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Nursing in Critical Care Nov 2015Critically ill patients are a vulnerable group at very high risk of developing pressure ulcers, and the incidence varies within critical care.
INTRODUCTION
Critically ill patients are a vulnerable group at very high risk of developing pressure ulcers, and the incidence varies within critical care.
METHODS
A number of strategies were used to implement the pressure ulcer assessment tool CALCULATE across four adult critical care units. Strategies included, nursing leadership, the provision of definitions for each risk factor, information laid out on posters at each patient's bedside, changes to pre-printed nursing documentation and a 30-min focused training package. Two local audits were conducted to measure the number and types of risk factors occurring in patients with pressure ulcers, and to assess the frequency of assessments and gain feedback on the usability of the tool in practice.
FINDINGS
Critical care acquired pressure ulcer incidence was 3.4%. The two most commonly occurring risk factors were impaired circulation (82%) and mechanical ventilation (75%). Patients had a mean score of 4, and 65% had 4 or more reported risk factors. Feedback on the usability of the tool was mainly positive.
DISCUSSION
The tool CALCULATE was relatively straightforward to implement and was likely to be due to the design and the various change strategies used to implement the new approach. The seven point tool was revised to an eight point score based on nurses' clinical feedback.
CONCLUSIONS
Research is required to further enhance and develop pressure ulcer assessment. Meanwhile CALCULATE offers an easy to use and appropriate tool to assist in the identification of patients at an elevated risk of pressure ulcer damage.
IMPLICATIONS FOR PRACTICE
Careful choice of change management strategies are needed when implementing a new assessment tool. CALCULATE should be considered for use in critical care for pressure ulcer assessment, but used alongside nurses' clinical judgement and observations of skin.
Topics: Critical Care; Critical Care Nursing; Critical Illness; Female; Humans; Incidence; Male; Middle Aged; Nursing Assessment; Organizational Innovation; Pressure Ulcer; Risk Assessment; Risk Factors
PubMed: 25787803
DOI: 10.1111/nicc.12172 -
Advances in Experimental Medicine and... 2023Pressure ulcers have high prevalence in patients and can be prevented with proper nursing interventions. The aim of this study was to evaluate nurses' knowledge about...
Pressure ulcers have high prevalence in patients and can be prevented with proper nursing interventions. The aim of this study was to evaluate nurses' knowledge about prevention and treatment of pressure ulcers. The present study was conducted with 111 nurses working in a General hospital in Greece. In this study, nurses had adequate knowledge about prevention and treatment of pressure ulcers. Respondents answered correctly in questions about staging of pressure ulcers (98.2%, 98.2%, 99.1%, 97.3%, 93.7%), the role of changing position in prevention of pressure ulcer (97.3%), the use of foam mattress (85.6%) and stretched sheets (92.8%), the use of antiseptic solution (95.5%, 85.6%), and interventions to reduce pressure on patients' heels (88.3%). A number of participants had adequate level of knowledge in the questions about the role of diet in healing of pressure ulcers (71.2%), products or devices for prevention or treatment of pressure ulcers (61.3%, 36.9%), healing of pressure ulcers (58.6%, 46.8%), prevention of bone pressure ulcers (31.5%), cleaning of a pressure ulcer (52.3%), and the role of low blood pressure as a risk factor for pressure ulcer (55.9%). However, the development of educational programs can help nurses to improve their knowledge about prevention and treatment of pressure ulcers.
Topics: Humans; Pressure Ulcer; Clinical Competence; Wound Healing; Bone and Bones; Greece; Health Knowledge, Attitudes, Practice; Nurses
PubMed: 37581833
DOI: 10.1007/978-3-031-31986-0_58 -
Zentralblatt Fur Chirurgie Apr 2015The aim of this overview is based on remarks on the pathogenesis of and therapy for pressure ulcers and selected but representative cases to demonstrate current options... (Review)
Review
The aim of this overview is based on remarks on the pathogenesis of and therapy for pressure ulcers and selected but representative cases to demonstrate current options of plastic coverage. As a consequence of the demographic developments, in particular, with regard to the increasing proportion of older patients as well as the advances in modern medicine, the number of multimorbid, geriatric and bedridden patients and of those with prolonged sickbed periods has been steadily growing. Therefore, partly severe manifestations of pressure ulcers at various exposed body regions can be observed in spite of the best preventive intention of care. While in the early stages rather conservative treatment is adequate, surgical intervention might become important and indispensable for a sufficient treatment in advanced stages. To facilitate basic care and to appropriately treat the infectious focus, the methods and procedures of plastic surgery can become relevant. Although there are several options and approaches existing to sanitise and cover defects of pressure ulcers, which are described within the article based on representative cases, preventive measures can still be considered the best approach.
