scholarly journals Reducing Hospital Acquired Pressure Ulcers

2015 ◽  
Author(s):  
Jessica LeBlanc

<p>Pressure ulcers have been a persistent issue in hospitals for many years and continue to remain a major cause of morbidity and mortality. Most hospital acquired pressure ulcers (HAPUs) are considered preventable and are identified by the National Quality Forum as a nurse-sensitive quality indicator. Intensive care patients in particular tend to be at a higher risk to develop PUs and prevention in the intensive care population continues to be a major challenge in many hospitals. Recently, some intensive care units have been utilizing a preventative silicone foam barrier dressing applied to patients admitted to the unit in order reduce the incidence of HAPUs. The purpose of this research was to determine if a silicone foam border dressing applied to medical intensive care patients would result in a decreased sacral HAPU occurrence rate in the medical ICU. The data collection took place at the Miriam Hospital, a 247-bed tertiary care hospital in Providence, Rhode Island. The medical ICU at the Miriam Hospital is a 16-bed unit. A retrospective chart review was conducted on 250 medical records that were coded with ICD-9 codes for pressure ulcers. Group One (treatment group) included medical intensive care unit patients who had preventative dressings applied to the sacrum. Group Two (comparison group) included patients who did not have a preventative dressing applied. Results demonstrated that there was a decrease in the occurrence rate of HAPUs after the preventative dressings were initiated. Recommendations and implications for advanced practice nursing are discussed.</p>

2014 ◽  
Vol 20 (4) ◽  
pp. 362-368 ◽  
Author(s):  
Francisco Manzano ◽  
Ana M. Pérez-Pérez ◽  
Susana Martínez-Ruiz ◽  
Cristina Garrido-Colmenero ◽  
Delphine Roldan ◽  
...  

Author(s):  
VS Gaurav Narayan ◽  
SG Ramya ◽  
Sonal Rajesh Kumar ◽  
SK Nellaiappa Ganesan

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.


Author(s):  
Siddharth Suryakant Athawale ◽  
Madhuri D. Kulkarni

Background: The medical intensive care unit (MICU) is a setting were patients who are critically ill are admitted and thus usually receive a large number of drugs of different pharmacological classes due to life threatening illnesses which may be fatal. The various drugs used in MICU and there clinical outcome was investigated in this study.Methods: Patients admitted between January 2017 to June 2018 in Medicine ICU of GMC Aurangabad were included in this study.Results: Total of 351 prescriptions was analyzed from the medicine intensive care unit. Out of 351 patients 243 (69.23%) were male, while 108 (30.77%) were female. The mean age of the patients admitted in MICU was 42.78±18.14 years. The most common type of patients admitted in MICU have the diagnosis of organophosphorous poisoning (25.36%), followed by cerebrovascular accident (15.95%), pneumonitis (10.26%), snake bite (7.12%), chronic kidney disease (5.98%), diabetic ketoacidosis (5.70%) and seizure disorder (3.42%). The most common drugs used were ranitidine (99.71%) and ondansetron (99.43%). Among antibiotics cephalosporins were most commonly used, ceftriaxone (39.03%), cefotaxim (40.46%), cefoperazone and sulbactum (24.22%). Other antibiotics most commonly used were metronidazole (61.25%), amoxicillin and potassium clavulanate (26.78%), piperacillin and tazobactum (11.68%), meropenem (11.40%).Conclusions: In conclusion, we found that in MICU utilization rate of gastroprotective (ranitidine), antiemetic (ondansetron) and antibiotics (cephalosporins) was high. The present study provides valuable insight about the overall pattern of drugs used in medicine intensive care unit.


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