determine why the patients with limited mobility are at higher risk of developing pressure ulcer in acute care settings rather than long- term care facilities.

s part 1 and the third attachment is part 2.Human Resource and Organisational Development. The first assignment consists of 2 parts. The first part is Description of Learning Event and the second Part is Critical Evaluation of Learning Event. So I have got the assignment from my friend and I need you to make a comprehensive paraphrase for the two parts. Also I need you to use another references where possible in part 2. Additional file Criticaldocx 0.02 Mb None 04:38 07 Sep 2015 Client Additional file NIdentifying a problem Introduction Each day around the globe there is a soaring number of individuals that often demand various responsive services as measures to counter various medical conditions that often require prompt and radical responses. These may include acute exacerbation of chronic illness and pressure ulcers among others (Goodman Schindler & Washington 2014). Description of the problem Pressure ulcer (PU) is a localized injury to the skin and underlying tissue usually over a bony prominence as a result of pressure friction and shear and sometimes combination of all (Glasgow et al. 2014). The development of pressure ulcerdepends on various factors such as age mobility status length of stay in the health care facility continence initial skin state and other medical conditions. For instance an elderly incontinent person with limited mobility is more likely to develop a pressure ulcer. Moreover based on the study held in Germany in 2009findings suggest that immobile patients in hospitals have a higher probability to develop pressure ulcers than immobile residents in nursing home.(Kottner et al. 2010). Hence it is important to determine why the patients with limited mobility are at higher risk of developing pressure ulcer in acute care settings rather than long- term care facilities. Furthermore it is vital to find the best approach in preventing and/or avoiding pressure ulcer development in these population. Impact of the problem in the work environment quality of care and patient outcome Patients tend to develop PU within the first week of hospital admission (Barton 2009).Patients in acute care settings have a higher risk of developing pressure ulcer as compared to patients in long term care facilities. One of the reasons can be the prioritization of tasks. According to Newham & Hudgell (2015) in intensive care units (ICUs) stabilizing patient medically administering medications and monitoring vital-signs come before repositioning patients. Different factors facilitate in increasing the risk of developing pressure ulcers.The risk of the patient to develop PU also increases with the time spent in the hospital especially those in the intensive care unit.Patients using respiratory equipment sequential compression devices and urinary catheters among others are at higher risk of developing PU as they limit the ability to reposition them frequently. Mechanical ventilation also increases the risk of developing Pressure Ulcers in patients. Pressure ulcers secondary to medical devices present a significant health burden (Glasgow et al. 2014). In addition according to Goodman Schindler Washington Bogie and Ho (2014) pressure ulcer is very common in patients with spinal injuries leading to repeat hospitalization. The duration of injury plays a significant role in increasing the risk of developing Pressure Ulcer in patients. The heel sacrum and ears are the most vulnerable parts to develop Pressure Ulcer (Cooper 2013). Proposed Solution Pressure ulcers are most of the time avoidable or preventable. In order to implement pressureulcer prevention in patients with limited mobility thorough initial assessment is imperative. Nurses who spend the most time at the patients bedside must identify the risk factors for each individual and adopt the most appropriate method of preventing pressure ulcer development. The clinical judgment of the nurses is considered to be very important in the assessment of the risk of developing PU (Balzer et al. 2014). Different units take different measures in the assessment and prevention of development of pressure ulcers in patients. According to Sving Idvall Hgberg and Gunningberg (2014) nurses in some hospitals concentrate on helping patients recover quickly and pay little or no attention to the pressure ulcers. Nurses need to have adequate awareness about the pressure ulcers for them to provide the most appropriate care to the patients. According to Waugh (2014) pressure ulcers can be prevented by providing pressure-redistributing surfaces to patients at risk and ensuring that they receive frequent repositioning. Furthermore it is advisable to ensure that the patients skin is protected from moisture and excessive dryness. Different guidelines have been developed to assist nurses take part in the prevention of PU development in patients. According to Cooper (2013) alongside the pressure redistribution mattresses lifting the heel with a pillow or with the heel lift boots are necessary for the prevention of the development of PU. Furthermore it is also important to ensure that the nutrition of the patient is closely monitored to prevent PU as undernourished patients are found to be at a higher risk. Earlier it was also mentioned that frequently patient suffer from pressure ulcers secondary to medical devices. Dyer (2015) in her article on how to prevent device-related pressure ulcers suggests ten tips. It begins with the risk assessment includes patient education and ends with recommendations of collaborative work among multidisciplinary teams and shared learning (Dyer 2015). The goal is first of all to identify the risk factors and then focus on preventing the pressure ulcer development. Gravity of the problem Pressure ulcers have become very common and challenging issue which represent expensive adverse events and are a significant cause of pain and distress to patients (Keen & Gaudario 2014).Patients in different care settings have varying risks of developing PU. From the discussion it is clear that patients in acute care setting are at higher risk of developing pressure ulcers as compared to those in long-term care setting. There were different reasons mentioned above such as nursing prioritization when it comes to patients in acute care settings as well as use of medical devices on acute patients which also increase the chances of developing pressure ulcers. Since PU is preventable in most cases it remains imperative to implement the importance of skin assessment and appropriate care involve other disciplines for example the department who supplies with special mattresses and other assistive devices along with providing continuous education to staff so that nurses can translate their knowledge to practice for a better patient outcome. Rapid appraisal of each article 1. How does each article describe the nature of the problem issue or deficit you have identified The articles address the problems at hand in a comprehensive manner and are up-to-date. They are based on certain studies and are evidence-based. In addition some articles propose different solutions to prevent the identified problem. 2. Does each article provide statistical information to demonstrate the gravity of the issue problem or deficit No. Not all articles provide statistical data to demonstrate the gravity of the problem. Some are only limited to certain geographical locations. 3. What are example(s) of morbidity mortality and rate of incidence or rate of occurrence in the general population The general incidences of such factors as morbidity and mortality are relatively fair among the different articles. 4. Does each article support your proposed change No. Not all articles support the proposed change but the majority of the articles do. In this case some articles address the issue with some specificity.