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Journal of Tissue Viability Feb 2022Consumer engagement is a requirement of high quality clinical guidelines. Developing strategies to engage consumers and incorporate the perspectives of individuals with...
An exploration of the perspectives of individuals and their caregivers on pressure ulcer/injury prevention and management to inform the development of a clinical guideline.
BACKGROUND
Consumer engagement is a requirement of high quality clinical guidelines. Developing strategies to engage consumers and incorporate the perspectives of individuals with or at risk of pressure ulcers/injuries and their informal caregivers was one priority in the recent update of the EPUAP/NPIAP/PPPIA's Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline.
AIMS
The aims were to determine the goals of individuals and caregivers for pressure ulcer/injury care, priorities for pressure ulcer/injury education and biggest problems related to pressure ulcers/injuries.
METHODS
An online, anonymous, international 10-item survey, accessible in nine languages was provided to individuals and their caregivers from April to October 2018. Descriptive statistics were used for quantitative data and a thematic analysis approach was used to analyse qualitative data.
RESULTS
There were 1233 individuals from 27 countries who completed the survey. Overall, individuals and caregivers had similar goals of care. Reducing the size of pressure ulcer/injury was selected more often as a care goal than complete healing. Individuals, compared to caregivers, considered managing pain more important. Qualitative data analysis identified five themes including knowledge, attitudes, and skills; risk factors for pressure ulcer/injury; accessing pressure ulcer/injury care; quality of life for patients and caregivers; and the pressure ulcer/injury.
CONCLUSIONS
The consumer survey provided consumer engagement and perspective that was incorporated into guideline development, including consideration during evaluation of the relevance and acceptability of recommendations, and assignment of recommendation strength ratings.
Topics: Caregivers; Humans; Pressure Ulcer; Quality of Life; Skin Care; Surveys and Questionnaires
PubMed: 34776327
DOI: 10.1016/j.jtv.2021.10.008 -
PloS One 2024Pressure ulcers and dehydration are common conditions among residents of long-term care facilities that result in negative health effects. They have been associated with...
Pressure ulcers and dehydration are common conditions among residents of long-term care facilities that result in negative health effects. They have been associated with signs of neglect and increased 30-day mortality among LTC residents. However, they are both preventable and with proper care can be effectively managed and treated. We conducted a retrospective cohort study to examine factors associated with pressure ulcers and dehydration among long-term care residents in the province of Ontario, Canada. Results indicated that close to one-fifth of residents were dehydrated (17.3%) or had a pressure ulcer (18.9%) during the study period. Advanced age was significantly associated with the presence of pressure ulcers and dehydration for both men and women. However, men were more likely to present with a pressure ulcer while women were more likely to exhibit symptoms of dehydration. Study findings also demonstrate the presence of both conditions being higher in municipal and not-for-profit homes compared to for-profit homes. The significant differences observed in relation to home ownership which require further investigation to identify the most relevant factors in explaining these differences. Overall, pressure ulcers and dehydration are preventable conditions that warrant attention from policymakers to ensure quality of care and resident safety are prioritized.
Topics: Male; Humans; Female; Long-Term Care; Ontario; Pressure Ulcer; Retrospective Studies; Dehydration
PubMed: 38295099
DOI: 10.1371/journal.pone.0297588 -
Spinal Cord Series and Cases 2019A quantitative, descriptive study using a cross-sectional survey.
STUDY DESIGN
A quantitative, descriptive study using a cross-sectional survey.
OBJECTIVES
To describe the pressure ulcer knowledge, beliefs and practices amongst persons with SCI, who received rehabilitation at a Cape Town rehabilitation centre.
SETTING
A rehabilitation centre for clients with physical disabilities in Cape Town, South Africa.
METHODS
A quantitative, descriptive study, that employed consecutive sampling, was done. Participants included inpatients ( = 30), outpatients ( = 33) and peer supporters ( = 8). Data were collected during April and March 2015 with a questionnaire developed through collating existing questionnaires and adapting it for the study context. This rendered a knowledge score and data on beliefs and practices. The Fisher's exact test was used for comparative analysis ( < 0.05).
