An Examination of Nurse Caring and Hospital Acquired Pressure Ulcers

2013 ◽  
Vol 17 (4) ◽  
pp. 32-42 ◽  
Author(s):  
Judy C. Paull, ◽  
Patricia Hanson, ◽  
Susan Hasenau, ◽  
Deborah Dunn,
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Standards Of Care ◽  
National Database ◽  
Southeast United States ◽  
Critical Care Units ◽  
Nurse Caring ◽  
Pressure Ulcer Development ◽  
High Standards ◽  
Hospital Acquired

The Nyberg Caring Assessment Scale (NCA) and the National Database of Nursing Quality Indicators (NDNQI) were used to measure nurse caring and hospital acquired pressure ulcers. This is an exploratory, descriptive, single-site study conducted in a large academic, trauma center, twice Magnet® designated in the southeast United States. Caring theory, the mechanics of pressure ulcer development, and wound prevalence between medical-surgical and critical care units was explored. No statistically significant differences in caring scores were identified between nurse groups, although pressure ulcer prevalence differed. Existing high standards of care and the tool itself are noted as factors influencing the results.

Heel pressure ulceration: the perennial clinical and financial problem?

2021 ◽  
pp. 1-5
Author(s):  
Deborah Glover ◽  
Trevor Jones ◽  
Henning von Spreckelsen
Keyword(s):  
Cost Analysis ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Cost Savings ◽  
Shear Forces ◽  
Financial Problem ◽  
Pressure Ulcer Development ◽  
Hospital Acquired

The heel of the foot is particularly susceptible to pressure, friction and shear forces. In consequence, heel pressure ulcers account for approximately 18% of all hospital-acquired pressure ulcers in England. To ameliorate the effects of friction and shear forces, the use of heel protectors made from silk-like fabric is recommended. This article outlines how one such product, the Parafricta bootee (APA Parafricta), has facilitated a reduction in heel pressure ulcer development, resulting in both time and cost savings in an acute NHS trust over the course of 8 years and thousands of patients. A cost-analysis will also be detailed to show that if the products and processes pioneered by this trust were used throughout NHS England, over £300 million in resource savings could be achieved each year.

scholarly journals Prediction Model for Hospital-Acquired Pressure Ulcer Development: Retrospective Cohort Study

10.2196/13785 ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. e13785 ◽  
Author(s):  
Sookyung Hyun ◽  
Susan Moffatt-Bruce ◽  
Cheryl Cooper ◽  
Brenda Hixon ◽  
Pacharmon Kaewprag
Keyword(s):  
Cohort Study ◽  
Prediction Model ◽  
Pressure Ulcer ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pressure Ulcer Development ◽  
Hospital Acquired

Effects of Using a High-Density Foam Pad Versus a Viscoelastic Polymer Pad on the Incidence of Pressure Ulcer Development During Spinal Surgery

2010 ◽  
Vol 13 (4) ◽  
pp. 419-424 ◽  
Author(s):  
Tsokuang Wu ◽  
Shin-Tien Wang ◽  
Pi-Chu Lin ◽  
Chien-Lin Liu ◽  
Yann-Fen C. Chao
Keyword(s):  
Pressure Ulcer ◽  
Spinal Surgery ◽  
Iliac Crest ◽  
Pressure Ulcers ◽  
Female Gender ◽  
High Density ◽  
Ulcer Formation ◽  
Viscoelastic Polymer ◽  
Significant Difference ◽  
Pressure Ulcer Development

The purpose of this study was to evaluate the effect of high-density foam (HDF) pads versus viscoelastic polymer (VP) pads in the prevention of pressure ulcer formation during spinal surgery and their cost-effectiveness. Subjects were 30 patients who underwent spinal surgery for more than 3 hr in a prone position. One side of the chest and iliac crest was padded with HDF pads and the other side was padded with VP pads. An Xsensor® pressure measuring sheet was placed between the pad and the patient. Bilateral chest and iliac crest points were observed for the presence of pressure ulcers at 30 min after the operation. Results showed that a pressure ulcer had occurred at 9 of 120 compression points (7.5% of the total), 30 min after the operation. Risk evaluation showed that female gender, weight <50 kg, and body mass index (BMI) <18 kg/m2 as well as location (the iliac crest) were all risk factors for development of pressure ulcers. The most significant factor was BMI <18 kg/m2. The average and peak pressures measured at the points padded with the VP pads were significantly lower than those padded with the HDF pads. However, there was no significant difference between the VP and the HDF pads regarding ulcer prevention. Because the cost of a VP pad is 250 times greater than that of an HDF pad of similar size, the VP pad should only be considered for use in high-risk patients.

scholarly journals The Design and Implementation of a Local Strategy to Increase the Accuracy of Pressure Ulcer Classification: The Pressure Ulcer Guidance (PUG) Tool

