Effect of Implementing Care Bundle on Preventing Pressure Ulcers Development among Immobilized Orthopedic Patients

Background: Pressure ulcers are localized injuries of the skin or underlying tissue caused by prolonged pressure, and exposure to shear forces or friction. Patients with pressure ulcers experience significantly increased morbidity, mortality and financial burden. Evidence based researches has indicated that pressure ulcers prevention is an essential component of patient care. As there are some standardized guidelines and protocols could be implemented for pressure ulcers prevention among immobilized patients. This study aimed to evaluate the effect of implementing care bundle on preventing pressure ulcers development among immobilized orthopedic patients. Method: A quasi experimental research design was utilized by the investigators to conduct this study. A purposeful sample technique was used to carry out this study. The number of the subjects was 80 (40 patients in each intervention and control groups). Data collection tools: Two tools were used in this study: First Tool was; Patient Assessment Tool: This tool consisted of two parts: Part I: Patient’s Demographic and Medical Data that was used to assess  patient’s gender, age, educational level, marital status, occupation, date of admission, medical diagnosis on admission, and length of hospital stay. Part II: Braden Risk Assessment Scale: It was used to assess presence of risk factors for developing pressure ulcers. Second Tool: Observation Checklist for Assessing Pressure Ulcers Preventive Interventions: This tool was used to observe the nurses interventions regarding nursing care bundle elements and routine nursing care on preventing development of pressure ulcers. Results: Stated that, 52.5% of the patients who were cared through implementing care bundle elements did not develop pressure ulcers after four days, however, the majority of the patients who were cared by routine nursing care developed pressure ulcers after four days. Conclusion: This study concluded that, implementing care bundle elements had statistically significant effect on reducing development of pressure ulcers among immobilized orthopedic patients. Recommendation: This study recommended that implementing care bundle elements is considered as one of the most organized steps of care for immobilized orthopedic patients to prevent development of pressure ulcers.