RESULTS
The mean combined knowledge score was 42.7%. The majority of participants (88.7%) believed pressure ulcers to be serious and 45% thought they were likely to develop a PU. They believed daily skin checks (80.3%), weight shifting (86%) and limiting sitting time (80.3%) could prevent PU development. Study participants indicated that they did not regularly follow guideline recommended practices like regular pressure relief (51%) (36 participants) or daily skin inspection (38%) (27 participants) and 37% (26 participants) reported being current smokers.
CONCLUSION
Participants showed a lack of knowledge, which might have affected their pressure ulcer prevention practices negatively. The study findings can be used to assist with the development of a contextually relevant training programme on pressure care.
Topics: Adolescent; Adult; Aged; Cross-Sectional Studies; Culture; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Pressure Ulcer; Rehabilitation Centers; South Africa; Spinal Cord Injuries; Young Adult
PubMed: 31700681
DOI: 10.1038/s41394-019-0226-4 -
Journal of Wound Care Jan 2017
Topics: Humans; Neoplasms; Patient Care Team; Pressure Ulcer
PubMed: 28105898
DOI: 10.12968/jowc.2017.26.Sup1.S3 -
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 -
International Wound Journal Dec 2022We performed a meta-analysis to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing. A systematic... (Meta-Analysis)
Meta-Analysis
We performed a meta-analysis to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing. A systematic literature search up to January 2022 was done and 13 studies included 1073 subjects with pressure ulcer wound at the start of the study; 593 of them were using traditional Chinese medicine treatments, and 480 were control for pressure ulcer wound. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the effect of Chinese herbal topical medicine, acupuncture, and moxibustion on pressure ulcer wound healing by the dichotomous methods with a random or fixed-influence model. Traditional Chinese medicine treatments had significantly higher complete healing (OR, 5.94; 95% CI, 3.94-8.95, P < .001), and curative ratio post-treatment (OR, 4.79; 95% CI, 2.62-8.76, P < .001) compared with control for subjects with pressure ulcer wound. Traditional Chinese medicine treatments had a significantly higher complete healing and curative ratio post-treatment compared with control for subjects with pressure ulcer wounds. Further studies are needed to validate these findings.
Topics: Humans; Moxibustion; Pressure Ulcer; Acupuncture Therapy; Wound Healing; China
PubMed: 35396823
DOI: 10.1111/iwj.13803 -
The Journal of Spinal Cord Medicine Sep 2023The treatment of pressure injury (PI) stage III and IV in people with spinal cord injury or spinal cord disorder (SCI/D) requires a multidisciplinary and surgical... (Review)
Review
CONTEXT
The treatment of pressure injury (PI) stage III and IV in people with spinal cord injury or spinal cord disorder (SCI/D) requires a multidisciplinary and surgical involvement.
OBJECTIVES
This scoping review aims to identify published relevant surgical multidisciplinary treatment approaches, describe the elements and evaluate the effectiveness of the approaches.
METHODS
We searched PubMed and Medline databases for studies about treatment approaches for people aged ≥18 years with chronic SCI/D and PI stage III or IV over ischium, trochanter or sacrum published between January 1990 and December 2021 in English or German language. Two independent reviewers screened the articles. One reviewer extracted information on study author(s), year of publication, study title, study design, country of origin, sample size as well as data on elements and effectiveness of the approaches.
RESULTS
10 different approaches were described in two retrospective cohort studies, three case series, five discussion papers, one review and one guideline. All approaches included debridement, flap surgery, pressure relief and immobilization as well as infection control. Some approaches described elements such as risk screening (7/10), osteomyelitis treatment (8/10), nutritional therapy (8/10), physiotherapy, occupational therapy and psychology (6/10), spasticity control (7/10), and prevention and education (6/10). Only one study reported on the effectiveness of the approaches.
