Healthcare Problem Presentation By: Vannelyn Oriel 1 Problem Definition In this case, pressure ulcers is the problem that was identified. Pressure ulcers refer to injuries to the skin and underlying tissue and this is can be attributed to prolonged pressure on the skin. Today, pressure ulcers is increasingly becoming a major health concern globally. Healthcare systems worldwide continue to direct resources towards helping patients effectively and efficiently manage pressure ulcers. Pressure ulcers is becoming a major health concern globally. It root cause is prolonged pressure on the skin. It mostly affects patients in hospitals. Few studies have focused on assessing this healthcare problem. It is a pattern that I would like to change to improve quality. 2 Pressure Ulcers According to data from the Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the U.S. develop pressure ulcers annually. Pressure ulcers especially among patients recovering in hospitals bring pain. The healthcare problem also leads to increased health care utilization. There is increase risk for serious infection among patients in hospitals. Overall, documented cases of pressure ulcers has been on an upward trend globally. In most cases, pressure ulcers develop among patients who have a specific health condition that limits their ability to change positions. 3 Symptoms and Causes of Pressure Ulcers There exist various symptoms and causes of pressure ulcers. The first symptom is unusual changes in a patient’s skin color or texture. Increased tenderness of skin areas. Swelling can be observed. Pus-like draining is another symptom. Bedsores can be categorized into different stages that cause pressure ulcers. Common areas for pressure ulcers Buttocks. Back of legs, and arms where a patient rests against the chair. Shoulder and spine. 4 Risk Factors Immobility for example, assuming a patient in hospital is using a wheelchair, they would apply pressure to specific parts such as buttocks leading to pressure ulcers. Incontinence where a patient’s skin becomes susceptible due to extended exposure to urine and stool. Poor diet and nutrition leading to lack of vitamins and minerals that can lead to a healthy skin. Patients with diabetes also have high risk of experiencing pressure ulcers. Pressure ulcers if not well managed and treated among patients can lead to complications such as cancer, and bone and joint infections. 5 Description of the Problem Pressure ulcers is a major health concern in today’s nursing practice. Despite so, it is largely preventable in nature. The management of pressure ulcers relies on its severity. A study by Surg, 2015 established that cleaning of wound, using antibiotics, and undergoing reconstructive surgery were the present treatment options for pressure ulcers (Surg, 2015). However, there exist newer treatment options such as cell therapy, wound therapy and wound therapy. ...

1. Healthcare Problem Presentation
By: Vannelyn Oriel
1
Problem Definition
In this case, pressure ulcers is the problem that was identified.
Pressure ulcers refer to injuries to the skin and underlying
tissue and this is can be attributed to prolonged pressure on the
skin.
Today, pressure ulcers is increasingly becoming a major health
concern globally.
Healthcare systems worldwide continue to direct resources
towards helping patients effectively and efficiently manage
pressure ulcers.
Pressure ulcers is becoming a major health concern globally.
It root cause is prolonged pressure on the skin.
It mostly affects patients in hospitals.
Few studies have focused on assessing this healthcare problem.
It is a pattern that I would like to change to improve quality.
2
Pressure Ulcers
According to data from the Agency for Healthcare Research and
Quality (AHRQ), more than 2.5 million people in the U.S.
develop pressure ulcers annually.

2. Pressure ulcers especially among patients recovering in
hospitals bring pain.
The healthcare problem also leads to increased health care
utilization.
There is increase risk for serious infection among patients in
hospitals.
Overall, documented cases of pressure ulcers has been on an
upward trend globally.
In most cases, pressure ulcers develop among patients who have
a specific health condition that limits their ability to change
positions.
3
Symptoms and Causes of Pressure Ulcers
There exist various symptoms and causes of pressure ulcers.
The first symptom is unusual changes in a patient’s skin color
or texture.
Increased tenderness of skin areas.
Swelling can be observed.
Pus-like draining is another symptom.
Bedsores can be categorized into different stages that cause
pressure ulcers.
Common areas for pressure ulcers
Buttocks.
Back of legs, and arms where a patient rests against the chair.
Shoulder and spine.
4
Risk Factors

