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AACN Clinical Issues in Critical Care... Nov 1990Prevention of pressure ulcers in the critically ill patient is a major responsibility of the critical care nurse. The authors review the causes of pressure ulcer... (Review)
Review
Prevention of pressure ulcers in the critically ill patient is a major responsibility of the critical care nurse. The authors review the causes of pressure ulcer development and the methods of identifying the patient at increased risk. Pressure relief strategies for use in critical care are presented, and currently available pressure reduction and relief devices are discussed. Because few research studies address pressure ulcer prevention in the critical care setting, future research in this area is needed to develop a reliable predictive tool for use with the critically ill patient. Level of risk needs to be linked with intervention to assist the nurse in managing the pressure relief options available in today's market. In the meantime, prevention of pressure ulcers in critical care patients requires vigilance and the best use of available knowledge in the field.
Topics: Critical Care; Humans; Nursing Assessment; Nursing Care; Pressure Ulcer
PubMed: 2223326
DOI: 10.4037/15597768-1990-3016 -
Journal of Tissue Viability Aug 2012
Topics: Consensus; Humans; Mandatory Reporting; Practice Guidelines as Topic; Pressure Ulcer; United Kingdom
PubMed: 22732050
DOI: 10.1016/j.jtv.2012.06.001 -
Nursing TimesThe Department of Health wants to reduce harm caused by pressure ulcers dramatically. Identifying which patients are at risk is an important part of prevention. This...
The Department of Health wants to reduce harm caused by pressure ulcers dramatically. Identifying which patients are at risk is an important part of prevention. This article discusses the most common risk factors, the advantages and disadvantages of risk assessment tools, and challenges in prevention.
Topics: Cost of Illness; Humans; Pressure Ulcer; Risk Assessment; United Kingdom
PubMed: 22428402
DOI: No ID Found -
Physical Medicine and Rehabilitation... Aug 2014Pressure ulcers continue to impact the lives of spinal cord injury patients severely. Pressure ulcers must be accurately staged according to National Pressure Ulcer... (Review)
Review
Pressure ulcers continue to impact the lives of spinal cord injury patients severely. Pressure ulcers must be accurately staged according to National Pressure Ulcer Advisory recommendations before treatment design. The first priority in treatment of pressure ulcers is offloading. Intact skin ulcers may be treated with noncontact nonthermal low-frequency ultrasound. Superficial pressure ulcers may be treated with a combination of collagenase and foam dressings. Deeper pressure ulcers warrant negative-pressure wound therapy dressings along with biologic adjuncts to fill in wound depth. Discovery and treatment of osteomyelitis is a high priority when initially evaluating pressure ulcers. Surgical intervention must always be considered.
Topics: Bandages; Debridement; Humans; Pressure Ulcer; Spinal Cord Injuries
PubMed: 25064794
DOI: 10.1016/j.pmr.2014.05.002 -
International Wound Journal Jun 2018Successful prevention of pressure ulcers is the end product of a complex series of care processes including, but not limited to, the assessment of vulnerability to... (Review)
Review
Successful prevention of pressure ulcers is the end product of a complex series of care processes including, but not limited to, the assessment of vulnerability to pressure damage; skin assessment and care; nutritional support; repositioning; and the use of beds, mattresses, and cushions to manage mechanical loads on the skin and soft tissues. The purpose of this review was to examine where and how Statistical Process Control (SPC) measures have been used to assess the success of quality improvement initiatives intended to improve pressure ulcer prevention. A search of 7 electronic bibliographic databases was performed on May 17th, 2017, for studies that met the inclusion criteria. SPC methods have been reported in 9 publications since 2010 to interpret changes in the incidence of pressure ulcers over time. While these methods offer rapid interpretation of changes in incidence than is gained from a comparison of 2 arbitrarily selected time points pre- and post-implementation of change, more work is required to ensure that the clinical and scientific communities adopt the most appropriate SPC methods.
Topics: Data Interpretation, Statistical; Humans; Pressure Ulcer
PubMed: 29446244
DOI: 10.1111/iwj.12876 -
Advances in Skin & Wound Care Jan 2010
Review
Topics: Friction; Humans; Pressure Ulcer; Risk Factors
PubMed: 20101111
DOI: 10.1097/01.ASW.0000363489.38996.13 -
Ostomy/wound Management Jan 1999The Agency for Health Care Policy and Research (AHCPR) clinical practice guidelines on the treatment of pressure ulcers are based on the literature published before... (Review)
Review
The Agency for Health Care Policy and Research (AHCPR) clinical practice guidelines on the treatment of pressure ulcers are based on the literature published before 1994. For the patient and wound assessment recommendations, a review of the literature from 1993 to 1998 was conducted in an effort to update this section of the guideline. In addition, the strength-of-evidence rating system used was critiqued for its narrow definitions, particularly as it pertains to recommendations related to assessment practices. Studies to determine the prospective validity of the entire guideline, as well as further research to assess the validity of individual recommendations, is needed.
Topics: Humans; Nursing Assessment; Pressure Ulcer; Risk Factors
PubMed: 10085976
DOI: No ID Found -
Advances in Skin & Wound Care Feb 2010
Review
Topics: Bandages; Debridement; Humans; Pain; Pain Measurement; Palliative Care; Pressure Ulcer; Risk Assessment; Risk Factors; Skin Care; United States
PubMed: 20087072
DOI: 10.1097/01.ASW.0000363502.84737.c8 -
Journal of the American Academy of... Apr 1998Pressure ulcers are localized areas of tissue necrosis that result from unrelieved pressure. They are graded or staged according to the degree of tissue damage observed.... (Review)
Review
Pressure ulcers are localized areas of tissue necrosis that result from unrelieved pressure. They are graded or staged according to the degree of tissue damage observed. The main etiologic factors include pressure, shearing forces, friction, and moisture. The clinical course may be complicated by several conditions including infection, sepsis, osteomyelitis, fistulas, and carcinoma. Preventive measures in persons at risk can significantly reduce the incidence of pressure ulcers. Successful management should address the four etiologic factors as well as the general condition of the patient.
Topics: Humans; Pressure Ulcer; Risk Factors
PubMed: 9555790
DOI: 10.1016/s0190-9622(98)70113-6 -
Clinics in Geriatric Medicine May 2011Pressure ulcers are common, costly, and debilitating chronic wounds, which occur preferentially in people with advanced age, physical or cognitive impairments, and... (Review)
Review
Pressure ulcers are common, costly, and debilitating chronic wounds, which occur preferentially in people with advanced age, physical or cognitive impairments, and multiple comorbidities. Residents with pressure ulcers have decreased quality of life and increased morbidity and mortality, and facilities with high rates of pressure ulcers have higher costs and risks of litigation. Health professionals who practice in this setting should be well versed in pressure ulcer management. This article reviews the significance, risk factors, pathophysiology, prevention, diagnosis, and management of pressure ulcers in long-term care.
Topics: Aged; Aged, 80 and over; Comorbidity; Female; Homes for the Aged; Humans; Incidence; Long-Term Care; Male; Nursing Homes; Palliative Care; Patient-Centered Care; Pressure Ulcer; Prevalence; Quality of Health Care; Risk Factors
PubMed: 21641509
DOI: 10.1016/j.cger.2011.02.001