CONCLUSION
There are key elements for surgical multidisciplinary treatment approaches. However, due to differences in the content of some of these elements and missing elements in some approaches, comparability is difficult and the effectiveness of the complex approaches remains uncertain.
Topics: Humans; Adolescent; Adult; Spinal Cord Injuries; Pressure Ulcer; Retrospective Studies; Occupational Therapy
PubMed: 36129337
DOI: 10.1080/10790268.2022.2108645 -
International Wound Journal Mar 2023This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature... (Review)
Review
This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature search was conducted in March 2022, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 1727 records were returned, with 9 studies satisfying the inclusion criteria. Data were extracted using a pre-designed extraction tool and a narrative synthesis of the data was undertaken. The methodological quality of the included articles was assessed using the evidence-based librarianship checklist. Included studies were published between 1997 and 2021, with most using a prospective cohort design (88.9%, n = 8). The mean sample size was 74 participants (SD = 38.6; median 71). All studies measured skin hydration objectively, with 55.6% (n = 5) using the Corneometer® CM825 and 33.3% (n = 3) of studies reported a statistically significant association between skin hydration and pressure ulcer development. The mean evidence-based librarianship percentage was 66.6% (SD: 20.7%), however, only 33.3% (n = 3) of studies scored ≥75%, indicating validity. The quality of included studies, methodology variation, and reported results has reduced the homogeneity of outcomes. This review highlights the requirement for future research evidence to ascertain the role of skin hydration in pressure ulcer development.
Topics: Humans; Adult; Pressure Ulcer; Prospective Studies
PubMed: 35989452
DOI: 10.1111/iwj.13934 -
Asian Journal of Surgery Oct 2023
Topics: Humans; Pressure Ulcer; Acupuncture Therapy
PubMed: 37173247
DOI: 10.1016/j.asjsur.2023.04.118 -
PloS One 2020Pressure ulcer is a frequent complication in patients hospitalized in nursing homes and has a serious impact on quality of life and overall health. Moreover, ulcer...
INTRODUCTION
Pressure ulcer is a frequent complication in patients hospitalized in nursing homes and has a serious impact on quality of life and overall health. Moreover, ulcer treatment is highly expensive. Several studies have shown that pressure ulcer prevention is cost-effective. Audit and feedback programmes can help improve professional practices in pressure ulcer prevention and thus reduce their occurrence. The aim of this study was to analyze, with a prospective longitudinal study, the effectiveness of an audit and feedback programme at 1- and 2-year follow-up for reducing pressure ulcer prevalence and enhancing adherence to preventive practices in nursing homes.
METHODS
Pressure ulcer point prevalence and preventive practices were measured in 2015, 2016 and 2017 in nursing homes of the Canton of Geneva (Switzerland). Oral and written feedback was provided 2 months after every survey to nursing home reference nurses.
RESULTS
A total of 27 nursing homes participated in the programme in 2015 and 2016 (4607 patients) and 15 continued in 2017 (1357 patients). Patients were mostly females, with mean age > 86 years and median length of stay about 2 years. The programme significantly improved two preventive measures: patient repositioning and anti-decubitus bed or mattress. It also reduced acquired pressure ulcers prevalence in nursing homes that participated during all 3 years (from 4.5% in 2015 to 2.9% in 2017, p 0.035), especially in those with more patients with pressure ulcers.
CONCLUSION
Audit and feedback is relatively easy to implement at the regional level in nursing homes and can enhance adherence to preventive measures and reduce pressure ulcers prevalence in the homes.
Topics: Aged; Aged, 80 and over; Costs and Cost Analysis; Female; Homes for the Aged; Humans; Longitudinal Studies; Male; Nursing Audit; Nursing Homes; Pressure Ulcer; Prevalence; Prospective Studies; Regional Medical Programs; Switzerland
PubMed: 32469916
DOI: 10.1371/journal.pone.0233471