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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 -
International Wound Journal Feb 2016Heel ulceration, most frequently the result of prolonged pressure because of patient immobility, can range from the trivial to the life threatening. Whilst the vast... (Review)
Review
Heel ulceration, most frequently the result of prolonged pressure because of patient immobility, can range from the trivial to the life threatening. Whilst the vast majority of heel pressure ulcers (PUs) are superficial and involve the skin (stages I and II) or underlying fat (stage III), between 10% and 20% will involve deeper tissues, either muscle, tendon or bone (stage IV). These stage IV heel PUs represent a major health and economic burden and can be difficult to treat. The worst outcomes are seen in those with large ulcers, compromised peripheral arterial supply, osteomyelitis and associated comorbidities. Whilst the mainstay of management of stage I-III heel pressure ulceration centres on offloading and appropriate wound care, successful healing in stage IV PUs is often only possible with surgical intervention. Such intervention includes simple debridement, partial or total calcanectomy, arterial revascularisation in the context of coexisting peripheral vascular disease or using free tissue flaps. Amputation may be required for failed surgical intervention, or as a definitive first-line procedure in certain high-risk or poor prognosis patient groups. This review provides an overview of heel PUs, alongside a comprehensive literature review detailing the surgical interventions available when managing such patients.
Topics: Amputation, Surgical; Anti-Bacterial Agents; Calcaneus; Debridement; Free Tissue Flaps; Heel; Humans; Limb Salvage; Osteomyelitis; Pressure Ulcer; Prognosis; Reperfusion; Therapeutic Irrigation; Wound Healing
PubMed: 25683573
DOI: 10.1111/iwj.12416 -
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 -
Journal of Wound Care Aug 2019Wound care experts at the 2019 EWMA conference described the need to adopt biofilm-based wound care, the case for silver dressings, the importance of early intervention...
Wound care experts at the 2019 EWMA conference described the need to adopt biofilm-based wound care, the case for silver dressings, the importance of early intervention and the benefits of effective antibiofilm technologies. , chief sub editor, summarises the main points.
Topics: Bandages; Biofilms; Humans; Pressure Ulcer; Wound Healing
PubMed: 31393795
DOI: 10.12968/jowc.2019.28.8.524 -
Journal of Rehabilitation Research and... 2015Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support... (Review)
Review
Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.
Topics: Humans; Pressure Ulcer; Self Care; Self-Help Devices; Spinal Cord Injuries
PubMed: 26237111
DOI: 10.1682/JRRD.2014.02.0064 -
Machine learning-based prediction models for pressure injury: A systematic review and meta-analysis.International Wound Journal Dec 2023Despite the fact that machine learning (ML) algorithms to construct predictive models for pressure injury development are widely reported, the performance of the model... (Meta-Analysis)
Meta-Analysis Review
Despite the fact that machine learning (ML) algorithms to construct predictive models for pressure injury development are widely reported, the performance of the model remains unknown. The goal of the review was to systematically appraise the performance of ML models in predicting pressure injury. PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Grey literature and other databases were systematically searched. Original journal papers were included which met the inclusion criteria. The methodological quality was assessed independently by two reviewers using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed with Metadisc software, with the area under the receiver operating characteristic curve, sensitivity and specificity as effect measures. Chi-squared and I tests were used to assess the heterogeneity. A total of 18 studies were included for the narrative review, and 14 of them were eligible for meta-analysis. The models achieved excellent pooled AUC of 0.94, sensitivity of 0.79 (95% CI [0.78-0.80]) and specificity of 0.87 (95% CI [0.88-0.87]). Meta-regressions did not provide evidence that model performance varied by data or model types. The present findings indicate that ML models show an outstanding performance in predicting pressure injury. However, good-quality studies should be conducted to verify our results and confirm the clinical value of ML in pressure injury development.