3. Immobility for example, assuming a patient in hospital is using
a wheelchair, they would apply pressure to specific parts such
as buttocks leading to pressure ulcers.
Incontinence where a patient’s skin becomes susceptible due to
extended exposure to urine and stool.
Poor diet and nutrition leading to lack of vitamins and minerals
that can lead to a healthy skin.
Patients with diabetes also have high risk of experiencing
pressure ulcers.
Pressure ulcers if not well managed and treated among patients
can lead to complications such as cancer, and bone and joint
infections.
5
Description of the Problem
Pressure ulcers is a major health concern in today’s nursing
practice.
Despite so, it is largely preventable in nature.
The management of pressure ulcers relies on its severity.
A study by Surg, 2015 established that cleaning of wound, using
antibiotics, and undergoing reconstructive surgery were the
present treatment options for pressure ulcers (Surg, 2015).
However, there exist newer treatment options such as cell
therapy, wound therapy and wound therapy.
Nurses have a vital role to play in prevention and management
of pressure ulcers among patients.
It has today become a patient safety issue.
For this reason, effective preventive and management strategies

4. signifies a marker of quality of care that should be leveraged by
nurses.
6
What could happen if the problem is not addressed
As a nurse, if the problem of pressure ulcers among patients in
hospitals is not effectively addressed, then the consequences
can be unimaginable.
First, it can lead to a significant damage of tissues on a
patient’s body and they may eventuall y die.
Most often, pressure ulcers do not lead to death.
However, it can lead to a decline in health of an individual.
Treatment of pressure ulcers can be costly thus negatively
impacting on the economic well-being of patients and their
families.
Consequences of pressure ulcers can be significant for example,
severe skin damage, reduced body immunity, increased cost of
treatment and even death if not well-managed.
7
Relevance of the problem
It is important for individuals especially those in nursing career
to be aware and know more about pressure ulcers.
A research anchored on knowledge and practice of nurses
towards prevention of pressure ulcer found it to be inadequate
among them (Nuru et al., 2015).
It presents a huge challenge as many nurses lack knowledge and
practice of effectively and efficiently preventing and managing
pressure ulcers.
Understanding pressure ulcers will help in determining how it
impacts an patient’s well-being in hospital.

5. It is important to appreciate the fact that there is a huge gap in
terms of knowledge and practice regarding pressure ulcers
among nurses globally.
For this reason, there is need for an intervention towards
equipping nurses with the requisite support systems to help
them effectively prevent and manage pressure ulcers.
Eventually, this will lead to desirable health outcomes among
patients.
8
A real-life scenario of Pressure Ulcers Knowledge and Practice
among Nurses
To effectively describe the problem, there was need to create a
real-life scenario of pressure ulcers.
The figure show’s nurses knowledge and practice concerning
how to prevent pressure ulcers at Gondar University Hospital,
Northwest Ethiopia (Nuru et al., 2015).
Ways of reducing knowledge and experience gap in Pressure
Ulcer among Nurses.
Boosting nursing in-service training anchored on pressure
ulcers.
Providing requisite facilities and equipment to effectively
prevent and manage pressure ulcers among patients.
Upgrading nursing courses.
9
Proposal to address the problem
As pressure ulcer continues to become a major health concern

