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Journal of Tissue Viability Nov 2022The European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance developed international Clinical... (Review)
Review
The uptake of the international pressure ulcer/injury prevention and treatment guidelines in the scientific literature: A systematic analysis of two major citation databases.
BACKGROUND
The European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance developed international Clinical Practice Guidelines of the prevention and treatment of pressure ulcers/injuries in 2009, 2014, and 2019. Despite substantial dissemination efforts, evidence about guideline dissemination and uptake in the international literature is lacking.
AIM
The aim of this review was to capture to the greatest detail possible the number of the citations of the three published Clinical Practice Guidelines.
METHODS
The citation databases Web of Science and Scopus were searched for citations of the 2009, 2014 and 2019 Clinical Practice Guidelines including all derivative products including short versions and translations. Two separate search strategies were iteratively developed to ensure highest sensitivity.
RESULTS
The Cited Reference Search in Web of Science identified hundreds of different referencing formats with more than 2000 citing articles. The Scopus search revealed 250 different reference formats and more than 2000 citation counts. After publication there was a gradual increase of citations that peaks approximately after four years.
CONCLUSION
The three Clinical Practice Guidelines including all derivate versions had a substantial uptake in the scientific literature. This supports the assumption that the guideline dissemination strategies were and are successful.
Topics: Humans; Pressure Ulcer; Bibliometrics; Skin Care
PubMed: 35961874
DOI: 10.1016/j.jtv.2022.07.011 -
The Pan African Medical Journal 2020Pressure ulcers (PUs) are defined as localised injuries to the skin and/or underlying tissue as a result of pressure or pressure together with shear. PUs present... (Review)
Review
Pressure ulcers (PUs) are defined as localised injuries to the skin and/or underlying tissue as a result of pressure or pressure together with shear. PUs present significant health implications to patients; costing billions to manage and/or treat. The burden of PU prevention in hospitals must be the concern of all healthcare professionals, including radiographers. The purpose of this narrative review article was to identify and critically evaluate relevant literature and research conducted into pressure ulcers (PUs) relevant to medical imaging. It is expected that this review article will increase the level of awareness about PUs amongst radiographers and help to develop appropriate interventions to minimise the risk of PUs. A literature search was conducted in PubMed/Medline, Scopus, CINAHL, and Google Scholar to retrieve relevant articles. Also, books, professional body guidelines, magazines, grey and unpublished literatures were also searched. The search was limited to English Language articles. Only five articles were retrieved and reviewed. There are limited studies on PUs relevant to medical imaging. Available studies provide some evidence that radiographic procedures and settings subject patients attending for radiographic procedures to the risk of PUs. Further studies are needed into PU risk assessment, minimisation and management in medical imaging to help raise awareness and address the problem of the potential for PU development.
Topics: Humans; Pressure Ulcer; Radiography; Risk Assessment; Risk Factors; Risk Management
PubMed: 32754293
DOI: 10.11604/pamj.2020.36.66.19431 -
Intensive & Critical Care Nursing Feb 2024To describe published work on the current situation of mucosal membrane pressure injury of patients in the intensive care unit. (Review)
Review
AIM
To describe published work on the current situation of mucosal membrane pressure injury of patients in the intensive care unit.
BACKGROUND
Device-related pressure injuries in critically ill patients are mostly focused on skin surface injuries, and less attention is paid to mucosal membrane pressure injury.
METHODS
We searched PubMed, Embase, Web of Science, CINAHL, and Cochrane Library from database construction until March 1, 2023. Two researchers independently screened and extracted data.
RESULTS
Eighteen articles met our criteria and were published in 2014-2023. The included studies showed that the incidence of mucosal membrane pressure injury in critically ill patients ranged from 0.83% to 88.2%, and the prevalence ranged from 0.16% to 55.6%. The most frequently reported site of mucosal injury is the oral mucosa, followed by the nasal mucosa. Ten studies used Braden to assess the risk of mucosal membrane pressure injury, and only six studies reported specific stages of mucosal membrane pressure injury. Thirteen studies described 30 risk factors for mucosal membrane pressure injury, with albumin being the most frequently reported risk factor, followed by the vasoconstrictive drugs use. Thirty risk factors were summarized in six aspects: medical device-related factors, disease-related factors, treatment- related factors, physiological and biochemical parameters, demographic-related factors, and microbial colonisation.
