Management of Pressure Ulcers
The use of borrowed theory in the recent years in nursing practice denotes an analysis of the same to establish their suitability in evidence-based practice. Borrowed theories refer to theories from other disciplines that are essential in developing new information on the management of clinical conditions affecting patients. They have been used in nursing to in association with proven nursing theories to manage diseases. Thus, the same approach is also befitting in the management of adverse events such as pressure sores. Pressure ulcers are costly to treat, and their complications affect the well-being of the patients massively. It, therefore, makes sense when healthcare organizations invest in inventing and reinventing the wheel when managing and preventing this menace. An example of a strategy is the utilization of renowned nursing theories whose credibility is unquestionable. For instance, the self-care model by Dorothea Orem has widely received accolades for its immense contribution to the management of pressure sores. However, more is possible concerning this direction and path. Central to that is the nurses’ adoption of borrowed theories such as the theory of pressure ulcer causation. In essence, such frameworks can complement the above-mentioned middle-range theory in control of this worrying healthcare element. An analysis of the suitability of this borrowed theory in the management of decubitus ulcers is the central theme of this discussion.
Firstly, the theory of pressure ulcer causation delineates pressure as the dominant factor that may result in pressure ulcers. In this school of thought, pressure to the high-risk areas such as sacrum is the cause for ischemia which in turn leads to necrosis and ultimately to an ulcer. The theory recognizes that constant pressure on the skin surface deprives it oxygen, thereby resulting in cell death, which is the essence of pressure sores. The same is inconsistent to some with Charcot’s viewpoint. In his neurotrophic theory, he asserted that the ulcer development should be directly related to injury to the central nervous system (CNS). According to him, the CNS injury will result to the release of an intrinsic neurotropic factor that regulates nutrition and reduces the tissue tolerance to pressure causing an ulcer(Agrawal & Chauhan, 2012). Despite the differences in the developmental approach, the central theme in the two viewpoints is pressure. Thus, this is proof enough of the indispensability of pressure in the development of pressure ulcers.
That aside, the theory of pressure as a causative agent of pressure ulcers is an appropriately borrowed theory to the management pressure sores. Such is the case given its contribution to the body of contemporary knowledge concerning the etiology of pressure ulcers. An understanding of this kind is the essence of the preventive strategies that can be utilized to bypass this challenge. Thus, it makes sense if nurses can consider this invaluable theory.
That notwithstanding, the efficacy of this approach is evident through its previous application. The model has widely influenced the development of pressure ulcers’ risk assessment tools, which is the essence of decubitus ulcers prevention. Moreover, this theory also affords credentials of being a major contributor to preventive pressure ulcer strategies. A case in point is the continual reliance on pressure relievers to reduce the chances of pressure sores in bedridden patients(Agrawal & Chauhan, 2012). Evidently, these instances prove the massive contribution of this theory in the management and prevention of this adverse event.
Besides, its use in the past, the application in the current nursing practice in high-risk areas is very possible. For instance, a nurse can utilize his/her knowledge of this theory to extrapolate the likelihood of a patient to develop bedsores. A befitting explanation of the same is that this method will enable to a nurse to appreciate the role of risk assessment in unconscious patients that are most vulnerable. By adopting the risk assessment tools in their practice, the nurses more equipped to avert the challenge of bedsores. Furthermore, this theory can also enable an individual to institute measures that will relieve pressure, thereby preventing decubitus. It is through such revelation that the nurse’s ability to prevent pressure ulcers is beyond the reasonable doubt. Additionally, this pressure theory is also a true asset that one can use to determine the staging of pressure ulcers through regular risk assessment(Risk assessment & prevention of pressure ulcers, 2011). In essence, it is the risk assessments that will enable the nurse to institute preventive strategies that will reduce or halt the progression to severity.
With that in mind, the utilization of this framework will ultimately result in a change in one’s practice. Firstly, the practice will switch to the better since an individual can rely on his/her assessment skills that are of the essence in such cases. The individual is thus more aware of the need to perform risk assessment since he/she understands how pressure can result in such ulcers. Moreover, the nurse’s knowledge base improves as he/she can give a rationale for the nursing actions instituted. For example, he/she can initiate a plan of care without necessarily awaiting the physician(Risk assessment & prevention of pressure ulcers, 2011). Apparently, all these instances point to the fact that the theory will change one’s practice.
Lastly, an integration of this theory with the self-care model can offer an invaluable means of evading this healthcare problem. A solution of this kind is possible given the dual advantages that the approach will afford. Self –care model will enable the nurse to attend to the needs of the patient in a nursing system approach. Apparently, the design is important as it prevents pressure ulcers progression. Similarly, the pressure theory, on the other hand, enables the nurses to appreciate what needs to be done to avoid the same. Thus, the two models upon simultaneous usage will result in certain synergy, which is the only way to go if we are to bypass this challenge.
In conclusion, there is indispensability need for more use of middle-range and borrowed theories in nursing practice. A deduction of this kind is on the premise that this approach as discussed can be the answer to the challenge of pressure ulcers. It is beyond doubt that this practice affords the nurse the best-known practice in the management of pressure ulcers. Moreover, the utilization of the two utilities complements the deficiency that may have occurred if their usage is in solitude. For instance, self-care model usage may not always assure better returns in the management of pressure ulcers in the high-risk departments such as ICU. Such is the case given the small number of nursing staffs in comparison to a large number of patients requiring their attention. Thus, it is imperative to note that the future of nursing management of pressure sores can only be brighter if only nurses adopt integrated models in their practice. Failure to do so can only mean a future characterized by harsh effects of the pressure ulcers.
Agrawal, K. & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian Journal Of Plastic Surgery, 45(2), 244. http://dx.doi.org/10.4103/0970-0358.101287
Registered Nurses’ Association of Ontario. (2011). Risk assessment & prevention of pressure ulcers. Toronto, Ont: Registered Nurses’ Association of Ontario.