Topics: Aged; Comorbidity; Cross-Sectional Studies; Germany; Humans; Population Dynamics; Pressure Ulcer; Plastic Surgery Procedures; Risk Factors; Wound Healing
PubMed: 25874469
DOI: 10.1055/s-0035-1545808 -
Applied Nursing Research : ANR Aug 2019To examine the inter-practitioner variability of repositioning for pressure ulcer prevention, the effectiveness of the intervention, and whether the provision of written...
AIM
To examine the inter-practitioner variability of repositioning for pressure ulcer prevention, the effectiveness of the intervention, and whether the provision of written guidance influenced the repositioning technique.
METHODS
A pre-test post-test study design was utilised. Descriptive data regarding the work history of participants was collected. Participants were invited to reposition a healthy volunteer before and after reviewing guidance detailing the 30° side-lying technique. The researchers measured the resulting turn angles and assessed offloading of bony prominences.
RESULTS
The repositioning technique varied considerably in the sample of nurse participants. Turn angles decreased following the guidance, but offloading of body sites vulnerable to pressure damage remained sporadic.
CONCLUSION
Pressure ulcer prevention training should include practical demonstrations of repositioning. Clear guidance regarding the optimal repositioning technique for pressure ulcer prevention is needed.
Topics: Adult; Humans; Male; Patient Positioning; Pressure Ulcer
PubMed: 31266609
DOI: 10.1016/j.apnr.2019.05.013 -
Journal of Tissue Viability Nov 2020Pressure ulcer is a significant healthcare problem throughout the world. Nurse educators should take the responsibility for students' improving knowledge, skills and...
BACKGROUND
Pressure ulcer is a significant healthcare problem throughout the world. Nurse educators should take the responsibility for students' improving knowledge, skills and attitudes regarding prevention of Pressure ulcer and allocate sufficient time to teach them by using various teaching methods. In this study we evaluate effects of education about prevention of pressure ulcer on knowledge and attitudes of nursing students.
METHODS
This is a quasi-experimental study with a control group and a posttest. The study population comprised of 96 second-year nursing students at a university in Middle Anatolia Region of Turkey. The study sample included 84 second year nursing students, of whom 42 were assigned into an intervention group and 42 were assigned into a control group. The intervention group was offered education for two hours weekly for four weeks. Data collection between April and May in 2019. The statistics program SPSS 22 packaged software was used in the analyses of data.
RESULTS
There was not a significant difference in sociodemographic features between the intervention and control groups. The groups significantly differed in their total scores for attitudes to prevention of pressure ulcer (p < 0.05). The intervention group got a significantly higher mean score for knowledge about prevention of pressure ulcer (63.00 ± 16.71) than the control group (39.35 ± 9.77) (p < 0.05).
CONCLUSION
The control group had lower scores for knowledge and attitudes about prevention, evaluation and management of pressure ulcer. Educators should revise the content of the national nursing curriculum about pressure ulcer and update their learning material and lectures in accordance with national and international guidelines.
Topics: Adult; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Patient Education as Topic; Pressure Ulcer; Students, Nursing; Surveys and Questionnaires; Turkey
PubMed: 32819802
DOI: 10.1016/j.jtv.2020.06.006 -
AORN Journal Oct 2018
Topics: Documentation; Humans; Nursing Assessment; Patient Positioning; Patient Safety; Perioperative Nursing; Pressure Ulcer
PubMed: 30265398
DOI: 10.1002/aorn.12387 -
Journal of Wound, Ostomy, and... 2020
Topics: Disease Management; Humans; Nursing Assessment; Pressure Ulcer; Risk Assessment
PubMed: 32150144
DOI: 10.1097/WON.0000000000000624 -
Artificial Intelligence in Medicine Jul 2023Hospital-acquired pressure injuries (HAPIs) constitute a significant challenge harming thousands of people worldwide yearly. While various tools and methods are used to... (Review)
Review
BACKGROUND
Hospital-acquired pressure injuries (HAPIs) constitute a significant challenge harming thousands of people worldwide yearly. While various tools and methods are used to identify pressure injuries, artificial intelligence (AI) and decision support systems (DSS) can help to reduce HAPIs risks by proactively identifying patients at risk and preventing them before harming patients.
OBJECTIVE
This paper comprehensively reviews AI and DSS applications for HAPIs prediction using Electronic Health Records (EHR), including a systematic literature review and bibliometric analysis.