2017 ◽  
Vol 2 (4) ◽  
Keyword(s):  
Pressure Ulcer ◽  
Healthcare Professionals ◽  
Pressure Ulcers ◽  
Hospital Admissions ◽  
Healthcare Providers ◽  
Staging System ◽  
Initial Assessment ◽  
Skin Damage ◽  
Key Factor ◽  
Pressure Ulcer Development

Skin inspection should be seen as an essential part of patient assessment and therefore should be compulsory for all hospital admissions. Recognising this as a key factor of risk assessment can ensure healthcare professionals are providing the best possible care and protection for their patients. Identifying skin damage on initial assessment ensures appropriate and early intervention, thus minimising or even preventing the risk of damage to the skin and avoiding pressure ulcer development. Once a pressure has developed the patient is generally dependent on others to manage, treat and care for their ulcer. Healthcare providers need to recognise that a pressure ulcer is a crucial element in preventing a full recovery, it can lead to increased hospital stay, resulting in ongoing treatment which may take weeks, even months of nursing care. Patients may also experience pain and discomfort, which has serious consequences on a patient’s quality of life, as well as a very costly exercise for the National Health Service (NHS). Understanding the mechanism of how the skin can be damaged and identifying the different stages of pressure damage can help in reducing, or even avoiding hospital acquired pressure ulcers. However, failure to identify pressure ulcers correctly can lead to inaccurate reporting and consequently inappropriate management. This article aims to explain the development and introduction of a new strategy to aid healthcare professionals overcome the difficulties in classifying pressure ulcers and differentiating superficial pressure ulcers from moisture lesions. Using the European Pressure Ulcer classification guide (EPUAP 2014) a pressure ulcer guide wheel, or ‘PUG wheel/ tool’, was designed to help healthcare professionals understand pressure ulcer categories and differentiate between pressure ulcers and moisture lesions [1]. To test the accuracy regarding classification, a group of 20 Tissue Viability Link Nurses were tested using this new tool against various verified pressure ulcer and moisture lesion images. A supporting poster was also designed to help healthcare professionals understand the staging system.

scholarly journals The Effectiveness of Home Based Nursing Care in Treatment of Hospital Acquired Pressure Ulcer (HAPU) in Participants Seeking Home Health Services: An Exploratory Study

2019 ◽  
Vol 4 (2) ◽  
pp. 88
Author(s):  
Punitha Singh ◽  
Deepti Damodaran ◽  
Gaurav Thukral ◽  
Joseph P. C.
Keyword(s):  
Health Services ◽  
Home Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Home Health ◽  
Home Care Nursing ◽  
Clinical Complications ◽  
Home Health Services ◽  
Home Based ◽  
Hospital Acquired

Hospital-Acquired Pressure Ulcers (HAPU) are serious clinical complications that can lead to increased length of stay, pain, infection, and, potentially, death. Unfortunately, a large proportion of home care clients received from hospital present with pressure ulcer that varies from stage 1 to stage 4.  Home care nurses have an opportunity to manipulate favorably certain environmental factors that can prevent pressure ulcers from newly developing or to manage effective treatment plans for any stages ulcers which were present while onboarding.Objective: The objective of this study was to determine the prevalence, duration and outcome in terms of healing; worsening of pressure ulcers and the ones whose condition remained the same seeking home health services. The study also describes the home care nursing interventions done to minimize the risk of worsening of pressure ulcer.

scholarly journals Pressure Ulcer Assessment and Documentation

2015 ◽  
Author(s):  
Cynthia Ruggiero
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Adult Learning Theory ◽  
Stage Iv ◽  
Staff Nurses ◽  
Advanced Practice ◽  
Accurate Assessment ◽  
Post Intervention ◽  
Nursing Activity ◽  
Hospital Acquired

<p>Accurate assessment and documentation of skin is an important nursing activity yet the task of identifying and documenting wounds can be difficult. New regulations from the Centers for Medicare and Medicaid dictate that hospitals will not receive payment for the treatment of stage III or stage IV hospital-acquired pressure ulcers. Literature supports that accurate assessment and documentation of a pressure ulcer is important to the care of the patient, to provide legal documentation, and for reimbursement. The purpose of this project was to develop and implement a pressure ulcer assessment and documentation pocket guide. The development of the pocket guide was guided by Malcolm Knowles’ adult learning theory and developed by evaluating different pocket guides, the NPUAP website, and evidence based literature. The project employed an intervention, post intervention evaluation design. The sample was drawn from nurse members of the Pressure Ulcer Prevalence Committee at the Miriam Hospital in Providence, RI. Nurse members of the committee who agreed to participate utilized the Pressure Ulcer Assessment and Documentation Pocket Guide to assess patients during the monthly meeting and then completed an evaluation. The guide was evaluated as being valuable in assessing and documenting pressure ulcers and it was recommended for distribution to staff nurses. Use of the tool has the potential to improve assessment, identification, and documentation of pressure ulcers. Implications for advanced practice are discussed.</p>

scholarly journals Using the braden and glasgow scales to predict pressure ulcer risk in patients hospitalized at intensive care units

