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Journal of Tissue Viability Feb 2022Pressure ulcers (PUs) occur in a range of care settings, resulting in reduced quality of life for the individual. There has been a growing awareness that medical devices... (Review)
Review
UNLABELLED
Pressure ulcers (PUs) occur in a range of care settings, resulting in reduced quality of life for the individual. There has been a growing awareness that medical devices can cause PUs, although reporting has been limited. There is a need to evaluate PU reporting practice and identify whether standards exist for medical device-related pressure ulcers (MDRPUs).
AIM
To synthesize academic and grey literature relevant to reporting of PUs and MDRPUs in healthcare settings.
METHODS
A systematic search of multiple scientific and grey literature databases was undertaken. Key search terms and Boolean operators were used to identify relevant literature. All sources of evidence discussing reporting practices were included in a synthesis. Primary topics are discussed in the corresponding analysis.
RESULTS
Thirty-one evidence sources met the inclusion criteria, including 16 journal articles and 15 policy and guidance documents. The results revealed a variation in reporting practices. MDRPUs were often not identified as a separate category in local and national systems. Policies for related patient safety reporting varied across all organisational levels, with more serious categories of PUs reported more consistently. Reporting to medical device regulatory bodies was not mandatory.
CONCLUSION
This narrative review identified inconsistencies in local and national reporting of PUs and MDRPUs, prohibiting meaningful comparisons and improvements in patient safety. Lack of specific medical device data and low levels of voluntary reporting to regulatory bodies is likely to result in an under-reporting, with little evidence of specific devices which may be a patient safety concern.
Topics: Humans; Policy; Pressure Ulcer; Quality of Life
PubMed: 34949521
DOI: 10.1016/j.jtv.2021.10.010 -
British Journal of Community Nursing Mar 2017
Review
Topics: Bandages; Detergents; Evidence-Based Nursing; Humans; Patient Positioning; Pressure Ulcer; Research
PubMed: 28252342
DOI: 10.12968/bjcn.2017.22.Sup3.S37 -
Journal of Wound Care May 2015
Topics: Humans; Negative-Pressure Wound Therapy; Pressure Ulcer; Wound Healing; Wounds and Injuries
PubMed: 25970754
DOI: 10.12968/jowc.2015.24.5.187 -
British Journal of Nursing (Mark Allen...This article describes a study to ascertain what it is like to follow the processes in practice for prevention and management of pressure ulcers as one aspect of care...
This article describes a study to ascertain what it is like to follow the processes in practice for prevention and management of pressure ulcers as one aspect of care among others. The participants in this study were bands 5 and 6 staff nurses and healthcare assistants (HCAs) (n=72) recruited from two acute and two primary NHS trusts. Data were gathered from open-ended questions via an online survey (n=61) and interviews (n=11). The interviews were transcribed and all the data were analysed by thematic analysis. The findings show that participants believe there has been a high-profile imposition of guidelines and policies by management during at least the past 18 months, resulting in perceived good outcomes in the form of fewer pressure ulcers generally and less fragmentation of care, particularly within primary care. However, a number of perceived obstacles to the implementation of recommended interventions remain, notably lack of time and lack of knowledge.
Topics: Humans; Pressure Ulcer; Primary Health Care; State Medicine; United Kingdom
PubMed: 25816003
DOI: 10.12968/bjon.2015.24.Sup6.S4 -
Nursing Outlook 2024The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific... (Review)
Review
BACKGROUND
The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies.
PURPOSE
Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA.
METHODS
This systematic review of the literature used, PRISMA to guide the search.
FINDINGS
The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces.
DISCUSSION
There were gaps in the interventions that have been proven successful in other global settings.
CONCLUSION
In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.
Topics: Pressure Ulcer; Humans; Africa South of the Sahara; Female; Male; Adult; Middle Aged
PubMed: 38490058
DOI: 10.1016/j.outlook.2024.102151 -
International Journal of Nursing Studies Nov 2018People with altered skin status are conventionally considered to have a higher risk of developing new ulcers. However, the evidence underpinning this potentially... (Meta-Analysis)
Meta-Analysis
BACKGROUND
People with altered skin status are conventionally considered to have a higher risk of developing new ulcers. However, the evidence underpinning this potentially prognostic relationship is unclear.
OBJECTIVES
To systematically review the evidence for the prognostic association of skin status with pressure ulcer risk.
