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International Wound Journal Feb 2017The objective of this article was to study characteristics of pressure ulcer patients and their ulcers, pressure ulcer preventive and treatment measures in four...
The objective of this article was to study characteristics of pressure ulcer patients and their ulcers, pressure ulcer preventive and treatment measures in four Indonesian general hospitals. A multicentre cross-sectional design was applied to assess pressure ulcers and pressure ulcer care in adult patients in medical, surgical, specialised and intensive care units. Ninety-one of the 1132 patients had a total of 142 ulcers. Half (44·0%) already had pressure ulcers before admission. The overall prevalence of category I-IV pressure ulcers was 8·0% (95% CI 6·4-9·6), and the overall nosocomial pressure ulcer prevalence was 4·5% (95% CI 3·3-5·7). Most pressure ulcer patients had friction and shear problems, were bedfast, had diabetes and had more bedridden days. Most ulcers (42·3%) were category III and IV. One third of the patients had both pressure ulcers and moisture lesions (36·3%) and suffered from pain (45·1%). The most frequently used prevention measures were repositioning (61·5%), skin moisturising (47·3%), patient education (36·3%) and massage (35·2%). Most pressure ulcer dressings involved saline-impregnated or antimicrobial gauzes. This study shows the complexities of pressure ulcers in Indonesian general hospitals and reveals that the quality of pressure ulcer care (prevention and treatment) could be improved by implementing the recent evidence-based international guideline.
Topics: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Hospitals; Humans; Indonesia; Intensive Care Units; Male; Middle Aged; Pressure Ulcer; Prevalence
PubMed: 27021798
DOI: 10.1111/iwj.12580 -
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 -
Contrast Media & Molecular Imaging 2022In order to meta-analyze the effect of evidence-based ministration on the efficacy, incidence of pressure ulcers and prognosis of stroke are used. Literature retrieval...
In order to meta-analyze the effect of evidence-based ministration on the efficacy, incidence of pressure ulcers and prognosis of stroke are used. Literature retrieval is carried out in Wanfang Medicine, PubMed database, biomedical literature, and other medical databases through medical data and computers, focusing on the efficacy, pressure ulcer incidence, and prognosis of stroke sufferers after applying evidence-based ministration. For the relevant medical information literature on the effect, RevMan 5.2 software is used for meta-decomposition. For stroke sufferers, the application of evidence-based ministration intervention can notoriously enhance the clinical therapy effect of stroke sufferers, reduce the incidence of clinical pressure ulcers, and enhance the prognosis and quality of life of sufferers.
Topics: Humans; Incidence; Pressure Ulcer; Prognosis; Quality of Life; Stroke
PubMed: 36159173
DOI: 10.1155/2022/8778487 -
Assistive Technology : the Official... Sep 2022Wheelchair users often experience prolonged periods of stationary sitting. Such periods are accompanied with increased loading of the ischial tuberosities. This can lead...
Wheelchair users often experience prolonged periods of stationary sitting. Such periods are accompanied with increased loading of the ischial tuberosities. This can lead to the development of pressure ulcers which can cause complications such as sepsis. Periodic pressure offloading is recommended to reduce the onset of pressure ulcers. Experts recommend the periodic execution of different movements to provide the needed pressure offloading. Wheelchair users, however, might not remember to perform these recommended movements in terms of both quality and quantity. A system that can detect such movements could provide valuable feedback to both wheelchair users as well as clinicians. The objective of this study was to present and validate the WiSAT - a system for characterizing in-seat activity for wheelchair users. WiSAT is designed to detect two kinds of movements - weight shifts and in-seat movements. Weight shifts are movements that offload pressure on ischial tuberosities by 30% as compared to upright sitting and are maintained for 15 seconds. In-seat movements are shorter transient movements that involve either a change in the center of pressure on the sitting buttocks or a transient reduction in total load by 30%. This study validates the use of WiSAT in manual wheelchairs. WiSAT has a sensor mat which was inserted beneath a wheelchair cushion. Readings from these sensors were used by WiSAT algorithms to predict weight shifts and in-seat movements. These weight shifts and in-seat movements were validated against a high-resolution interface pressure mat in a dataset that resembles real-world usage. The proposed system achieved weight shift precision and recall scores of 81% and 80%, respectively, while in-seat movement scores were predicted with a mean absolute error of 22%. Results showed that WiSAT provides sufficient accuracy in characterizing in-seat activity in terms of weight shifts and in-seat movement.
