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Journal of Healthcare Engineering 2022A pressure injury is a common and painful health condition, particularly among people who are elderly or surgical patients. In order to explore how to use the...
A pressure injury is a common and painful health condition, particularly among people who are elderly or surgical patients. In order to explore how to use the information management system to optimize the pressure injury management process of surgical patients, this work establishes an integrated pressure injury management information platform for surgical patients, which can effectively control the key links in the process and realize the multistep full-process monitoring of surgical patients from admission to discharge. A total of 578 patients before the operation of the information platform were selected as the control group (CG), and after the operation of the information platform, 662 cases became the observation group (OG). Various evaluation metrics are employed to evaluate pressure injury in terms of single-pass rate, high-risk pressure injury, transfer skin condition description matching rate, hospital pressure injury incidence, and incidence of pressure injury in surgical patients at various stages. The results showed that the qualified rate of the pressure injury assessment in the OG was 99.2%, the accuracy rate of high-risk pressure injury screening and reporting was 100.0%, and the matching rate of the transfer skin description was 100.0%, which was higher than that of the CG. The integrated pressure injury management information platform for surgical patients based on the information management system realizes the full, continuous, accurate, and dynamic evaluation and monitoring of patients' skin. Furthermore, it can effectively improve the quality of pressure injury care and facilitate care management.
Topics: Aged; Humans; Incidence; Information Management; Operating Rooms; Pressure Ulcer
PubMed: 35047148
DOI: 10.1155/2022/1463826 -
Journal of Patient Safety Jun 2022This study aimed to investigate how many preventable adverse events (PAEs) and near misses are identified through the methods structured record review, Web-based... (Review)
Review
OBJECTIVES
This study aimed to investigate how many preventable adverse events (PAEs) and near misses are identified through the methods structured record review, Web-based incident reporting (IR), and daily safety briefings, and to distinguish the type of events identified by each method.
METHODS
One year of retrospective data from 2017 were collected from one patient cohort in a 422-bed acute care hospital. Preventable adverse events and near misses were collected from the hospital's existing resources and presented descriptively as number per 1000 patient-days.
RESULTS
The structured record review identified 19.9 PAEs; the IR system, 3.4 PAEs; and daily safety briefings, 5.4 PAEs per 1000 patient-days. The most common PAEs identified by the record review method were drug-related PAEs, pressure ulcers, and hospital-acquired infections. The most common PAEs identified by the IR system and daily safety briefings were fall injury and pressure ulcers, followed by skin/superficial vessel injuries for the IR system and hospital-acquired infections for the daily safety briefings. Incident reporting and daily safety briefings identified 7.8 and 31.9 near misses per 1000 patient-days, respectively. The most common near misses were related to how care is organized.
CONCLUSIONS
The different methods identified different amounts and types of PAEs and near misses. The study supports that health care organizations should adopt multiple methods to get a comprehensive review of the number and type of events occurring in their setting. Daily safety briefings seem to be a particularly suitable method for assessing an organization's inherent security and may foster a nonpunitive culture.
Topics: Humans; Medical Errors; Near Miss, Healthcare; Pressure Ulcer; Retrospective Studies; Risk Management
PubMed: 35617591
DOI: 10.1097/PTS.0000000000000921 -
Yakugaku Zasshi : Journal of the... Dec 2009Even though they have not been diagnosed with a recognized disease, many people have or are at risk of contracting debilitating conditions. They can be referred to as... (Review)
Review
Even though they have not been diagnosed with a recognized disease, many people have or are at risk of contracting debilitating conditions. They can be referred to as being in the "ill-health zone." For example, many bedridden elderly develop pressure ulcers. The prevention and treatment of pressure ulcers should focus on two main factors: the role of pressure in the development of circulatory disorders; and increased dermal pH. In preventing the development of circulatory disorders resulting in pressure ulcers, using an air or polyurethane mattress is helpful. However, changing the mattress has little effect if the position of the bedridden person is not also changed regularly. To avoid an increase in dermal pH, caregivers should apply moisture-repellent cream and/or oil to the sacral region after careful cleansing. It is important that such preventive measures and treatment be performed daily, and caregivers should be educated on this need and subsequently monitored. Pharmacists have a role in caring for those in the ill-health zone.
Topics: Blood Circulation; Caregivers; Health Education; Humans; Hydrogen-Ion Concentration; Pharmacists; Pressure Ulcer; Professional Role; Skin; Skin Care
PubMed: 19952526
DOI: 10.1248/yakushi.129.1483 -
BMJ (Clinical Research Ed.) Feb 2006
Review
Topics: Bandages; Beds; Debridement; Equipment Design; Humans; Pressure Ulcer; Risk Assessment; Risk Factors; Wound Healing
PubMed: 16497764
DOI: 10.1136/bmj.332.7539.472 -
International Wound Journal Oct 2020A tertiary public hospital in Saudi Arabia set out in 2015 to establish a team focused on reducing hospital-acquired pressure ulcers (HAPUs). The pressure ulcer...
Hospital-acquired pressure ulcer incident rates among hospitals that implement an education program for staff, patients, and family caregivers inclusive of an after discharge follow-up program in Saudi Arabia.