METHODS
We performed a comprehensive electronic database search in February 2017 to identify longitudinal studies that considered skin status in multivariable analysis for predicting pressure ulcer risk in any population. Study selection was conducted by two reviewers independently. We collected data on the characteristics of studies, participants, skin status, and results of multivariable analyses of skin status-pressure ulcer incidence associations. We applied the Quality In Prognosis Studies tool to assess risk of bias. We conducted meta-analyses using STATA where data were available from multivariable analyses. We used the Grades of Recommendation Assessment, Development and Evaluation approach to assess the certainty of evidence generated from each meta-analysis.
RESULTS
We included 41 studies (with 162,299 participants, and 7382 having new ulcers) that investigated 15 skin descriptors. Participants were predominantly hospitalised adults and long-term care residents (with a median age of 75.2 years). Studies had a median follow-up duration of 7.5 weeks. 61.0% (25/41) of studies were judged as being high risk of bias. 53.7% (22/41) of studies had small sample sizes. Subsequently, the certainty of evidence was rated as low or very low for all 13 meta-analyses that we conducted though all analyses showed statistically significant associations of specific skin descriptors-pressure ulcer incidence. People with non-blanchable erythema may have higher odds of developing pressure ulcers than those without (Odds Ratio 3.08, 95% Confidence Interval 2.26-4.20 if pressure ulcer preventive measures were not adjusted in multivariable analysis; 1.99, 1.76-2.25 if adjusted) (both low-certainty evidence). The evidence for other skin descriptors was judged as very low-certainty and their prognostic value is uncertain.
CONCLUSIONS
There is low-certainty evidence that people with non-blanchable erythema may be more likely to develop new pressure ulcers than those without non-blanchable erythema. The evidence for the prognostic effects of other skin descriptors (e.g., history of pressure ulcer) is of very low-certainty. The findings support regular skin assessment and preventive action being taken in the presence of non-blanchable erythema. Given the millions at risk of ulceration and the widely recommended use of skin status as part of risk assessment there is a need for more, high quality confirmatory studies.
Topics: Humans; Incidence; Pressure Ulcer; Prognosis; Risk Factors; Skin
PubMed: 30015089
DOI: 10.1016/j.ijnurstu.2018.07.003 -
BMC Geriatrics Dec 2022The Long-Term Care Insurance Act in the Republic of Korea has enabled the elderly population to receive benefits through the long-term care system since July 2008....
BACKGROUND
The Long-Term Care Insurance Act in the Republic of Korea has enabled the elderly population to receive benefits through the long-term care system since July 2008. Because one nurse or nursing assistant is assigned to 25 elderly persons and one care worker is assigned to 2.5 elderly persons in long-term care facilities, registered nurses should educate care workers to participate in pressure ulcer prevention activities. This descriptive study investigated the effect of the knowledge and attitude related to pressure ulcer prevention on care performance.
METHODS
Data were collected from February 20 to December 15, 2021 using a structured questionnaire targeting 165 care workers in four long-term care facilities located in I-city and Y-gun, Gyeongsangbuk-do. The questionnaires of the knowledge, attitude, and care performance developed for nurses were modified to survey the care workers. The content validity was verified on a 4-point scale by 10 clinical experts. A preliminary survey was conducted for 30 care workers, and the contents of the modified questionnaire were further revised. Data analyses were performed by t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, and a multiple linear regression modeling using the SPSS/WIN 25.0 program.
RESULTS
Care performance on pressure ulcer prevention had a significant positive correlation with knowledge (r = 0.692, p < .001), attitude (r = 0.426, p < .001), work experience (r = 0.760, p < .001), amount of experience (r = 0.712, p < .001), and the number of training sessions received (r = 0.551, p < .001). In multiple regression modeling, work experience (β [standardized coefficient beta] = 0.534, p = .000), knowledge (β = 0.323, p = .000), and attitude (β = 0.103, p = .049) related to pressure ulcer prevention were identified as variables significantly affecting care performance. The regression model explained 65.4% with 5 independent variables.
CONCLUSION
To prevent bedsores in long-term care facilities, it is necessary to educate care workers regularly about pressure ulcer prevention. In addition, clinical guidelines could help standardize the pressure ulcer prevention work of caregivers, strongly regulating their practice in all long-term care facilities and monitoring bedsore prevention regularly.