Topics: Buttocks; Fitness Trackers; Humans; Pressure; Pressure Ulcer; Wheelchairs
PubMed: 33617402
DOI: 10.1080/10400435.2021.1893237 -
Ostomy/wound Management Feb 2011Although pressure ulcer (PrU) development is now generally considered an indicator for quality of care, questions and concerns...
Although pressure ulcer (PrU) development is now generally considered an indicator for quality of care, questions and concerns about situations in which they are unavoidable remain. Considering the importance of this issue and the lack of available research data, in 2010 the National Pressure Ulcer Advisory Panel (NPUAP) hosted a multidisciplinary conference to establish consensus on whether there are individuals in whom pressure ulcer development may be unavoidable and whether a difference exists between end-of-life skin changes and pressure ulcers. Thirty-four stakeholder organizations from various disciplines were identified and invited to send a voting representative. Of those, 24 accepted the invitation. Before the conference, existing literature was identified and shared via a webinar. A NPUAP task force developed standardized consensus questions for items with none or limited evidence and an interactive protocol was used to develop consensus among conference delegates and attendees. Consensus was established to be 80% agreement among conference delegates. Unanimous consensus was achieved for the following statements: most PrUs are avoidable; not all PrUs are avoidable; there are situations that render PrU development unavoidable, including hemodynamic instability that is worsened with physical movement and inability to maintain nutrition and hydration status and the presence of an advanced directive prohibiting artificial nutrition/hydration; pressure redistribution surfaces cannot replace turning and repositioning; and if enough pressure was removed from the external body the skin cannot always survive. Consensus was not obtained on the practicality or standard of turning patients every 2 hours nor on concerns surrounding the use of medical devices vis-à-vis their potential to cause skin damage. Research is needed to examine these issues, refine preventive practices in challenging situations, and identify the limits of prevention.
Topics: Humans; Pressure Ulcer
PubMed: 21350270
DOI: No ID Found -
Journal of Rehabilitation Research and... 2011The formation and underlying causes of pressure ulcers (PUs) are quite complex, with multiple influencing factors. However, by definition pressure ulcers cannot form... (Review)
Review
The formation and underlying causes of pressure ulcers (PUs) are quite complex, with multiple influencing factors. However, by definition pressure ulcers cannot form without loading, or pressure, on tissue. Clinical interventions typically target the magnitude and/or duration of loading. Pressure magnitude is managed by the selection of support surfaces and postural supports as well as body posture on supporting surfaces. Duration is addressed via turning and weight shifting frequency as well as with the use of dynamic surfaces that actively redistribute pressure on the body surfaces. This article shows that preventative interventions must be targeted to both magnitude and duration and addresses the rationale behind several common clinical interventions--some with more scientific evidence than others.
Topics: Beds; Humans; Posture; Pressure; Pressure Ulcer; Surface Properties; Wheelchairs
PubMed: 21480095
DOI: 10.1682/jrrd.2010.05.0102 -
Journal of Rehabilitation Research and... 2011
Pressure ulcer management and research priorities for patients with spinal cord injury: consensus opinion from SCI QUERI Expert Panel on Pressure Ulcer Research Implementation.
Topics: Biomedical Research; Humans; Practice Guidelines as Topic; Pressure Ulcer; Risk Assessment; Risk Factors; Spinal Cord Injuries
PubMed: 21480093
DOI: 10.1682/jrrd.2011.01.0011 -
Journal of Tissue Viability Feb 2018Costs for the prevention and management of pressure ulcers have increased significantly with limited published advice from health and social care organisations on...
BACKGROUND
Costs for the prevention and management of pressure ulcers have increased significantly with limited published advice from health and social care organisations on seating and preventing pressure ulcers. At the request of the UK Tissue Viability Society the aim of the publication was to develop a practical guide for people, carers and health and social care professionals on how the research and evidence base on pressure ulcer prevention and management can be applied to those who remain seated for extended periods of time.
