Ethical and Cultural Perspectives of Inquiry

Up to 23% of long-term care and rehabilitation facility patients develop pressure ulcers. (Russo, 2003). According to the Agency for Healthcare Research & Quality (AHRQ) (2012), there are more than 2.5 million pressure ulcer cases in only the United States each year.

Pressure ulcer development is a highly complex process, and the difficulty of implementing evidence-based preventative practices is sometimes a result of ethical and cultural concerns. Informed permission, secrecy, methodological ambiguities, and the tension between accountability and responsibility are only a few of these obstacles.

Guy (2004) states that although it is often impossible to remove inherent factors, including age, medical problems, and medication, doing so helps reduce the development of pressure ulcers. Although not all pressure damage can be prevented, it’s possible to lessen its occurrence (Bennett, 2004). This essay aims to address and validate the ethical and social barriers to pressure ulcer prevention and how these barriers impact efforts to reduce the condition’s incidence.

What moral barriers influence how the medical profession approaches the treatment and prevention of pressure ulcers?

For patients and their clinicians, managing and preventing pressure ulcers in long-term healthcare institutions presents many difficulties. Poor inter-agency working relationships, poor training, nurses’ inability to stage pressure ulcers, poor relationships between clinicians and patients, a lack of appropriate equipment to treat and prevent pressure ulcers, and a lack of risk and preventative awareness are among the majority of these challenges. All long-term healthcare facilities have general intervention measures in place to reduce the prevalence of these wounds, some of which include policies to prevent pressure ulcers and their infections, good hand hygiene, education and training on evidence-based practices and strategies from preventing pressure ulcers, and use of protective clothing by medical personnel (Emmerson, 1995). The occurrence of pressure ulcers has long been considered to be a sign of poor patient care. Since nurses and other healthcare workers are in charge of preventing them, there have been unresolved ethical problems involving their accountability related to legislation and practice. The strategic, financial, and administrative responsibilities that oversee the established strategies for pressure ulcer prevention and assure adherence falls on all healthcare professionals, including those at management levels.

Ethics has long been characterized as the philosophical analysis of right and wrong and the effects of human behavior (Welch, 2014). When doctors and other caregivers refuse to accept their role in developing pressure ulcers, it poses one of the biggest problems. The majority of healthcare facilities employ a collaborative approach to pressure ulcer avoidance, which negatively impacts frail older folks, fragile adults, and those with learning disabilities by resulting in subpar care. There is evidence of inadequate personnel and supplies at most healthcare facilities, as well as a lack of a healthy diet to support healthy skin, inadequate hydration, and a lack of basic cleanliness to support well-being. To improve patient outcomes, all healthcare facilities must guarantee the application of safety procedures within their own operations.

Pressure ulcer occurrences in long-term healthcare institutions are governed and safeguarded by state and federal laws. These rules guarantee that pressure ulcer incidences are decreased and controlled, offering patients and their families a safety net. The regulations specifically target healthcare organizations, departments, and other healthcare providers (Bryan, 2017). In order to ensure a safe environment for patients, the state government effectively coordinates federal standards with statutory rules and regulations to oversee all healthcare services. Any healthcare facility’s primary concerns are patient safety and dignity. To ensure the same, nurses and clinicians have moral and ethical obligations. Healthcare practitioners must address their knowledge and perception of pressure ulcer prevention techniques according to the ethical theories relevant to preventing pressure ulcers. In order to ensure their safety and freedom from developing pressure ulcers in healthcare facilities, patients are advised by these same theories on the best tactics and possibly daily routines they should adopt.

Cultural Perspective: Which cultural beliefs and/or customs have an impact on pressure ulcer treatment and prevention?

In the modern healthcare sector, most facilities have created and implemented a culture embraced by personnel to control the development of pressure ulcers. A multidisciplinary team made up of nursing personnel, nutritionists, physical therapists, dermatologists, consultants, and other experts oversees an efficient preventative program. In their clinical settings, these teams concentrate on preventing and managing pressure ulcer occurrences. The team also outlines the necessary controls to encourage a favorable patient outcome (Baral, 2015). The culture of the hospital setting has an impact on some areas of pressure ulcer prevention.

Lack of thorough skin assessment is one of these reasons. A general assessment must include identifying and effectively managing medical conditions and health issues such as urine incontinence, nutritional status, pain tolerance, and psychological health problems that may have put patients at risk for pressure-ulcer development. There is no unified classification scheme for pressure ulcers that are accepted worldwide. It is obvious that the proper treatment strategy is determined by each stage of an ulcer. The executive management team and the clinical staff must work together for pressure ulcer prevention strategies to be successful. This is crucial and significant in supporting pressure ulcer prevention strategies that aim to provide high-quality patient outcomes, encouraging feedback, and patient-staff collaboration.

The workforce at healthcare facilities has access to rules and procedure documents that serve as instructions for how their everyday responsibilities should be carried out. Some healthcare facilities do not support or encourage educational initiatives for their staff that would encourage and strengthen adherence to the standards they have established for the prevention of pressure sores. Additionally, due to a lack of understanding, familiarity, agreement, and self-efficacy with the standards, some patients, nurses, clinicians, and other healthcare workers do not follow or adhere to the clinical policies and procedures that are offered (Baral, 2015). The majority of healthcare facilities operate cooperatively, and ultimately, the kind of care the patients receive will depend on their financial situation. Most patients receive subpar care when the patient-to-nurse staff ratio is low. The neighborhood of a medical center has a significant impact on patient outcomes. They might plan community events that include patients to encourage mobility and an active lifestyle. Additionally, engaging in healthy nutrition-promoting activities like gardening will benefit patients who are undernourished. Nutritional consultation is also advised, and a swallowing examination should be routinely taken into account.