Topics: Humans; Aged; Pressure Ulcer; Long-Term Care; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Nursing Homes; Surveys and Questionnaires
PubMed: 36544097
DOI: 10.1186/s12877-022-03702-3 -
Pressure ulcer definitions and core curricula-how does this affect wound care and the older patient?British Journal of Community Nursing Dec 2018Chronic wounds are associated with a significant patient, healthcare and financial burden and can have extensive implications for healthcare. Age is a significant risk...
Chronic wounds are associated with a significant patient, healthcare and financial burden and can have extensive implications for healthcare. Age is a significant risk factor for developing chronic wounds, due to physical changes in skin integrity and several age-related complex comorbidities, including poor nutrition and mobility. Pressure ulcers (PU) are a common type of chronic wound that can have a substantial impact on health-related quality of life and patient outcomes. Understanding the extent of PU harm is problematic, due to discrepancies in the definition, recording and reporting of PUs on both a local and national level. Education and training are central to ensuring the risk factors associated with PU development are recognised, and a consistent and coherent structure to the definition, measurement and reporting of PUs across the NHS is developed.
Topics: Curriculum; Education, Nursing; Humans; Pressure Ulcer; Research Design; Risk Assessment; Risk Factors
PubMed: 30521358
DOI: 10.12968/bjcn.2018.23.Sup12.S6 -
Cells Jul 2023Although the proportion of ulcer patients with medical problems among the elderly has increased with the extension of human life expectancy, treatment efficiency is...
Although the proportion of ulcer patients with medical problems among the elderly has increased with the extension of human life expectancy, treatment efficiency is drastically low, incurring substantial social costs. MSCs have independent regeneration potential, making them useful in clinical trials of difficult-to-treat diseases. In particular, ADMSCs are promising in the stem cell therapy industry as they can be obtained in vast amounts using non-invasive methods. Furthermore, studies are underway to enhance the regeneration potential of ADMSCs using cytokines, growth factors, and gene delivery to generate highly functional ADMSCs. In this study, key regulators of wound healing, SOCS-1, -3, and -5, were combined to maximize the regenerative potential of ADMSCs in pressure ulcer treatments. After transfecting SOCS-1, -3, -5, and SOCS-com into ADMSCs using a non-viral method, the expression of the inflammatory factors TNF-alpha, INF-gamma, and IL-10 was confirmed. ADMSCs transfected with SOCS-com showed decreased overall expression of inflammatory factors and increased expression of anti-inflammatory factors. Based on these results, we implanted ADMSCs transfected with SOCS-com into a pressure ulcer mouse model to observe their subsequent wound-healing effects. Notably, SOCS-com improved wound closure in ulcers, and reconstruction of the epidermis and dermis was observed. The healing mechanism of ADMSCs transfected with SOCS-com was examined by RNA sequencing. Gene analysis results confirmed that expression changes occurred in genes of key regulators of wound healing, such as chemokines, MMP-1, 9, CSF-2, and IL-33, and that such genetic changes enhanced wound healing in ulcers. Based on these results, we demonstrate the potential of ADMSCs transfected with SOCS-com as an ulcer treatment tool.
Topics: Mice; Animals; Humans; Aged; Adipose Tissue; Ulcer; Pressure Ulcer; Wound Healing; Disease Models, Animal
PubMed: 37508509
DOI: 10.3390/cells12141840 -
Sensors (Basel, Switzerland) Mar 2023Visual diagnosis and rejuvenation are methods currently used to diagnose and treat pressure ulcers, respectively. However, the treatment process is difficult. We...
Visual diagnosis and rejuvenation are methods currently used to diagnose and treat pressure ulcers, respectively. However, the treatment process is difficult. We developed a biophotonic sensor to diagnose pressure ulcers and, subsequently, developed a pressure ulcer care device (PUCD.) We conducted animal and clinical trials to investigate the device's effectiveness. We confirmed the accuracy of the pressure ulcer diagnosis algorithm to be 91% and we observed an 85% reduction in immune cells when using the PUCD to treat pressure ulcer-induced mice. Additionally, we compared the treatment group to the pressure ulcer induction group to assess the PUCD's effectiveness in identifying immune cells through its nuclear shape. These results indicate a positive effect and suggest the use of PUCD as a recovery method for pressure ulcer diagnosis and treatment.
Topics: Animals; Mice; Pressure Ulcer; Electric Impedance; Algorithms
PubMed: 37050680
DOI: 10.3390/s23073620