2008 ◽  
Vol 16 (6) ◽  
pp. 973-978 ◽  
Author(s):  
Luciana Magnani Fernandes ◽  
Maria Helena Larcher Caliri
Keyword(s):  
Intensive Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
University Hospital ◽  
Major Health ◽  
Braden Scale ◽  
Hospital Patients ◽  
Patients At Risk ◽  
Pressure Ulcer Development ◽  
Critical Patients

Pressure ulcers remain a major health issue for critical patients. The purpose of this descriptive and exploratory study was to analyze the risk factors for the development of pressure ulcers in patients hospitalized at an intensive care unit of a university hospital. Patients were assessed through the Braden scale to determine the risk for the development of pressure ulcers and to identify individual risks, and the Glasgow scale was used to assess their consciousness. It was found that the risks associated with pressure ulcer development were: low scores on the Braden Scale on the first hospitalization day and low scores on the Glasgow scale. The results showed that these tools can help nurses to identify patients at risk, with a view to nursing care planning.

Pressure ulcers in patients receiving palliative care: A systematic review

2019 ◽  
Vol 33 (7) ◽  
pp. 770-782 ◽  
Author(s):  
Amy Ferris ◽  
Annie Price ◽  
Keith Harding
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Palliative Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Cochrane Library ◽  
Long Duration ◽  
Organ Failures ◽  
Pressure Ulcer Development ◽  
Inadequate Care

Background: Pressure ulcers are associated with significant morbidity and mortality as well as high cost to the health service. Although often linked with inadequate care, in some patients, they may be unavoidable. Aim: This systematic review aims to quantify the prevalence and incidence of pressure ulcers in patients receiving palliative care and identify the risk factors for pressure ulcer development in these patients as well as the temporal relationship between pressure ulcer development and death. Design: The systematic review is registered in the PROSPERO database (CRD42017078211) and conducted in accordance with the ‘PRISMA’ pro forma. Articles were reviewed by two independent authors. Data sources: MEDLINE (1946–22 September 2017), EMBASE (1996–22 September 2017), CINAHL (1937–22 September 2017) and Cochrane Library databases were searched. In all, 1037 articles were identified and 12 selected for analysis based on pre-defined inclusion and exclusion criteria. Results: Overall pressure ulcer prevalence and incidence were found to be 12.4% and 11.7%, respectively. The most frequently identified risk factors were decreased mobility, increased age, high Waterlow score and long duration of stay. Conclusion: The prevalence of pressure ulcers is higher in patients receiving palliative care than the general population. While this should not be an excuse for poor care, it does not necessarily mean that inadequate care has been provided. Skin failure, as with other organ failures, may be an inevitable part of the dying process for some patients.

scholarly journals The risks in nursing interventions offered by nurses with the purpose of preventing hospital-acquired pressure ulcers

2020 ◽  
Vol 71 (1) ◽  
pp. 34-41
Author(s):  
Claudia Elena Dobre ◽  
Florin Cătălin Cîrstoiu ◽  
Mariana Zazu ◽  
Doina Carmen Mazilu
Keyword(s):  
Statistical Analysis ◽  
Pressure Ulcer ◽  
Time Allocation ◽  
Pressure Ulcers ◽  
Nursing Interventions ◽  
Clinical Approach ◽  
Predictive Capacity ◽  
Pressure Ulcer Prevention ◽  
Hospital Acquired ◽  
Ulcer Prevention

AbstractThe study was performed in seven medical units in Bucharest with the intention to offer a comprehensive analysis of the nurses’ current prevention practices for hospital-acquired pressure ulcers and also to determine: (1) the main risks that can negatively affect the prevention activities for this type of injury, and (2) if there is a correlation between the nurses’ knowledge and the clinical approach to the current hospital-acquired pressure ulcer prevention practices. The statistical analysis was based on data collected from 713 questionnaires from subjects who met the inclusion criteria of the study. The results showed that nurses considered protocols for hospital-acquired pressure ulcer prevention and its management to be important, but both were not always fully implemented into practice due to the lack of resources, time allocation and staff shortages. The regression analysis method we used was focused to assess the predictive capacity for the combined clinical knowledge and professional approaches to hospital-acquired pressure ulcer prevention and management. The conclusion was that a simultaneous improvement in the clinical approaches and professional knowledge on the topic of pressure-ulcer prevention and management may lead to an improvement of up to 6% of the practices in this field according to the results of the statistical analysis performed.

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