CONCLUSIONS
The incidence or prevalence of mucosal membrane pressure injury varies widely, and specific risk assessment tools and standardized staging criteria need to be further determined. The risk factors of mucosal membrane pressure injury involve multiple aspects, and some risk factors have only been explored in few studies and need to be further verified, in order to detect the risk group of mucosal membrane pressure injury early and take targeted preventive measures.
IMPLICATIONS FOR CLINICAL PRACTICE
We synthesized the current research status of mucosal membrane pressure injury in critically ill patients, which can provide a valuable reference for the clinical staff to develop preventive and management measures for such patients.
Topics: Humans; Pressure Ulcer; Critical Illness; Intensive Care Units; Risk Factors
PubMed: 37918080
DOI: 10.1016/j.iccn.2023.103560 -
International Wound Journal Apr 2019Complications after pressure ulcer reconstruction are common. A complication rate of 21% to 58% and a 27% wound recurrence has been reported. The aim of this study was...
Complications after pressure ulcer reconstruction are common. A complication rate of 21% to 58% and a 27% wound recurrence has been reported. The aim of this study was to decrease postoperative wound-healing complications with incisional negative pressure wound therapy (iNPWT) postoperatively. This was a prospective non-randomised trial with a historic control. Surgically treated pressure ulcer patients receiving iNPWT were included in the prospective part of the study (Treatment group) and compared with the historic patient cohort of all consecutive surgically treated pressure ulcer patients during a 2-year period preceding the initiation of iNPWT (Control). There were 24 patients in the Control and 37 in the Treatment groups. The demographics between groups were similar. There was a 74% reduction in in-hospital complications in the Treatment group (10.8% vs 41.7%, P = 0.0051), 27% reduction in the length of stay (24.8 vs 33.8 days, P = 0.0103), and a 78% reduction in the number of open wounds at 3 months (5.4 vs 25%, P = -0.0481). Recurrent wounds and history of previous surgery were risk factors for complications. Incisional negative pressure wound therapy shortens hospital stay, number of postoperative complications, and the number of recurrent open wounds at 3 months after reconstructive pressure ulcer surgery, resulting in significant cost savings.
Topics: Adult; Aged; Aged, 80 and over; Cost Savings; Female; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Postoperative Complications; Pressure Ulcer; Prospective Studies; Plastic Surgery Procedures; Risk Factors; Surgical Wound Infection; Wound Healing; Young Adult
PubMed: 30548531
DOI: 10.1111/iwj.13045 -
The Journal of Spinal Cord Medicine Nov 2021Clinicians have guidance on prevention and treatment of pressure injuries, but little is known regarding characteristics of patients who develop additional pressure...
Clinicians have guidance on prevention and treatment of pressure injuries, but little is known regarding characteristics of patients who develop additional pressure injuries. Thus, our objective was to explore the first pressure injury and characteristics of individuals who develop subsequent pressure injuries during acute care and inpatient rehabilitation following spinal cord injury. Secondary analysis of longitudinal data from a cohort of adults following initial traumatic spinal cord injury. Urban acute care hospital and inpatient rehabilitation facilities. A convenience sample of adults ( = 38) who developed at least one pressure injury during acute care and inpatient rehabilitation. Not applicable. The primary outcomes were number of additional pressure injuries and stage of care during which they occurred, prior to community discharge. A covariate-adjusted model revealed that participants with ASIA D injury had a 67% decrease in the rate of additional pressure injury incidence compared to participants with ASIA A injury (Rate Ratio = .33, 95% CI [0.13, 0.88]). The severity of the first pressure injury had no significant association with subsequent pressure injury incidence (= .10). These findings indicated that individuals with greater sensory and motor loss had an increased risk of developing additional pressure injuries compared to individuals with less impairment. These results are meaningful for stakeholders interested in understanding factors associated with developing subsequent pressure injuries during the index rehabilitation stay and provide a foundation for future research in this area.
