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Pressure Ulcer Development (pressure + ulcer_development)
Selected AbstractsContinuous monitoring of interface pressure distribution in intensive care patients for pressure ulcer preventionJOURNAL OF ADVANCED NURSING, Issue 4 2009Kozue Sakai Abstract Title.,Continuous monitoring of interface pressure distribution in intensive care patients for pressure ulcer prevention. Aim., This paper is a report of a study conducted to examine whether continuous interface pressure monitoring of postoperative patients in an intensive care unit is feasible in clinical practice. Background., The interface pressure between skin and surfaces is generally evaluated for pressure ulcer prevention. However, the intensity and duration of interface pressure necessary for pressure ulcer development remains unclear because the conventional interface pressure sensors are unsuitable for continuous monitoring in clinical settings. Methods., A total of 30 postoperative patients in an intensive care unit participated in this study in 2006,2007. A sensor was built into a thermoelastic polymer mattress. The whole-body interface pressure was recorded for up to 48 hours. Pressure ulcer development was observed during the morning bed-bath. For analysis, the intensity and duration of the maximal interface pressure was evaluated. Findings., The mean age of the study group was 62·0 ± 15·4 years. Two participants developed stage I pressure ulcer and blanchable redness at the sacrum. The longest duration of pressures greater than 100 mmHg were 487·0, 273·5 and 275·7 minutes in the pressure ulcer, blanchable redness and no redness groups respectively. Conclusion., Continuous monitoring of the intensity and duration of whole-body interface pressure using the KINOTEX sensor is feasible in intensive care patients. [source] Assessment of Incidence, Cause, and Consequences of Pressure Ulcers to Evaluate Quality of Provided CareDERMATOLOGIC SURGERY, Issue 11 2009JAN WILLEM H. P. LARDENOYE MD BACKGROUND Pressure ulcers are one of the most frequently registered complications in general surgery. OBJECTIVE To obtain insight into the incidence, cause, and consequences of pressure ulcers and to evaluate the value of pressure ulcer registration to assess quality of care. RESULTS During the 9-year study period, 275 pressure ulcers were registered (5.8% of total registered complications). Age and female sex were independent risk factors for pressure ulcer development. Pressure ulcer classification was as follows: mild (53.3%), moderate (35.6%), severe (9.5%), and irreversible damage (1.5%). Patients undergoing hip surgery and major limb amputation were at risk for pressure ulcer development (10.4% and 8.8%, respectively). In most patients (89.5%), pressure ulcers had no consequences other than local wound therapy; in 12 patients (4.4%), pressure ulceration led to alteration in medication; in 15 patients (5.5%), length of hospital stay was prolonged; and four patients (0.4%) suffered from irreversible damage. CONCLUSION The incidence of pressure ulcers is strongly correlated to sex, age, and indication of admittance. Most ulcers were classified as mild and had no consequences. The insight obtained into incidence, cause, and consequences of pressure ulcers can be used as an indicator of quality of provided care if adjusted for case mix and indication of operation. [source] Estimating the risk of pressure ulcer development: is it truly evidence based?INTERNATIONAL WOUND JOURNAL, Issue 4 2006Article first published online: 12 DEC 200 No abstract is available for this article. [source] Continuous monitoring of interface pressure distribution in intensive care patients for pressure ulcer preventionJOURNAL OF ADVANCED NURSING, Issue 4 2009Kozue Sakai Abstract Title.,Continuous monitoring of interface pressure distribution in intensive care patients for pressure ulcer prevention. Aim., This paper is a report of a study conducted to examine whether continuous interface pressure monitoring of postoperative patients in an intensive care unit is feasible in clinical practice. Background., The interface pressure between skin and surfaces is generally evaluated for pressure ulcer prevention. However, the intensity and duration of interface pressure necessary for pressure ulcer development remains unclear because the conventional interface pressure sensors are unsuitable for continuous monitoring in clinical settings. Methods., A total of 30 postoperative patients in an intensive care unit participated in this study in 2006,2007. A sensor was built into a thermoelastic polymer