Pressure Ulcer Prevention Using Skin Bundle Research Paper

Pressure Ulcer Prevention Using Skin Bundle - Research Paper Example Once the skin succumbs to bacteria or sustains injuries from friction and shear, healing takes longer because reduced flow of blood brings nutrients and removes wastes more slowly. Ischemia due to unrelieved pressure is usually observed in the elderly, malnourished patients, patients reduced to immobility because of their medical condition, fecal incontinence, and patients under less than conscious condition (Mauk 2009, p. 501). Pressure Ulcers: Incidence, Prevalence and Prevention In 2004, the National Home Survey reported that for every 10 residents in nursing homes all over the United States, 11% have succumbed to pressure ulcers with stage 2 pressure ulcer as the most common (see Fig. 2). Both whites and non-whites had equal percentage with the males edging the females at 13% and 10%, respectively (Park-Lee & Caffrey 2009). In 2007, the Centers for Medicare and Medicaid Services reported some 257,412 preventable pressure ulcers as secondary diagnoses at cost averaging at $43,180 for every stay in the hospital. This compelled Medicare to give up shouldering pressure ulcer costs so as to encourage its prevention (Mauk 2009, p. 501). The Institute for Healthcare Improvement has recommended a set of simple interventions collectively known as ‘bundle’ for pressure ulcers prevention in 2003. Hospitals are encouraged to develop their own â€Å"bundle† in approaching pressure ulcer prevention (Paciella 2009, p. 43). The SKIN bundle, which is an acronym for Surface, Keep Moving, Incontinence and Nutrition, was developed by the Ascension Health facilities in 2004. In the succeeding pages a sample of change in practice program is outlined for a fictitious hospital ward called HTMC for the prevention of pressure ulcer using the SKIN bundle. Change in Practice for Pressure Ulcer Prevention Name of Ward (fictitious): East Wing 13 Holy Trinity Medical Center (HTMC) Demographics: 24-bed unit, 10 private and 14 semi-private; Staff is composed of ARNP, RN s, patient care technicians, nutritionists, therapists, and others Scope of Service: Patients in the ward are admitted for the following conditions: strokes and seizures, multiple sclerosis and other diseases that make them prone to develop pressure ulcers. A. ASSESSMENT In the first quarter of 2010, the East Wing 13 of the HTMC had reported 27% incidence of pressure ulcer cases compared to the National Database of Nursing Quality Indicators or NDNQI’s report of 3.8%, for Stage I-IV and 2.7%, for Stage II-IV for the year 2010. This is not a good development, not only because the ward’s statistic paled in comparison with the NDNQI’s but also because the CMS has stopped shouldering costs for pressure ulcers that are acquired in the ACFs. B. LINK The US DHHS recommended several measures in the prevention and care of pressure ulcers. These recommendations can be used by the East Wing 13 to reduce the percentage of pressure ulcer incidence. They include the following : skin inspection of patients at least once daily; skin cleansing in accordance to the needs of each patient; skin care such as moisturizers for dry skin and less exposure to humidity and cold; moisture due to incontinence, perspiration, or wound

Continental Europe seeks to combine flexibility with security in its Essay

Continental Europe seeks to combine flexibility with security in its relations with the workforce via a range of measures one of - Essay Example But the criticisms of the policy direct towards the fact that the diversities present at the national level leads to the decline of the ‘one-size-fits-all’ approach that flexicurity model proposes (Muffels, 2008, p.386). The Union has taken various measures for the establishment of the same but question still arise regarding its effectiveness with the outburst of the worst financial crisis in 2008 after the Great Depression in 1930 (Flexicurity: Europe's employment solution?, 2008). The paper will be discussing the flexicurity approach adapted by the European Union along with the discussion of its principles and objectives and with special focus on Germany and Denmark. Highlight will be also given on the youth unemployment problem with reference to the Viking, Laval and Ruffert cases discussing the protection measures of the other countries with respect to the benefits in compliance with Art 3 and 49 of the EC treaty which focuses on the right to establish in any state o r that of single market and rights of provision of services across the European Union. Now the subsequent section will be dealing with the concept of flexicurity. 2. Notion of flexicurity In today’s labor market there is a requirement of rigorous levels of flexibility and adaptability both in the interest of the employers as well as the employees for anticipating and responding to the demands of the market (Flexicurity Pathways, 2007, p.3). The crux of flexicurity is an emerging concept in the European Union and has been considered as a significant approach in the labor market and within the employment paradigm (EU Council: Common 'flexicurity' principles adopted, 2008). The policy has been first generated in the Nordic countries for the purpose of solving European Union’s employment paradox. From the studies of Wilthagen and Rogowski in the year 2002 it gets revealed that flexicurity is regarded as the policy that directs towards a synchronized platform that boosts la bor market flexibilities, work organizations as well as labor relations with security provision for the weak group of people inside and outside the labor market. The authors highlight that flexibility and security can be achieved through focus on coordination. They stress that initial jolt will be derived from the macro level actors like government and social partners. Implementation will be established on all levels of the economy with different means of flexibility complementing each other with corresponding varied security forms (Meyer, 2009, p.87). From the early 2000s, the European Union policy of flexicurity included an amalgamation of easy hiring and firing rules benefiting the unemployed and following a pro labor market policy (Flexicurity: Europe's employment solution?, 2008). 3. Underlying principles of flexicurity The European Foundation for the Improvement of Living and Working Conditions (Eurofound) has been established in the year 1975 working on the area of working co nditions, living conditions and industrial relation ( Agencies and other European bodies, n.d.). The EU body while drafting policies limited itself while applying flexicurity policies with some common principles. The common principles which the flexicurity model proposes is