some centers around clinical therapies, such as better recovery strategies and early mobility applications, while others address staffing patterns and coordinating healthcare logistics. Despite the scant data, some treatments are regularly associated with better length of stay for intended, scheduled procedures (Siddique et al., 2021). An example of this is improved rehabilitation following surgery services, primarily for optional admissions. The successful outcome of treatments in unexpected hospitalizations is far less well-established than in elective admissions, particularly for patients more likely to experience unfavorable outcomes (Siddique et al., 2021). Patients who have multiple chronic medical conditions, cardiovascular disease, advanced age, or other clinically difficult conditions that put them at risk for extended length of stay are included in this category. In a similar way, these treatments might not be as applicable to individuals with socioeconomic vulnerabilities who are more vulnerable to healthcare inequalities, are hospitalized for longer periods, or have unneeded release delays. In this essay, the impact of evidence-based preventive strategies to help minimize the duration of hospital stays for patients with pressure ulcers will be explored.
Pressure ulcer prevention information is widely available, and much research has been done to evaluate the efficacy of existing practices. When there is pressure on a patient’s skin or tissue beneath an outside surface and an internal bony protrusion, typical pressure ulcers develop. The sacrum or heel are the most common sites for these traditional pressure ulcers, which are thought to account for most adult cases (Gibelli et al., 2022). Beyond the skin’s surface, pressure ulcers can also form and severely harm the underlying muscle or bone. Inactivity, incontinence, and low dietary intake are the five factors that raise the risk of developing these pressure ulcers. A painful and frequently preventable side effect of treatment, pressure ulcers impact hundreds of individuals. These frequently occur, especially in individuals whose ability to move is restricted as a result of disease, a serious physical impairment, or advancing age. Patients with pressure ulcers may experience higher rates of death, morbidity, and worse quality of life. Longer hospital stays are another effect of pressure ulcers (Walker et al., 2020). Hospitalized-acquired pressure ulcers lengthen stays by a mean of between five and eight days for every pressure ulcer. Additionally, they come at a significant financial expense to the healthcare system and its service providers.
Since pressure ulcers commonly develop in hospitalized patients, significantly impacting their quality lives and lengthening their stay, they pose a serious threat to the nation’s medical systems (Han et al., 2020). According to Han et al. (2020), a systematic review study found that children are commonly hospitalized for pressure ulcers, having a wide range of occurrences across various age groups. Furthermore, given the lengthening of hospital stays, it appears that hospital-acquired pressure-related conditions have a substantial financial impact on medical systems despite the paucity of publicly available information. These results underscore the necessity of implementing patient-based preventive strategies. Research indicates that pediatric populations are more susceptible to inpatient-acquired pressure ulcers, which lengthen hospital stays and put a financial strain on medical facilities. However, the effects of pressure ulcers fluctuate depending on the age category. These results confirm the necessity of developing and implementing pediatric preventive pressure ulcer interventions.
Since the significance of fundamental healthcare procedures was first acknowledged, medical professionals, mostly nurses, have concentrated on enhancing skin well-being and averting pressure ulcers. Pressure ulcers are usually preventable wounds due to shear, pressure, or both, causing injuries to the skin and the tissues underneath. Global priorities for early detection, prevention, and therapeutic intervention have been codified via national and global security and excellence in healthcare standards (Triantafyllou et al., 2021). Numerous excellent systematic studies are available to guide the prevention and therapy of pressure injuries. However, because of poor quality studies, they frequently cannot offer suggestions for research and implementation. The poor confidence in PI preventive and treatment studies is confirmed by this meta-analysis, which leaves little guidance for clinical practice. Producing top-notch research on PI prevention and therapy is essential.
Additionally, a lot of institutions in teaching healthcare systems, such as safety-net facilities, serve patients who are especially vulnerable to extended lengths of absence from surgery. As a result, they frequently have difficulty maintaining operating margins (Triantafyllou et al., 2021). For underprivileged communities to have access to healthcare, these institutions must remain financially viable over the long run. Thus, there is a need to find broad system-level interventions to lower the length of stay among individuals at a higher risk of having a longer stay. Researchers conducted a summary of systematic literature reviews to find treatments meant to lower readmission rates for high-risk patients and pinpoint evidence gaps to meet this demand (Gibelli et al., 2022). We present a comprehensive overview of the literature in this comprehensive overview, emphasizing hospitalized older individuals and cardiovascular clients in particular.
