Pressure ulcer risk assessment in critical care: Interrater reliability and validity studies of the Braden and Waterlow scales and subjective ratings in two intensive care units

2010 ◽  
Vol 47 (6) ◽  
pp. 671-677 ◽  
Author(s):  
Jan Kottner ◽  
Theo Dassen
Keyword(s):  
Risk Assessment ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Pressure Ulcer ◽  
Interrater Reliability ◽  
Reliability And Validity ◽  
Subjective Ratings ◽  
Validity Studies

scholarly journals ESCALAS DE PREDIÇÃO DE RISCO PARA LESÃO POR PRESSÃO EM PACIENTES CRITICAMENTE ENFERMOS: REVISÃO INTEGRATIVA

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Ludmila Silva Castanheira ◽  
Andreza Werli-Alvarenga ◽  
Allana Dos Reis Correa ◽  
Daniela Mascarenhas de Paula Campos
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Risk Prediction ◽  
Pressure Ulcer ◽  
Critically Ill Patients ◽  
Skin Integrity ◽  
Pressure Injury ◽  
Terapia Intensiva

Resumo: Feridas afetam a integridade da pele, e quando não prevenidas ou tratadas podem levar a complicações decorrentes da integridade da pele prejudicada, especialmente em Unidades de Terapia Intensiva (UTIs). Atualmente, as escalas de predição de risco disponíveis para esta avaliação e validadas para o português são as de Braden, Waterlow e Norton. Objetivo: determinar qual a escala mais acurada para a avaliação de pacientes criticamente enfermos. Metodologia: Trata-se de uma revisão integrativa, cuja questão norteadora foi: qual escala para predição de risco para LP, disponível e validada para o português é mais acurada para estimar o risco de LP em pacientes criticamente enfermos internados na UTI? A busca dos estudos foi realizada na BVS, PubMed/MedLine e CINAHL. Resultados: Foram encontrados 134 artigos, elegíveis 123 e incluídos 18 na revisão. Conclusão: Os resultados apontam a necessidade da realização de estudos nesta área.Descritores: Úlcera por Pressão; Unidades de Terapia Intensiva; Cuidados Críticos; EscalasPREDICTION RISK SCALES FOR PRESSURE INJURY IN CRITICALLY ILL PATIENTS INTEGRATIVE REVIEWSummary: Wounds affect skin integrity, and when not prevented or treated can lead to complications resulting from impaired skin integrity, especially in intensive care units (ICUs). Currently, the prediction of risk scales available for this evaluation and validated for the Portuguese are Braden, Waterlow and Norton. Objective: to determine what the more accurate scale for the assessment of critically ill. Methodology: it is an integrative review, whose guiding question was: which to scale for risk prediction for LP, available and validated to Portuguese is more accurate for estimating the risk of LP in critically ill hospitalized in ICU? The search of the studies was held at the BVS, PubMed/MedLine and CINAHL. Results: found 134 items, 123 and included 18 eligible in the review. Conclusion: the results show the need of carrying out studies in this area.Descriptors: Pressure ulcer; Intensive Care Units; Critical Care; ScalesESCALAS DE PREDICCIÓN DE RIESGO PARA LESIÓN POR PRESIÓN EN PACIENTES CRÍTICAMENTE ENFERMOS: REVISIÓN INTEGRATIVAResumen: Las heridas afectan la integridad de la piel y cuando no prevenido o Tratado pueden conducir a las complicaciones resultantes de la integridad de la piel deteriorada, especialmente en unidades de cuidados intensivos (UCI). Actualmente, la predicción de las escalas de riesgo disponibles para esta evaluación y validadas para los portugueses son Braden, Waterlow y Norton. Objetivo: determinar la escala que más precisa para la evaluación de estado crítico. Metodología: ¿ es un examen integrador, cuyo rector era: que a la escala de predicción de riesgo de LP, disponible y validado al portugués es más exacta para estimar el riesgo de LP en críticamente enfermos hospitalizados en UCI? La búsqueda de los estudios se realizó en la BVS, PubMed/MedLine y CINAHL. Resultados: elegibles 18 134 artículos encontrados, 123 e incluido en la revisión. Conclusión: los resultados muestran la necesidad de llevar a cabo estudios en esta área.Descriptores: Úlcera por Presión, Unidades de Cuidados Intensivos, Cuidados Críticos, Escalas.

scholarly journals Paediatric admissions to a district general hospital adult intensive care unit over a six year period: A single centre retrospective case series, with review of practitioner confidence and competence in paediatric critical care

2021 ◽  
pp. 175114372110121
Author(s):  
Stephen A Spencer ◽  
Joanna S Gumley ◽  
Marcin Pachucki
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Series ◽  
Critically Ill Children ◽  
Single Centre ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Paediatric Critical Care ◽  
Doctors And Nurses