METHODS
A systematic literature review was conducted through PRISMA and bibliometric analysis. In February 2023, the search was performed using four electronic databases: SCOPIS, PubMed, EBSCO, and PMCID. Articles on using AI and DSS in the management of PIs were included.
RESULTS
The search approach yielded 319 articles, 39 of which have been included and classified into 27 AI-related and 12 DSS-related categories. The years of publication varied from 2006 to 2023, with 40% of the studies taking place in the US. Most studies focused on using AI algorithms or DSS for HAPIs prediction in inpatient units using various types of data such as electronic health records, PI assessment scales, and expert knowledge-based and environmental data to identify the risk factors associated with HAPIs development.
CONCLUSIONS
There is insufficient evidence in the existing literature concerning the real impact of AI or DSS on making decisions for HAPIs treatment or prevention. Most studies reviewed are solely hypothetical and retrospective prediction models, with no actual application in healthcare settings. The accuracy rates, prediction results, and intervention procedures suggested based on the prediction, on the other hand, should inspire researchers to combine both approaches with larger-scale data to bring a new venue for HAPIs prevention and to investigate and adopt the suggested solutions to the existing gaps in AI and DSS prediction methods.
Topics: Humans; Artificial Intelligence; Retrospective Studies; Pressure Ulcer; Risk Factors; Hospitals
PubMed: 37295900
DOI: 10.1016/j.artmed.2023.102560 -
Annual International Conference of the... Jul 2022Pressure ulcers, also called bedsores, occur when the skin is under constant pressure for a long time and is more common in hospitalized patients. To prevent a diminish...
Pressure ulcers, also called bedsores, occur when the skin is under constant pressure for a long time and is more common in hospitalized patients. To prevent a diminish in quality of daily lives and the additional cost of clinical care, a "patient rotate system" is the standard procedure. Although there are commercial clinical platforms that suggest when and how to rotate a patient lying in bed, some of these platforms are 1) using a wearable system that has one-use accessories which increase the total cost of operation 2) rely on a system-on-a-chip that should be placed on a predetermined location which might not be the most comfortable based on the posture. This study evaluates an alternative by using a simple inertial measurement unit (IMU) hardware inside a self-designed and re-usable (disinfectable) 3d printed case placed on different anatomical regions (sternum, left and right acromion, above talus, below patella) for performance. It is suggested that, based on the regions selected, a "patient rotate system" automation is feasible with more comfortable sensor placements (e.g., on the lower limbs) without statistically significant differences (p<0.05). Clinical Relevance- The outcome of this study promises a pressure ulcer prevention system, with placing a wearable and multi-use sensor system on more comfortable and various locations on the body for a "patient rotate system".
Topics: Automation; Humans; Pressure Ulcer; Skin; Skin Care; Wearable Electronic Devices
PubMed: 36085634
DOI: 10.1109/EMBC48229.2022.9871428 -
Journal of Nursing Management Jul 2022To analyse patient factors and nurse staffing-related issues involving hospital-acquired pressure ulcers in patients at two types of hospital.
AIM
To analyse patient factors and nurse staffing-related issues involving hospital-acquired pressure ulcers in patients at two types of hospital.
BACKGROUND
Hospital-acquired pressure ulcers are important for the safety of hospitalized patients. Hospital-acquired pressure ulcers not only cause health problems, but also pose an economic burden to patients. In addition to patient factors such as mobility and skin integrity, hospital factors such as nurse staffing can also affect the management of such patients.
METHODS
This study is a retrospective review of patient data and analysis of factors related to hospital-acquired pressure ulcers using stratified Cox proportional hazards regression.
RESULTS
A total of 53,923 patients were included. The incidence of hospital-acquired pressure ulcers was 0.98 per 1,000 days. Hospital-acquired pressure ulcers were affected by gender, age, previous falls, low oxygen levels, positioning and toilet use. When the levels of nurse staffing were determined as one of the hospital factors, the daily hours of patient care was increased thereby contributing to the reduced incidents of hospital-acquired pressure ulcers.
CONCLUSION
Strategies for preventing hospital-acquired pressure ulcers should be based on the analysis of risk factors.
IMPLICATIONS FOR NURSING MANAGEMENT
Most individual risk factors for hospital-acquired pressure ulcers identified cannot be modified easily in a short time. Nurse staffing should be set at adequate levels to prevent hospital-acquired pressure ulcers.
Topics: Humans; Incidence; Nursing Staff, Hospital; Personnel Staffing and Scheduling; Pressure Ulcer; Risk Factors; Workforce
PubMed: 31811735
DOI: 10.1111/jonm.12928