mattress. The whole-body interface pressure was recorded for up to 48 hours. Pressure ulcer development was observed during the morning bed-bath. For analysis, the intensity and duration of the maximal interface pressure was evaluated. Findings., The mean age of the study group was 62·0 ± 15·4 years. Two participants developed stage I pressure ulcer and blanchable redness at the sacrum. The longest duration of pressures greater than 100 mmHg were 487·0, 273·5 and 275·7 minutes in the pressure ulcer, blanchable redness and no redness groups respectively. Conclusion., Continuous monitoring of the intensity and duration of whole-body interface pressure using the KINOTEX sensor is feasible in intensive care patients. [source] Pressure ulcers: validation of two risk assessment scalesJOURNAL OF CLINICAL NURSING, Issue 3 2005Tom Defloor PhD Aims and objectives., To compare the predictive value of two pressure ulcer risk assessment scales (Braden and Norton) and of clinical judgement. To evaluate the impact of effective preventive measures on the predictive validity of the two risk assessment scales. Methods., Of the 1772 participating older patients, 314 were randomly selected and assigned to the ,turning' group; 1458 patients were assigned to the ,non-turning' group. Using the Braden and the Norton scale the pressure ulcer risk was scored twice weekly during a four-week period. Clinical assessment was monitored daily. The patients at risk in the ,turning' group (Braden score <17 or Norton score <12) were randomly assigned to a two-hour turning schedule or to a four-hour turning schedule in combination with a pressure-reducing mattress. The ,non-turning' group received preventive care based on the clinical judgement of the nurses. Results., The diagnostic accuracy was similar for both scales. If nurses act according to risk assessment scales, 80% of the patients would unnecessarily receive preventive measures. The use of effective preventive measures decreased the predictive value of the risk assessment scales. Nurses predicted pressure ulcer development less well than the Braden and the Norton scale. Only activity, sensory perception, skin condition and existence of old pressure ulcers were significant predictors of pressure ulcer lesions. Relevance to clinical practice., The effectiveness of the Norton and Braden scales is very low. Much needless work is done and expensive material is wrongly allocated. The use of effective preventive measures decreases the predictive value of the risk assessment scales. Although the performance of the risk assessment scales is poor, using a risk assessment tool seems to be a better alternative than relying on the clinical judgement of the nurses. [source] Pressure ulcer prevention in intensive care patients: guidelines and practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009Eman S. M. Shahin BSc MSc RN PhD Abstract Background, Pressure ulcers are a potential problem in intensive care patients, and their prevention is a major issue in nursing care. This study aims to assess the allocation of preventive measures for patients at risk for pressure ulcers in intensive care and the evidence of applied pressure ulcer preventive measures in intensive care settings in respect to the European Pressure Ulcer Advisory Panel (EPUAP) and Agency for Health Care Policy and Research (AHCPR) guidelines for pressure ulcer prevention. Design, The design of this study was a cross-sectional study (point prevalence). Setting, The study setting was intensive care units. The sample consisted of 169 patients , 60 patients from surgical wards, 59 from interdisciplinary wards and 50 from medical intensive care wards. Results, The study results revealed that pressure reducing devices like mattresses (alternating pressure air, low air loss and foam) are applied for 58 (36.5%) patients, and all of these patients are at risk for pressure ulcer development. Most patients receive more than one nursing intervention, especially patients at risk. Nursing interventions applied are skin inspection, massage with moisture cream, nutrition and mobility (81.8%, 80.5%, 68.6% and 56.6%) respectively. Moreover, all applied pressure ulcer preventive measures in this study are in line with the guidelines of the EPUAP and AHCPR except massage which is applied to 8.8% of all patients. Conclusions, The use of pressure reducing devices and nursing interventions in intensive care patients are in line with international pressure ulcer guidelines. Only massage, which is also being used, should be avoided according to the recommendation of national and international guidelines. [source] |