Pressure ulcer prevention measures also heavily rely on cultural and religious beliefs. Some people link pressure sores to them. For instance, some people think that negligent medical staff and subpar patient care are to blame for pressure ulcers. Patients and their families expect nurses to adhere to the hospital’s pressure ulcer prevention guidelines and procedures in order to give them the best treatment possible. Nurses and other healthcare personnel who report negligence or deviation from the established standards must be held accountable and disciplined in order for the protocols for the prevention of pressure ulcers to be effective. Less than 10% of patients considered to be “at risk” for developing pressure ulcers receive the proper preventative measures, and up to 40% of patients do not receive care based on the most recent best practices (Waugh, 2014). Pressure ulcers are very common in Asian, Hispanic, and African cultures. They are more likely to get these pressure ulcers and other infections in subpar facilities because they lack the resources to seek out adequate medical interventions from the healthcare facilities. They seek treatments from healthcare facilities they can afford because of their financial limitations. Due to low-wage workers, subpar feeding standards, and a lack of essential supplies, these subpar facilities have a high prevalence of pressure ulcer formation.

Therefore, there is little to no adherence to the prevention recommendations, which raises the chance of developing pressure ulcers and other illnesses.

Conclusion: Both cultural and ethical concerns are impacted by pressure ulcers. The key ethical concerns are clinical nursing and management, which ensure patients and their families receive the best possible care, including pressure ulcer avoidance. Patients must participate in the prevention of pressure ulcers, especially those who are awake. They must follow the prescribed rules for preventing self-pressure sores. On the other hand, culture significantly influences pressure ulcer prevention. It concerns the set of requirements that must be met at a healthcare facility in order to improve patient outcomes. Positive patient outcomes can only be attained at healthcare institutions that have senior leadership support, education for staff, patients, and their families, increased quality assessment and improvement, evidence-based prevention approaches, and unit-level champions. However, the durability of pressure ulcer prevention depends on how these components interact inside the facility (Jankowski, 2011).

References;

Bennett, Gerry, Carol, & John. (2004, May 1). cost of pressure ulcers in the UK. Retrieved from https://academic.oup.com/ageing/article/33/3/230/.

Baral, R. (2015). Organizational culture and its implications on infection prevention and control. Journal of Pathology of Nepal, 5(10), 865–868. doi 10.3126/jpn. v5i10.15644

Bryan, C. S., Call, T. J., & Elliott, K. C. (2017). The ethics of infection control. Infection Control & Hospital Epidemiology, 28(9), 1077-1084. doi:10.1086/519863

Emmerson, M. (1995). Surveillance strategies for nosocomial infections. Current Opinion in Infectious Diseases, 8(4), 272–274. doi 10.1097/00001432-199508000-

Guy H. (2004). Preventing pressure ulcers: choosing a mattress. Professional nurse (London, England), 20(4), 43–46.

Jankowski, I. M., & Nadzam, D. M. (2011). Identifying Gaps, Barriers, and Solutions in Implementing Pressure Ulcer Prevention Programs. The Joint Commission Journal on Quality and Patient Safety, 37(6), 253–264. doi: 10.1016/s1553-7250(11)37033-x.

Preventing Pressure Ulcers in Hospitals. (n.d.). Retrieved from https://www.ahrq.gov/patient- safety/settings/hospital/resource/pressureulcer/tool/index.

Russo CA Elixhauser A. Hospitalizations Related to Pressure Sores, 2003: Statistical Brief #3.

Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD); 2006.

Waugh S. M. (2014). Attitudes of Nurses Toward Pressure Ulcer Prevention: A Literature Review. Medsurg nursing: official journal of the Academy of Medical-Surgical Nurses, 23(5), 350–357.

Welsh, L. (2014). Ethical issues and accountability in pressure ulcer prevention. Nursing Standard, 29(8), 56-63.

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Compose a focused paper that explains and describes your healthcare issue/topic from the scientific and mathematical/analytical perspectives of inquiry. (You will cover two perspectives in one paper.)

Address your general topic by forming and answering two levels of research questions for each inquiry.

• Choose a “Level 1 Research Question/Writing Prompt” from both of the lists below to answer in the paper.
• Compose a “Level 2 Research Question/Writing Prompt” for each kind of inquiry that provides detail, specificity, and focus to your inquiry, research, and writing.
• State your research questions in the introduction of your paper.
• Answer each research question and support your assertions with evidence (research) to form the body of your paper.
• In the conclusion of the paper, briefly review the issues, research questions, answers, and insights.

Level 1 Research Questions/Writing Prompts SCIENTIFIC Perspective of Inquiry What are the anatomical, physiological, pathological, or epidemiological issues? Which body systems are affected? What happens at the cellular or genetic level? Which chemical or biological issues are most important?

Level 1 Research Questions/Writing Prompts MATHEMATICAL/ANALYTICAL Perspective of Inquiry What are the economic issues involved? Which economic theories or approaches best explain the issue? What are the statistical facts related to the issue? Which statistical processes used to study the issue provide for the best explanation or understanding?

Your paper must be five pages in length and reference four to six scholarly, peer-reviewed resources. Be sure to follow the current APA Style (e.g., spacing, font, headers, titles, abstracts, and page numbering).

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