6. globally, there is need to develop requisite prevention and
management plans aimed at enhancing patient care.
It is vital to appreciate the fact that despite massive efforts
towards managing and preventing pressure ulcers, the
complexity of the problem continues to increase.
For this reason, there is need to develop an effective and
efficient strategies of addressing the problem of pressure ulcers.
Addressing the problem of pressure ulcer is becoming complex.
As a result, clinicians, nurses and patients experience
significant challenges in quest to achieving high-quality
healthcare.
Factors that have made addressing the issue of pressure ulcers
difficult.
Difficulties in categorizing pressure ulcers into levels.
Poor inter-agency working and relations.
Poor morale of nurses.
10
Addressing the problem of pressure ulcers
First, there is need for increased inter-agency working between
nurses and other medical professionals such as surgeons,
clinicians, and pharmacists,
Inter-agency collaboration will lead to formation of teams that
will tackle pressure ulcers in hospitals and achieve desirable
patient outcomes in the long run.
It also closes communication gaps and this will enable nurses
and other professions in health care share ideas concerning
treatment of patients with pressure ulcers.
Inter-agency working in healthcare has been given a wide berth.
Nurses ought to incorporate it in their practice to boost

7. knowledge and experience.
Eventually, they will deliver high-quality care to patients with
pressure ulcers.
11
Addressing the problem of pressure ulcers
Nurses have a vital role to play in increasing awareness among
patients at a hospital concerning risk of pressure ulcers.
For example, nurses can advise patients at a hospital to
minimize time that thy apply pressure on their skin.
Consequently, this will help in improving skin quality thus
improved health of the patient in the long run.
It is important that nurses maximize on using pressure injury
monitoring devices.
It will help in assessing various aspects of skin such as
moisture, body motion.
Pressure-sensing mats can be placed on patients wheel-chair to
monitor pressure applied thus preventing potential of sores.
12
Addressing the problem of pressure ulcers
Nurses can play an integral part in developing a plan to help the
caregiver of a patient follow when taking care of the patient at
hospital.
The care plan can also integrate various aspects such as position
changes, good diet and lifestyle changes.
Undertaking routine nursing assessment of patients at hospital
can help identify the problem in good time.
Early detection of pressure ulcers can help mitigate its effects
on a patient in the long run.

8. Factors that lead to improved health of pressure ulcer patients.
Position changes,
Good diet
Lifestyle changes
13
Addressing the problem of pressure ulcers
Apart from management and prevention as ways of addressing
pressure ulcers, nurses can incorporate treatment as a way of
enhancing high-quality patient care.
Through surgery, a patient with pressure ulcer can be treated.
Surgery helps to seal the wound and bring about healing.
Surgery also reduces the risk of infection among patients in
hospitals as wounds would be completely sealed.
The biggest impediment to surgery as a way of treating pressure
ulcers is that it does not suit people who are already in poor
state of health.
14
Addressing the problem of pressure ulcers
When addressing the issue of pressure ulcers, it is essential to
consider different groups of people who are at high-risk of
getting pressure ulcers.
Adult people who are older than 70 years old have high
probability of being infected with pressure ulcers due to
mobility problems associated with this age.
People with obesity also have high likelihood of getting
pressure ulcer.
Individuals who practice a poor diet also have high probability
of getting pressure ulcers.

9. Nurses ought to consider various aspects when handling patients
with pressure ulcers.
Central to improved patient care is accelerating awareness and
education on this health problem.
15
Identification and Discussion of Ethical, legal and Regulatory
Concerns relating to Pressure Ulcers
Concerning ethical concerns, nurses who undertake research in
pressure ulcers have to deal with confidentiality, ethical
dilemmas attributed to conflict between transparency and
responsibility to the patients and the requirements for research
and informed consent.
Additionally, five ethical theories that is utilitarianism, virtue
ethics, deontology, egoism and care ethics form the basis of
ethical aspects of nursing.
For example, under egoism as an ethical aspect, a nurse is
required not to overwork but at the same time promote self-care
among patients.
Understanding ethical aspects impacting pressure ulcers is
complex.
Five theories provide anchorage to the ethical aspects of
pressure ulcers.
Utilitarianism
Virtue ethics
Deontology
Egoism
Care ethics
16