METHODS AND FINDINGS
The evidence base informing the guidelines was obtained by applying a triangulation of methods: a literature review, listening event and stakeholder group consultation. The purpose was to engage users and carers, academics, clinicians, inspectorate and charities, with an interest in seating, positioning and pressure management to: gather views, feedback, stories, and evidence of the current practices in the field to create a greater awareness of the issue.
CONCLUSION
The new guidelines are inclusive of all people with short and long-term mobility issues to include all population groups. The document includes evidence on where pressure ulcers develop when seated, risk factors, best possible seated position and what seat adjustments are required, the ideal seating assessment, interventions, self-help suggestions and key seating outcomes. The updated TVS CPGs have been informed by the best available evidence, the insights and wisdom of experts, stakeholders and people who spend extended periods of time sitting.
Topics: Equipment and Supplies; Guidelines as Topic; Humans; Posture; Pressure Ulcer; Tissue Survival
PubMed: 28919021
DOI: 10.1016/j.jtv.2017.09.006 -
The Journal of Spinal Cord Medicine May 2014The purpose was to provide support for validity and reliability of the spinal cord impairment pressure ulcer monitoring tool (SCI-PUMT) to assess pressure ulcer (PrU)...
OBJECTIVE
The purpose was to provide support for validity and reliability of the spinal cord impairment pressure ulcer monitoring tool (SCI-PUMT) to assess pressure ulcer (PrU) healing.
DESIGN
Expert panels developed a 30-item pool, including new items and items from two established PrU healing tools, to represent potential variables for monitoring PrU healing. Subjects were prospectively assessed weekly for each variable over a 12-week period.
SETTING
Data collection was conducted on a cohort of inpatients and outpatients in one Spinal Cord Injury/Disorders Center in the Veterans' Health Administration.
SUBJECTS
A convenience sample of Veterans (n = 66) with spinal cord impairment (SCI) was recruited. Eligible subjects had at least one PrU (n = 167) and a history of SCI for longer than 1 year. Interventions Not applicable.
OUTCOME MEASURE
A change in PrU volume was calculated using VeV Measurement Documentation software and a digital imaging camera.
RESULTS
Content validity was established for a pool of items designed to gauge PrU healing. Exploratory factor analysis (construct validity) identified a parsimonious set of seven items for inclusion in the SCI-PUMT to assess PrU healing. The SCI-PUMT was found to explain 59% of the variance of the volume across the study. Inter-rater reliability was 0.79 and intra-rater reliability ranged from 0.81 to 0.99 among research assistants. Similar levels of reliability were subsequently established among registered nurses, who used the SCI-PUMT in the clinical setting.
CONCLUSIONS
The final version of the SCI-PUMT was determined to be valid, reliable, and sensitive in detecting PrU healing over time in Veterans with SCI.
Topics: Female; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Pressure Ulcer; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Spinal Cord Injuries; Wound Healing
PubMed: 24621044
DOI: 10.1179/2045772313Y.0000000163 -
Ostomy/wound Management Apr 2010Pressure ulcer assessment is usually performed at the bedside by a clinician with minimal training in wound assessment. A multidisciplinary panel of United States' wound... (Review)
Review
Pressure ulcer assessment is usually performed at the bedside by a clinician with minimal training in wound assessment. A multidisciplinary panel of United States' wound experts was assembled to provide anatomically accurate and practical terms associated with pressure ulcer assessment, healing, and nonhealing in order to help clinicians identify and describe tissue types and pressure ulcer stages. Specifically, anatomical markers and/or structures within the wound are described to facilitate tissue type identification and pressure ulcer staging. The panel agreed that the provision of a common language facilitates quality care across settings. Although some research has been conducted, additional studies to determine the validity and reliability of wound assessment and healing terms and definitions, as well as pressure ulcer staging systems, are needed.
Topics: Humans; Pressure Ulcer; United States
PubMed: 20424291
DOI: No ID Found