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.

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 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.

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.

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 Literature Review of Machine-Learning Algorithms for Pressure Ulcer Prevention: Challenges and Opportunities

Informatics ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 76
Author(s):  
Fernando Ribeiro ◽  
Filipe Fidalgo ◽  
Arlindo Silva ◽  
José Metrôlho ◽  
Osvaldo Santos ◽  
...  
Keyword(s):  
Machine Learning ◽  
Pressure Ulcer ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Pressure Ulcers ◽  
Learning Algorithms ◽  
Clinical Decision ◽  
Predisposing Factors ◽  
Machine Learning Algorithms ◽  
Challenges And Opportunities

Pressure ulcers are associated with significant morbidity, resulting in a decreased quality of life for the patient, and contributing to healthcare professional burnout, as well as an increase of health service costs. Their prompt diagnosis and treatment are important, and several studies have proposed solutions to help healthcare professionals in this process. This work analyzes studies that use machine-learning algorithms for risk assessment and management of preventive treatments for pressure ulcers. More specifically, it focuses on the use of machine-learning algorithms that combine information from intrinsic and extrinsic pressure-ulcer predisposing factors to produce recommendations/alerts to healthcare professionals. The review includes articles published from January 2010 to June 2021. From 60 records screened, seven articles were analyzed in full-text form. The results show that most of the proposed algorithms do not use information related to both intrinsic and extrinsic predisposing factors and that many of the approaches separately address one of the following three components: data acquisition; data analysis, and production of complementary support to well-informed clinical decision-making. Additionally, only a few studies describe in detail the outputs of the algorithm, such as alerts and recommendations, without assessing their impacts on healthcare professionals’ activities.

Role of Patient Specifics on Mechanical Risk and Load Relief During Support of Bony Prominences

2013 ◽  
Author(s):  
Ahmet Erdemir
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Region Of Interest ◽  
Clinical Effectiveness ◽  
Incidence Rates ◽  
Patient Specific ◽  
Support Surface ◽  
Load Relief ◽  
Bony Prominence ◽  
Pressure Ulcer Development

Prolonged mechanical loading of tissue in between a bony prominence and a support surface can lead to pressure ulcers. Despite recent initiatives to curb down incidence rates, the health care burden of pressure ulcer prevention remains significant [1]. Etiology of pressure ulcers are commonly attributed to interface pressures. As a result, interventions, e.g., support surfaces, routinely aim to reduce contact pressures. However, the clinical effectiveness of such an objective can be questionable [2]. Recent studies have shown that internal mechanics of the tissue can be associated with pressure ulcer development [3], potentially indicating the inefficacy of interventions targeted solely at contact pressure relief. Tissue characteristics at a bony prominence, e.g., tissue thickness and material properties, also influence load distribution within and on the surface of the tissue. Given the variability in patient populations and for a bony region of interest [4], it is possible that patient specific risk and load relief (with the use of support surface) may differ widely.

Cytokine and Chemokine Release Upon Sustained Mechanical Loading of the Epidermis

2007 ◽  
Author(s):  
Debbie Bronneberg ◽  
Lisette H. Cornelissen ◽  
Cees W. J. Oomens ◽  
Frank P. T. Baaijens ◽  
Carlijn V. C. Bouten
Keyword(s):  
Risk Assessment ◽  
Health Care ◽  
Soft Tissue ◽  
Mechanical Loading ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Objective Measures ◽  
Subjective Measures ◽  
Non Invasive ◽  
Pressure Ulcer Development

Pressure ulcers are areas of soft tissue breakdown resulting from sustained mechanical loading of the skin and underlying tissues. These ulcers are painful, difficult to treat, and represent a burden to the community in terms of health care and money. Currently, pressure ulcer risk assessment is dominated by subjective measures and does not predict pressure ulcer development satisfactorily [1]. Objective measures are therefore needed for early, non-invasive detection.