10. Ethical Issues
Ethical aspects of deontology and utilitarianism provide a
framework where the pressure ulcer patient can access all
relevant information to help in achieving best health outcomes
in the long run.
A nurse ought to inform a patient with pressure ulcers of their
condition and its implications.
Care ethics provides for delivery of patient-focused and focused
treatment plans of patients with pressure ulcers.
Nurses need to consider ethical aspects aimed at providing high-
quality care to patients with pressure ulcer.
Doing so will enable them avoid doing the wrong thing thus
enhancing their professionalism.
Training and coaching on ethical aspects can be crucial to
providing patient-focused care to patients with pressure ulcers.
17
The Legal and Regulatory Aspect of Pressure Ulcers
Today, lawsuits associated with patients with pressure ulcers
are common and continue to increase globally.
Under the legal aspect, assuming a patient develops pressure
ulcer and that there is documentation where a doctor had been
notified, in this case there will be no treatment since the
physician would not have intervened (Fife, 2020).
Consequently, this can lead to serious health problems for
patients with pressure ulcers.
It can then be classified as breach of duty and low -quality care
therefore, negligence (Lockhart & Goudberg, 2002).
An nurse or any healthcare professional can be sued.
A nurse ought to avoid litigation by providing high standard of
care to the patient with pressure ulcers.

11. Legal aspects surrounding pressure ulcers vary from country to
country.
Individual countries design laws in way that suits them.
However, one thing that cuts across regarding legal aspect is
that in leverages on making health care professionals deliver
high-quality care.
18
Explanation of why I chose the problem
First, pressure ulcers is increasingly becoming a major health
concern globally thus the reason why I chose it.
The problem was interesting to me as there exist few studies
that have be done on it.
Additionally, the impact of pressure ulcers tend to be
underestimated by many people yet they seriously impact a
patient’s health.
I wanted to explore this problem to determine how it has
impacted nursing as a career based on knowledge and
experience.
Pressure ulcers is underestimated.
It can be deadly if not detected early.
There exist mechanisms through which nurses can improve care
of patients with pressure ulcers.
Little research has been done anchored on pressure ulcers.
19
Why I chose the topic
Many hospitals especially those in developing nations have
nurses who have little knowledge and experience concerning
pressure ulcers
This was an insightful finding for me.

12. Pressure ulcers is a complex condition based on prevention and
management thus many people shy away from examining it.
I wanted to explore a problem that has not received the required
attention
Pressure ulcers hugely impacts the global health system yet
many people ignore it.;
Pressure ulcers as a problem has been neglected.
Need for increased on research anchored on pressure ulcers.
Inter-agency collaboration needed to boost quality of care given
to patients with pressure ulcers.
20
Conclusion
Lastly, pressure ulcers continues to evolves based on
prevention, treatment and management among patients.
Nurses need to be considerate of the ethical, and legal aspects
surrounding pressure ulcers to help their patients achieve high
quality care.
There is need for increased funding on research anchored on
pressure ulcers to aid in developing robust and efficient
interventions that will boost patient’s health in the long.
Eventually, nurses will be motivated and inspired to provide
high-quality care.
Future studies need to focus on how nurses knowledge and
experience on pressure ulcers can be improved to achieved a
patient-centered care in the long run.
21
References
Berlowitz. (2022). Preventing pressure ulcers in hospitals.

13. Agency for Healthcare Research and Quality.
https://www.ahrq.gov/patient-
safety/settings/hospital/resource/pressureulcer/tool/index.html
Fife. (2020). A Closer Look at the Legal Implications of
Pressure Injuries. Todays World Clinic.
https://www.hmpgloballearningnetwork.com/site/twc/articles/cl
oser-look-legal-implications-pressure-injuries
Lockhart, D. G. (2002). The legal implications of pressure
ulcers in acute care. Critical Care Nursing Quarterly, 25(1), 63-
68. https://doi.org/10.1097/00002727-200205000-00007
Nuru, Zewdu, Amsalu, & Mehretie. (2015, May 16). Knowledge
and practice of nurses towards prevention of pressure ulcer and
associated factors in Gondar University hospital, northwest
Ethiopia. BioMed Central.
https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-
015-0076-8
Surg. (2015, January). Pressure ulcers: Current understanding
and newer modalities of treatment. PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413488/