Topics: Humans; Pressure Ulcer; Sensitivity and Specificity; ROC Curve; Machine Learning; Software
PubMed: 37340520
DOI: 10.1111/iwj.14280 -
European Journal of Medical Research Feb 2023Patients who have undergone vascular operations are thought to be at an increased risk for developing pressure injuries; however, the extent to which pressure injuries... (Review)
Review
BACKGROUND
Patients who have undergone vascular operations are thought to be at an increased risk for developing pressure injuries; however, the extent to which pressure injuries occur in this population is not clear. This scoping review sought to summarize what is known about the incidence of pressure injuries, and the risk factors for the development of pressure injuries in patients who have undergone vascular operations. MAIN: An initial search identified 2564 articles, and 9 English language studies were included. Results showed that due to study design limitations in the available literature preventing hospital-acquired and present on admission pressure injuries to be distinguished, it is difficult to ascertain the incidence rate of pressure injuries in this population.
CONCLUSION
Certain vascular procedures were found to be higher risk for the development of pressure injuries such as major amputations and lower extremity bypass surgery. In addition to procedural risk factors, patient factors were identified that may be associated with the development of pressure injuries in the vascular population, and these in the authors' view deserve further exploration. Overall, this scoping review identified an area ripe for future research, the results of which would have implications for wound care in healthcare institutions and at home.
Topics: Humans; Incidence; Pressure Ulcer; Vascular Surgical Procedures; Risk Factors; Hospitalization; Retrospective Studies
PubMed: 36782315
DOI: 10.1186/s40001-023-01036-3 -
Journal of Wound Care Oct 2017
Topics: Health Services Needs and Demand; Humans; Models, Organizational; Physician Assistants; Practice Patterns, Physicians'; Pressure Ulcer; United States
PubMed: 28976833
DOI: 10.12968/jowc.2017.26.Sup10.S3 -
American Family Physician Nov 2015Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because...
Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because pressure ulcers are often missed in inpatient, outpatient, and long-term care settings. High-risk patients should use advanced static support surfaces to prevent pressure ulcers and air-fluidized beds to treat pressure ulcers. Physicians should document the size and clinical features of ulcers. Cleansing should be done with saline or tap water, while avoiding caustic agents, such as hydrogen peroxide. Dressings should promote a moist, but not wet, wound healing environment. The presence of infection is determined through clinical judgment; if uncertain, a tissue biopsy should be performed. New or worsening pain may indicate infection of a pressure ulcer. When treating patients with pressure ulcers, it is important to keep in mind the patient's psychological, behavioral, and cognitive status. The patient's social, financial, and caregiver resources, as well as goals and long-term prognosis, should also be considered in the treatment plan.
Topics: Education, Medical, Continuing; Humans; Practice Guidelines as Topic; Pressure Ulcer; Risk Factors; United States; Wound Healing
PubMed: 26554282
DOI: No ID Found -
The Surgeon : Journal of the Royal... Aug 2022The utilisation of prone positioning has been vital during the COVID-19 pandemic, however risks the development of anterior pressure ulcers. An observational study was... (Observational Study)
Observational Study
The utilisation of prone positioning has been vital during the COVID-19 pandemic, however risks the development of anterior pressure ulcers. An observational study was performed to examine the prevalence of pressure ulcers in this population and define risk factors. Eighty-seven patients admitted to critical care were studied. Of 62 patients with >1 day in prone position, 55 (88.7%) developed anterior pressure ulcers, 91% of which were anterior. The most commonly affected site were the oral commisures (34.6%), related to endotracheal tube placement. Prone positioning (p < .001) and the number of days prone (OR 3.11, 95% CI 1.46-6.62, p = 0.003) were a significant risk factors in development of an anterior ulcer. Prone positioning is therefore a significant cause of anterior pressure ulcers in this population.
Topics: COVID-19; Humans; Pandemics; Patient Positioning; Pressure Ulcer; Prone Position
PubMed: 34373210
DOI: 10.1016/j.surge.2021.07.001