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Introduction To Prevention Of Pressure Ulcers

I currently work as a senior staff nurse in the cardiovascular and cardiothoracic ward in a specialist hospital. Possessing an experience of working for five years, a lot of incidents have been observed by me that involve the negligence of the nurses or lack of proper nursing practice. The incidents that reflect the performance of the nurses of my hospital are rising day by day. These are events such as medication errors, complains of the patients, patient falls, pressure ulcer etc. As such, I consider it as my responsibility to identify the problems that are faced by all the nurses throughout their work for the whole day. I am more concerned about the incident of pressure ulcer.

The topic selected for given study is practice development around prevention of pressure ulcers. My hospital is attempting towards ensuring for zero per cent incidences in acquiring pressure ulcers. Although the ward has to a presence of many advanced technologies to prevent pressure ulcers but there is still a presence of 10% to 20% incidences in pressure ulcer.


The topic of the present dissertation is practice development around prevention of pressure ulcers. Pressure ulcers, also known as bed sores, are characterized by ulcerated area of skin which is caused by irritation and continuous pressure on part of the body. The risk of developing pressure ulcers increases on reduction in the mobility of a person. Most of the pressure ulcers occur when someone is admitted to hospital and is confined to a chair or bed. It is for this reason, that health care organizations have the responsibility to assess the patients for their risk of developing pressure ulcers (Huang, Chen and Xu, 2013).

The current situation in maintaining the skill of preventing pressure ulcers is that the nurses are not able to transform their theoretical knowledge to practical application. The knowledge that they have gained is not applied by them while caring for the patients in the hospital.

Sources Of Knowledge

For the present dissertation on the topic practice development around prevention of pressure ulcers, various sources of knowledge have been utilized. Empirical knowledge that is synonymous with positivist science is knowledge that is systematically organized into general laws and theories. This is done for the purpose of describing, explaining and predicting the phenomena of special concern to the discipline of nursing.

Practice Development

Practice development is the continuous process with the help of which person centered cultures can be developed. According to McCormack, Manley and Wilson, practice development deals with blending the personal qualities and creative imagination with the skills and wisdom of the concerned practice (What is Practice Development?, 2010). Sustained by embedding both processes and outcomes in the strategy of the organization, practice development is about improving patient care and helps in transforming the contexts and cultures of care (Cambron and Cain, 2004).

For supporting the development of excellence in practice, Mc Sherry and Warr offered simple and effective tools. According to them, practice development is necessary for addressing and responding to the growing pressures to change, reform or modernizes form keeping up with the times (McSherry and Warr, 2008). The health and social care professionals must recognizes and understand the ways in which practice development helps in the search of excellence in practice. According to Mc Sherry and Warr, practice development was primarily introduced to UK by the nursing profession in late 1970s (McSherry and Johnson, 2005).

According to Higgs, decision making is a broad term in which choice is to be made between the options for deciding on a course of action (Higgs, 2008). Clinical decision making by health care professionals is a more complex process and more individuals are required for making choices between limited options. Clinical decisions consist of situations that are characterized by elements of uncertainty. Here, all the information needed to make the decision is not available. Higgs argued that, owing to the complex nature of the health science practice, health care professionals need to utilize a rich array of knowledge and practice skills (Higgs, 2008).

Change Process

The current dissertation focuses on practice development around prevention of pressure ulcers. For preventing pressure ulcers, correct practice need to be adopted. However, the negative attitudes of the staff hinder the efforts made by the hospital for preventing pressure ulcers. As such, despite adoption of advanced technologies for the prevention of pressure ulcers, there are about 10 to 20 per cent incidents of pressure ulcers in the ward (Morrow and et.al., 2012). The negative attitude of the staff does not allow adoption of person centered cultures for preventing bed sores. There is a need to change the outlook of the staff.

Categories of change

There are different views in which the change can be understood in relation to the point and range of circumstances. Change can be of various categories. It can be a planned change. Planned change is guided by a deliberate and conscious reason to change. Emergent change is another category which is opposite to planned change (Burnes, 2004).

Transtheoretical model of behavior change

Transtheoretical model of change is a theoretical model of behavior change that was originally explained by Prochaska and DiClemente in 1983 (Stages of Change Model, 2012). This model forms the basis of development of effective interventions for promotion of change of health behavior.

Egan’s Model for bringing the desired change in the hospital

This is a model for the change process that can be used in the concerned hospital. The model includes three steps:

  • The assessment of the current scenario
  • The creation of a preferred scenario
  • Designing a plan that could move the system for the current scenario to the preferred scenario


Leadership can be defined as a process of social influence where one person can aid s well as support others in the accomplishment of task that has been bestowed (Millar, Hind and Magala, 2012). True leadership has been found to happen where there exists a transformation in the overall organization or culture. Hence, leadership has been found to occur when there is a gathering of people (Bass and Riggio, 2006).


Throughout the dissertation, I have learnt new things about myself and the topic. By using Gibb’s reflective cycle, I have realized that there is more that could be added to my knowledge. As a senior staff nurse, I found that the nurses were not complying with the practices for preventing pressure ulcer. My hospital is going for zero per cent incident of acquired pressure ulcers. Advanced technologies for the prevention of pressure ulcers are present in my ward. But still, there are about 10 to 20 per cent of incidents of acquired pressure ulcers in the ward.


Little recommendation can be suggested n the area of practice development so as to bring in attaining of zero % incident of acquired pressure ulcer. These have been described as under;

  • Undertaking commitment, teamwork and collaboration - There is a requirement of good commitment from all the staff members of hospital. This can only be done by strongly emplacing on preventing pressure ulcers in hospital setting.
  • Introducing and implementing new protocol - The hospital is also required to introduce a new protocol as well as other documents to ensure adherence to better practices. The new changes in the given area related to attaining of zero % incident of acquired pressure ulcer are required to be started in each and every department.
  • Research and development cell - A research and development setup is also required to be made. This department will do research as well as collect data on pressure ulcers. It will work on identifying the issues followed by keeping a track of overall improvements to be brought in.
  • Undertaking teaching sessions - Meanwhile, there is also a recommendation towards teaching session. This is to be done by training of care aid for helping the nursing staff in making the patient’s bed bath.


There is a huge importance of undertaking preventive measures towards bringing an overall reduction in pressure ulcers. This is not only important for every healthcare institution, hospitals as well as care home. In this regard, the current study has been based on analyzing knowledge for practice. It has been related to practice development around prevention of pressure ulcers. The research study began with an introduction session that set the scene regarding who is the reader as well as explaining the area of practice.


Journals and Books

  • Beech, N., and MacIntosh, R., 2012. Managing Change – Enquiry and Action Cambridge UP.
  • Beerel, A., 2010. Leadership and Change Management. Sage.
  • Beldon, P., 2007. Pressure ulcer prevention and management: using mattresses and cushions. Wound essentials. 2(0).
  • Bertocci, I. D., 2009. Leadership in Organizations: There is a Difference Between Leaders and Managers. University Press of America.
  • Bianco, A. T., and Schermerhorn, J., 2006. Self-regulation, strategic leadership and paradox in organizational change. Journal of Organizational Change Management. 19(4).
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