A tertiary public hospital in Saudi Arabia set out in 2015 to establish a team focused on reducing hospital-acquired pressure ulcers (HAPUs). The pressure ulcer prevention program (PUPP) had a multifaceted approach and data were collected for a period of 5 years. The results showed a definite reduction in the incidences of HAPUs. Many such programs show similar positive results and echo many of the same considerations of risk, prevention strategies, and the need for early intervention. However, none of the other studies either replicate the hospital's PUPP nor the extent of the positive and lasting effect of the program. Eager to determine the contributing factor(s) in order that the project success could be continued and possibly replicated in other quality improvement projects, it was decided that an examination and comparison of other similar programs and their results would be necessary in order to uncover the answer. It was determined that the in-person in-home discharge follow-up portion of the program most likely had the largest effect on the outcomes. Outcomes that were supported by the pre-work completed during the hospital portion of the PUPP towards reducing HAPUs and readmissions.
Topics: Caregivers; Follow-Up Studies; Hospitals; Humans; Patient Discharge; Pressure Ulcer; Saudi Arabia
PubMed: 32757385
DOI: 10.1111/iwj.13459 -
Ostomy/wound Management Jun 2018Globally, higher-than-expected pressure ulcer rates generally are considered a quality-of-care indicator. Nigeria currently has no national guidelines for pressure ulcer...
Globally, higher-than-expected pressure ulcer rates generally are considered a quality-of-care indicator. Nigeria currently has no national guidelines for pressure ulcer risk assessment, prevention, and treatment. A descriptive cross-sectional study was conducted to assess the pressure ulcer knowledge and the attitude of nurses regarding pressure ulcer prevention in a tertiary health institution in Nigeria. During a period of 2 months, nurses were recruited to complete a 25-item paper/pencil survey that included participant demographic information (6 items), pressure ulcer knowledge questions (11 items), and statements on participants' attitude toward pressure ulcer prevention (8 items). Data were entered manually into statistical analysis software, analyzed, and presented using descriptive statistics (frequencies and percentages). The majority of the 90 nurse participants were female (60, 66.7%), 45 (50%) were married, and 75 (83.3%) had 1 to 10 years' experience in nursing practice; 69 (76.7%) had received special training on pressure ulcer prevention. Overall, 58 (64.4%) nurses had correct pressure ulcer knowledge and 67 (74.4%) had a positive attitude toward preventing pressure ulcers. However, 56 nurses (62.2%) disagreed with regular rescreening of patients whom they deemed not at risk of developing pressure ulcer, and 70 (77.8%) believed pressure ulcer prevention should be the joint responsibility of both nurses and relatives of the patients. Thus, the majority of the 90 nurses knew the factors responsible for pressure ulcers and how to prevent them, but nurses need to be orientated to the fact that pressure ulcer risk screening of all patients with limited mobility is an integral part of their job and that it is important that nurses enlighten patients and their relatives on how to prevent pressure ulcers.
Topics: Adult; Attitude of Health Personnel; Clinical Competence; Cross-Sectional Studies; Female; Humans; Male; Nigeria; Nurses; Pressure Ulcer; Surveys and Questionnaires; Tertiary Care Centers
PubMed: 30059345
DOI: No ID Found -
Wound Repair and Regeneration :... Sep 2019Ulcers including pressure ulcers and diabetic foot ulcers damage the skin and underlying tissue in people with compromised blood circulation. They are classified into...
Ulcers including pressure ulcers and diabetic foot ulcers damage the skin and underlying tissue in people with compromised blood circulation. They are classified into four stages of severity and span from mild reddening of the skin to tissue damage and muscle/bone infections. Here, we used photoacoustic imaging as a noninvasive method for detecting early tissue damage that cannot be visually observed while also staging the disease using quantitative image analysis. We used a mouse model of pressure ulcers by implanting subdermal magnets in the dorsal flank and periodically applying an external magnet to the healed implant site. The magnet-induced pressure was applied in cycles, and the extent of ulceration was dictated by the number of cycles. We used both laser- and light-emitting diode (LED)-based photoacoustic imaging tools with 690 nm excitation to evaluate the change in photoacoustic signal and depth of injury. Using laser-based photoacoustic imaging system, we found a 4.4-fold increase in the photoacoustic intensity in stage I vs. baseline (no pressure). We also evaluated the depth of injury using photoacoustics. We measured a photoacoustic ulcer depth of 0.38 ± 0.09 mm, 0.74 ± 0.11 mm, 1.63 ± 0.4 mm, and 2.7 ± 0.31 mm (n = 4) for stages I-IV, respectively. The photoacoustic depth differences between each stage were significant (p < 0.05). We also used an LED-based photoacoustic imaging system to detect early stage (stage I) pressure ulcers and observed a 2.5-fold increase in photoacoustic signal. Importantly, we confirmed the capacity of this technique to detect dysregulated skin even before stage I ulcers have erupted. We also observed significant changes in photoacoustic intensity during healing suggesting that this approach can monitor therapy. These findings were confirmed with histology. These results suggest that this photoacoustic-based approach might have clinical value for monitoring skin diseases including pressure ulcers.
Topics: Animals; Disease Models, Animal; Mice; Mice, Nude; Photoacoustic Techniques; Pressure Ulcer; Reproducibility of Results; Wound Healing
PubMed: 31301258
DOI: 10.1111/wrr.12751 -
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 -
Journal of Advanced Nursing Oct 2014This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework.
AIM
This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework.
BACKGROUND
Recent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework.
DESIGN
Discussion Paper.
DATA SOURCES
The new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010-2011) and an international expert group meeting (conducted December 2011).
IMPLICATIONS FOR NURSING
A new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally.
CONCLUSION
By integrating existing knowledge from epidemiological, physiological and biomechanical evidence, a theoretical causal pathway and new conceptual framework are proposed with potential implications for practice and research.
Topics: Humans; Pressure Ulcer; Risk Factors
PubMed: 24684197
DOI: 10.1111/jan.12405