The frequency of pressure ulcers ranges from 4.6 percent to 27.2 percent, with a typical incidence of 10.8 percent, according to a recently released research paper that summarizes the data. Research indicates that risk factors for pressure ulcer formation include age, activity level, movement, continence, and dietary habits. In addition to the psychosocial load, pressure ulcers raise healthcare expenses and are seen as a sign of the standard of treatment given in medical facilities. The cost of treating pressure-related injuries per individual varies between $2.03 to $558.68, according to a published comprehensive investigation, whereas the cost of avoiding pressure ulcers extends from about$103.27 (Triantafyllou et al., 2021). The lengthening of hospital stays for patients, which increases the risk of infections that are nosocomial and their sequelae, including tissue death and gangrene, may account for a portion of the cost burden. Several studies have been carried out concerning the frequency, occurrence, and results of adult ulcers caused by pressure developed in hospitals. Although this data has been published in systematic studies, much less has been researched about pressure ulcers contracted in the hospital in the neonatal, young children, and teenager populations.
Pressure ulcers heavily impact quality of life and medical expenses. As an outcome of patient harm, they are becoming increasingly recognized. Physicians who avoid pressure ulcers may face ethical dilemmas linked to accountability from both the clinical and policy realms. When presented with moral conundrums, Doctors may find it useful to construct systems that reflect ethical ideas and notions. However, criticism of these ideas and notions has been leveled at their excessive generalization and simplification. Other approaches that promote a diversified approach to resolving ethical dilemmas, such as virtue ethics and experiential education, can provide more detailed guidance. In addition to major medical consequences, having a pressure ulcer significantly lowers one’s quality of life. The procedures required to cure pressure ulcers are time-consuming and significantly alter a person’s daily schedule. Suffering from pressure ulcers is associated with discomfort, fear, worry, social isolation, and diminished independence, according to published reports. The emergence of pressure wounds in a hospital assistance setting may be relevant from a medico-legal perspective in determining the implications of healthcare professionals’ culpability (Gibelli et al., 2022). In order to ascertain if these occurrences may be identified as instances of misconduct by healthcare workers, we perform a review of the existing literature on this subject, beginning with examining a case of medical liability connected to the development of pressure sores in a healthcare facility. Furthermore, we’ll confirm if there are standards that must be met and communicated by all medical facilities to stop this from happening.
In conclusion, the chosen topic provides evidence that evidence-based preventative interventions are essential for reducing the duration of hospitalization for pressure ulcer victims. In order to aid in preventing the development of pressure ulcers in the healthcare industry, patients must get evidence-based treatment. According to the study papers provided, pressure ulcers can be avoided by considering efficient evidence-based treatments. By using evidence-based strategies, healthcare providers may enhance patient outcomes and lessen the financial strain of wounds from pressure on the medical field.
Gibelli, F., Bailo, P., Sirignano, A., & Ricci, G. (2022). Pressure Ulcers from the Medico-Legal Perspective: A Case Report and Literature Review. Healthcare (Basel, Switzerland), 10(8), 1426. https://doi.org/10.3390/healthcare10081426
Han, D., Kang, B., Kim, J., Jo, Y. H., Lee, J. H., Hwang, J. E., … & Jang, D. H. (2020). Prolonged stay in the emergency department is an independent risk factor for hospital‐acquired pressure ulcers. International Wound Journal, 17(2), 259-267. https://doi.org/10.1111/iwj.13266
Siddique, S. M., Tipton, K., Leas, B., Greysen, S. R., Mull, N. K., Lane-Fall, M., McShea, K., & Tsou, A. Y. (2021). Interventions to Reduce Hospital Length of Stay in High-risk Populations: A Systematic Review. JAMA Network Open, 4(9), e2125846. https://doi.org/10.1001/jamanetworkopen.2021.25846
Triantafyllou, C., Chorianopoulou, E., Kourkouni, E., Zaoutis, T. E., & Kourlaba, G. (2021). Prevalence, incidence, length of stay and cost of healthcare-acquired pressure ulcers in pediatric populations: a systematic review and meta-analysis. International Journal of Nursing Studies, 115, 103843. DOI: 10.1016/j.ijnurstu.2020.103843
Walker, R. M., Gillespie, B. M., McInnes, E., Moore, Z., Eskes, A. M., Patton, D., … & Chaboyer, W. (2020). Prevention and treatment of pressure injuries: A meta-synthesis of Cochrane Reviews. Journal of Tissue Viability, 29(4), 227-243. https://doi.org/10.1016/j.jtv.2020.05.004
Welsh L. (2014). Ethical issues and accountability in pressure ulcer prevention. Nursing standard (Royal College of Nursing (Great Britain): 1987), 29(8), 56–63. https://doi.org/10.7748/ns.29.8.56.e9262