Topics: Adult; Cohort Studies; Humans; Incidence; Inpatients; Pressure Ulcer; Spinal Cord Injuries
PubMed: 32233917
DOI: 10.1080/10790268.2020.1744871 -
International Journal of Environmental... Sep 2022Applications where data mining tools are used in the fields of medicine and nursing are becoming more and more frequent. Among them, decision trees have been applied to...
Applications where data mining tools are used in the fields of medicine and nursing are becoming more and more frequent. Among them, decision trees have been applied to different health data, such as those associated with pressure ulcers. Pressure ulcers represent a health problem with a significant impact on the morbidity and mortality of immobilized patients and on the quality of life of affected people and their families. Nurses provide comprehensive care to immobilized patients. This fact results in an increased workload that can be a risk factor for the development of serious health problems. Healthcare work with evidence-based practice with an objective criterion for a nursing professional is an essential addition for the application of preventive measures. In this work, two ways for conducting a pressure ulcer risk assessment based on a decision tree approach are provided. The first way is based on the activity and mobility characteristics of the Braden scale, whilst the second way is based on the activity, mobility and skin moisture characteristics. The results provided in this study endow nursing professionals with a foundation in relation to the use of their experience and objective criteria for quick decision making regarding the risk of a patient to develop a pressure ulcer.
Topics: Decision Trees; Humans; Nursing Assessment; Pressure Ulcer; Quality of Life; Risk Assessment; Risk Factors
PubMed: 36141434
DOI: 10.3390/ijerph191811161 -
International Wound Journal Aug 2022
Topics: Bandages; Humans; Pressure Ulcer
PubMed: 35698859
DOI: 10.1111/iwj.13859 -
International Wound Journal May 2022The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating...
The aim of this national cross-sectional study was to explore the prevalence of pressure injuries and incidence of hospital-acquired pressure injuries, and the relating factors in somatic-specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow-up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital-acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital-acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital-acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals.
Topics: Adult; Cross-Sectional Studies; Humans; Incidence; Inpatients; Pressure Ulcer; Prevalence; Risk Factors
PubMed: 34605185
DOI: 10.1111/iwj.13692 -
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 -
Revista Latino-americana de Enfermagem Aug 2018to identify existing instruments in the scientific literature about the care of pressure injuries in pediatric and hebiatric patients. (Review)
Review
OBJECTIVE
to identify existing instruments in the scientific literature about the care of pressure injuries in pediatric and hebiatric patients.
METHOD
an integrative review that selected 32 articles from the PubMed/Medline, LILACS, Scopus and CINAHL databases using the descriptors pressure ulcer, decubitus ulcer, pediatrics, adolescent and protocols and their equivalent terms in Portuguese and Spanish. Inclusion criteria: research articles in full, in Portuguese, English or Spanish without any temporal cut-off. The descriptive analysis was adopted to categorize the instruments found into the three domains of care: evaluative, preventive and curative.
RESULTS
25 instruments for the care of pressure injuries in pediatric and hebiatric patients were found, with an emphasis on the Braden Q Scale being the most commonly used to assess pressure injury risk, and the protocols containing pressure injury staging guidelines developed by the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP).
CONCLUSION
the scientific literature has valid and reliable instruments that can be used in nursing care practice aimed at the evaluative, preventive and curative care of pressure injuries in pediatric and hebiatric patients.
Topics: Adolescent; Adolescent Medicine; Child; Clinical Protocols; Humans; Pediatrics; Pressure Ulcer; Young Adult
PubMed: 30110107
DOI: 10.1590/1518-8345.2289.3034