Background Critically ill children presenting to district general hospitals (DGH) are admitted to adult intensive care units (AICUs) for stabilisation prior to transfer to paediatric intensive care units (PICUs). Current training in PICU for adult intensive care physicians is only three months. This single centre retrospective case series examines the case mix of children presenting to a DGH AICU and a multidisciplinary survey assesses confidence and previous experience, highlighting continued training needs for DGH AICU staff. Methods all paediatric admissions to AICU and paediatric retrievals were reviewed over a 6-year period (2014-2019). Cases were identified from the Electronic Patient Record (EPR) and from data provided by the regional paediatric retrieval service. A questionnaire survey was sent to AICU doctors and nurses to assess confidence and competence in paediatric critical care. Results Between 2014-2019, 284 children were managed by AICU. In total 35% of cases were <1 y, 48% of cases were <2 y and 64% of cases were <5 y, and 166/284 (58%) children were retrieved. Retrieval reduced with increasing age (OR 0.49 [0.40-0.60], p < 0.0001). The survey had an 82% response rate, and highlighted that only 13% of AICU nurses and 50% of doctors had received prior PICU training. Conclusion At least one critically unwell child presents to the AICU each week. Assessment, stabilisation and management of critically unwell children are vital skills for DGH AICU staff, but confidence and competence are lacking. Formalised strategies are required to develop and maintain paediatric competencies for AICU doctors and nurses.

scholarly journals Interface pressure, pressure gradient with pressure ulcer development in Intensive Care Units

2014 ◽  
Vol 4 (9) ◽  
Author(s):  
Mr. Supriadi ◽  
Tomoe Nishizawa ◽  
Moriyoshi Fukuda ◽  
Yuka Kon ◽  
Matsuo Junko ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pressure Gradient ◽  
Intensive Care Units ◽  
Pressure Ulcer ◽  
Interface Pressure ◽  
Pressure Ulcer Development

Designing and Validity Evaluation of Quality of Nursing Care Scale in Intensive Care Units

2014 ◽  
Vol 22 (3) ◽  
pp. 461-471
Author(s):  
Mashaalah Zeraati ◽  
Negin Masoudi Alavi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nursing Care ◽  
Content Validity ◽  
Scale Level ◽  
Validity Index ◽  
Critical Care Units ◽  
Quality Of Nursing

Background and Purpose: Quality of nursing care measurement is essential in critical care units. The aim of this study was to develop a scale to measure the quality of nursing care in intensive care units (ICUs). Methods: The 68 items of nursing care standards in critical care settings were explored in a literature review. Then, 30 experts evaluated the items’ content validity index (CVI) and content validity ratio (CVR). Items with a low CVI score (<0.78) and low CVR score (<0.33) were removed from the scale. Results: The 50 items remained in the scale. The Scale level-CVI and Scale level-CVR were 0.898 and 0.725, respectively. Conclusion: The nursing care scale in ICU (Quality of Nursing Care Scale-ICU) that was developed in this research had acceptable CVI and CVR.

scholarly journals The challenges of using physical restraint in intensive care units in Iran: A qualitative study

2020 ◽  
pp. 175114371989278
Author(s):  
Zahra Salehi ◽  
Soodabeh Joolaee ◽  
Fatemeh Hajibabaee ◽  
Tahereh Najafi Ghezeljeh
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Structured Interviews ◽  
Standard Equipment ◽  
Restraint Use ◽  
Ensure Patient Safety

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

scholarly journals Alarm Compliance in Healthcare: Design Considerations for Actionable Alarms (In Intensive Care Units)

2019 ◽  
Vol 1 (1) ◽  
pp. 839-846
Author(s):  
Rosana Sanz-Segura ◽  
Eduardo Manchado Pérez ◽  
Elif Özcan
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intrinsic Motivation ◽  
Intensive Care Units ◽  
Design Strategies ◽  
Alarm Fatigue ◽  
Healthcare Design ◽  
Design Considerations ◽  
Potential Success ◽  
Per Se

AbstractIntensive care units are technologically advanced environments that are designed to safeguard the patient while their vitals are stabilized for further treatment. Audible and visual alarms are part of the healthcare ecology. However, these alarms are so many that clinicians suffer from a syndrome called ‘alarm fatigue’ and often do not comply with the task alarm is conveying. Measuring compliance with rules in the workspace and determining the success of a system belongs to the field of ergonomics and is based on data collected through task observations and scoring. In this paper, we will explore compliance with critical alarms by not only from their potential success or failure perspective but also from the perspectives of the clinician capacity, needs, and motivations to comply with alarms in critical environments. We will finally, reflect on further possible design strategies to increase compliance in critical care that are beyond following rules per se but through intrinsic motivation.

Neonatal Pressure Ulcer Prevention

2015 ◽  
Vol 34 (2) ◽  
pp. 126-132 ◽  
Author(s):  
Patricia Scheans
Keyword(s):  
Intensive Care ◽  
Best Practices ◽  
Case Studies ◽  
Intensive Care Units ◽  
Pressure Ulcer ◽  
Pressure Ulcer Prevention ◽  
Developmental Factors ◽  
Skin Breakdown ◽  
Preterm Newborns ◽  
Ulcer Prevention

AbstractThe incidence of pressure ulcers in acutely ill infants and children ranges up to 27 percent in intensive care units, with a range of 16–19 percent in NICUs. Anatomic, physiologic, and developmental factors place ill and preterm newborns at risk for skin breakdown. Two case studies illustrate these factors, and best practices for pressure ulcer prevention are described.

Critical care in Colombia: Differences between teaching and nonteaching intensive care units. A prospective cohort observational study

2012 ◽  
Vol 27 (1) ◽  
pp. 104.e9-104.e17 ◽  
Author(s):  
Sandra Rubiano ◽  
Fabian Gil ◽  
Edgar Celis-Rodriguez ◽  
Henry Oliveros ◽  
Gabriel Carrasquilla
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
Prospective Cohort
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