Patient At Risk Of Pressure Sores

Case study: Patient at risk of Pressure Sores
During a community practice placement I was involved in caring for one particular lady whom will name “Lucy” for confidentiality reasons (NMC2009). Even though Lucy was at risk of lots of other problems, I have chosen to focus on the risk of pressure ulcers ,its assessment and its management.Pressure ulcers are said to cost the NHS billions of pounds each year in terms of treatment. They are also known to cause severe harm and pain to patients hence why the NPSA is urging NHS organizations across Britain to work towards its prevention (NPSA 2010) .It is therefore important that patient receive good appropriate risk assessment in order to manage the risk because good management of risk could reduce unnecessary harm and pain to the patient and possible save the NHS money. A brief account of the patient status and medical history will be given. In the assignment I will also point out the importance of management risk and give reasons why they think the patient is at risk of pressure ulcers. The definition of pressure ulcers will also be given. The reliability and validity of the tools used to assess patient will be discussed, and will also explore the way in which care was given .A critical analysis of how poor management of risk could impact on the patient or organization will also be given . And finally the author will give a reflective account of the learning experience and how it’s going to affect their future practice.
Lucy an 82year old British lady is a resident in local care home. She has a past medical history Arterial Fibrillation, hiatus hernia, knee pain and left ventricular failure. This lady also suffers from Asthma which she was taking clenil modulate 100mcg inhaler 2 doses a twice a day for. She was also diagnosed with hypertension and was therefore taking Ramipril .Lucy `s does not have any family members close by as most of them had migrated to another country. She spends most of her time in her room watching television. Lucy occasionally goes downstairs to meet other residents in the hall. She can only walk a few steps with prompting. Her appetite is very poor and has been losing weight recently. For the past 2years she has been copying well, but only recently that she had become incontinent. The carers assist Lucy with her personal hygiene .The community nurses were contacted after Lucy to check Lucy`s legs which had become oedematous. It was upon doing a risk assessment that they realised Lucy was at risk of pressure ulcers.

A risk assessment was done using the Waterlow scale .Because of her age Lucy was considered to be at risk. Ageing makes skin thin and frail and more prone to injury. The skin’s main functions is to act as a barrier but it also functions as i.e mediation of sensation ,regulation of heat ,vitamin D synthesis ,excretion of water and salts as well as acting as a storage and reserve for water and lipid. Because of the skin changes that occur during this ageing process older people become more vulnerable to a wide variety of skin problems Voegeli (2012).Continence problems are said to increase the vulnerability of the skin because the moisture against the skin causes friction. The skin has 2main layers ,the dermis and the epirdemis.The dermis underlies the epirdemis and has several structures that work together to maintain homeostatis .It is comprised of proteins ,collagen elastin and connective tissue .The sensor nerve endings that are stimulated by touch makes the temperature ,pain and motor nerve fibres that control blood flow as well as the sweat glands to balance body temperature hair follicles and sebaceous glands that produce lipid rich sebum to help keep the skin moisturerised (Butcher M 2005). 3million to 3.5 million people are estimated to be affected from some kind of urinary incontinence ,with 50% of that figure being 65years or older .It is also mentioned that women are twice at risk than men Age uk( 2010).Stress

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