Hydration as a Key to Pressure Ulcer Prevention:

Development of a Hydration Management Module for a Community-Based App

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Introduction

In the National Health Service (NHS), pressure ulcers have caused significant challenges, especially among elderly individuals and those with poor mobility. Despite ongoing efforts, the occurrence of pressure ulcers remains alarmingly high. Furthermore, despite technological advancements in healthcare, the profound consequences for patient well-being and healthcare resources have been substantial. In my paper, I use this chapter to explore the current challenges related to pressure ulcer prevention in the community setting and examine the limitations of existing strategies, enabling me to introduce a targeted improvement through a digital application focused on hydration management. According to Taylor, Mulligan, and McGraw (2021), evidence-based practices in pressure ulcer prevention are crucial, yet they are often inconsistently utilized due to a variety of barriers in community care settings.

Current Challenges and NHS Policy Landscape

As mentioned, the emergence of pressure ulcers among community members, especially adults, is a critical issue exacerbated by several NHS challenges. Such challenges include patient safety, care quality, and health outcome inequalities. In 2014, the NHS Outcomes Framework and the Care Act aimed to address these challenges through innovative digital solutions (Forbes et al. 2017). However, despite these interventions, gaps still remain in effectively preventing pressure ulcers. Similarly, the NHS Long Term Plan (2019) aimed to address pressure ulcers using digital care solutions and enhanced community care strategies, but still, these policies fail to adequately address the gaps in at-risk populations.

However, studies and reports have indicated that although such a digital application exists, it does not include comprehensive features needed to tackle hydration—a critical aspect of prevention crucial for maintaining skin integrity and preventing ulcers. According to Forbes et al. (2017), initiatives like the Quality and Outcomes Framework in primary care have shown only modest improvements in managing long-term conditions and have not significantly influenced the holistic or personalized care essential for conditions like pressure ulcers.

Identified Gap and Role of Hydration

In the prevention of pressure ulcers, hydration plays an important role in maintaining skin health, which is a crucial factor in managing these ulcers. Hydration also has an overall benefit on the body's physiological functions. For instance, Benelam and Wyness (2010) emphasize that even mild dehydration can lead to reduced physical and mental performance, impacting patient health and complicating the prevention of pressure ulcers. However, hydration management has not been adequately addressed in existing apps. Such a significant oversight ignores the dangerous effects of dehydration, such as skin dryness, reduced elasticity, and increased vulnerability to pressure ulcers. This gap not only affects patient safety and care quality but also reflects broader issues of unequal health outcomes. For instance, those in community settings may receive less consistent care monitoring due to these unequal outcomes.

Hydration Module in the Pressure Ulcer Prevention App

Therefore, this paper proposes enhancing the existing pressure ulcer prevention app by including a hydration management module as an improvement to address the above-mentioned identified gap. Enhancing the pressure ulcer prevention app will provide regular

prompts and educational resources about maintaining adequate hydration levels, tailored to meet the specific needs of elderly users in the community setting. It will utilize user-friendly interfaces and reminders to ensure that both patients and caregivers are aware of and can easily access crucial hydration information. Effective hydration can significantly reduce the risk of pressure ulcers, and therefore, the addition of a hydration module forms the basis of the rationale behind this research. Supporting evidence from various studies shows that well-hydrated skin maintains better integrity and resilience against physical stressors such as prolonged pressure. Some studies like those conducted by Miranda and Salomé (2022) highlight the development of mobile apps focused on assessing, treating, and preventing pressure injuries, emphasizing the importance of comprehensive features in such applications. Other studies show that in elderly patients with mobility issues, stressors such as these are often unavoidable, therefore supporting the addition of a hydration module as the rationale behind this paper.

Furthermore, NHS digital care initiatives and the NHS Long Term Plan’s focus on enhancing community care align with our service improvement. This alignment is where our service directly addresses the critical intersection of technology and patient-centric care, which also forms the basis of NHS digital care initiatives and the NHS Long Term Plan. It is important to note that the NHS may already be aware that integrating advanced, evidence-based features into existing digital platforms can better meet the needs of populations discussed. However, we don’t shy away from showing exactly how the NHS can better meet those complex needs, especially for populations mentioned in this paper who are at high risk of pressure ulcers. Therefore, the NHS Long Term Plan as discussed by NHS England and NHS Improvement (2020) emphasizes a digitally and data-driven approach to healthcare, which supports the incorporation of such technological solutions in community care settings.

Consequently, the proposed service improvement that focuses on hydration management within the pressure ulcer prevention app will address a crucial gap in current healthcare delivery and also leverage digital innovation to enhance patient outcomes in the community setting. Therefore, we aim to contribute more equitable, effective, and patient-centered healthcare solutions through a serious evaluation of how effective the current policies are and thereafter pointing out the areas needed for the healthcare system to address required improvements. For instance, Cameron et al. (2014) discuss the necessity of education and awareness in the prevention and management of pressure ulcers, supporting the integration of eLearning solutions into healthcare services.

References

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Miranda, F. D., & Salomé, G. M. (2022). Development of a mobile app to assess, treat and

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