Managing pressure ulcers: the best equipment to use

2019 ◽  
Vol 21 (11) ◽  
pp. 635-638
Author(s):  
Adrienne Harris
Keyword(s):  
Pressure Ulcer ◽  
Healthcare Professionals ◽  
Pressure Ulcers ◽  
Evidence Based ◽  
Effective Management ◽  
Tissue Viability

Pressure ulcer management remains a key area of tissue viability nursing that applies to all disciplines and healthcare professionals alike. Adrienne Harris examines the research and informs us of the best evidence-based tools to achieve effective management

scholarly journals Validation of two case definitions to identify pressure ulcers using hospital administrative data

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016438 ◽  
Author(s):  
Chester Ho ◽  
Jason Jiang ◽  
Cathy A Eastwood ◽  
Holly Wong ◽  
Brittany Weaver ◽  
...  
Keyword(s):  
Administrative Data ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Case Definition ◽  
University Hospital ◽  
Case Definitions ◽  
Discharge Abstract Database ◽  
Accurate Identification ◽  
Prevalence Studies ◽  
Pressure Ulcer Development

ObjectivePressure ulcer development is a quality of care indicator, as pressure ulcers are potentially preventable. Yet pressure ulcer is a leading cause of morbidity, discomfort and additional healthcare costs for inpatients. Methods are lacking for accurate surveillance of pressure ulcer in hospitals to track occurrences and evaluate care improvement strategies. The main study aim was to validate hospital discharge abstract database (DAD) in recording pressure ulcers against nursing consult reports, and to calculate prevalence of pressure ulcers in Alberta, Canada in DAD. We hypothesised that a more inclusive case definition for pressure ulcers would enhance validity of cases identified in administrative data for research and quality improvement purposes.SettingA cohort of patients with pressure ulcers were identified from enterostomal (ET) nursing consult documents at a large university hospital in 2011.ParticipantsThere were 1217 patients with pressure ulcers in ET nursing documentation that were linked to a corresponding record in DAD to validate DAD for correct and accurate identification of pressure ulcer occurrence, using two case definitions for pressure ulcer.ResultsUsing pressure ulcer definition 1 (7 codes), prevalence was 1.4%, and using definition 2 (29 codes), prevalence was 4.2% after adjusting for misclassifications. The results were lower than expected. Definition 1 sensitivity was 27.7% and specificity was 98.8%, while definition 2 sensitivity was 32.8% and specificity was 95.9%. Pressure ulcer in both DAD and ET consultation increased with age, number of comorbidities and length of stay.ConclusionDAD underestimate pressure ulcer prevalence. Since various codes are used to record pressure ulcers in DAD, the case definition with more codes captures more pressure ulcer cases, and may be useful for monitoring facility trends. However, low sensitivity suggests that this data source may not be accurate for determining overall prevalence, and should be cautiously compared with other prevalence studies.

scholarly journals A Review of Intelligent Sensor-Based Systems for Pressure Ulcer Prevention

Computers ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 6
Author(s):  
Arlindo Silva ◽  
José Metrôlho ◽  
Fernando Ribeiro ◽  
Filipe Fidalgo ◽  
Osvaldo Santos ◽  
...  
Keyword(s):  
Pressure Ulcer ◽  
Healthcare Professionals ◽  
Pressure Ulcers ◽  
Critical Issue ◽  
Meaningful Improvement ◽  
Pressure Ulcer Prevention ◽  
Intelligent Sensor ◽  
Patient At Risk ◽  
General Architecture ◽  
Ulcer Prevention

Pressure ulcers are a critical issue not only for patients, decreasing their quality of life, but also for healthcare professionals, contributing to burnout from continuous monitoring, with a consequent increase in healthcare costs. Due to the relevance of this problem, many hardware and software approaches have been proposed to ameliorate some aspects of pressure ulcer prevention and monitoring. In this article, we focus on reviewing solutions that use sensor-based data, possibly in combination with other intrinsic or extrinsic information, processed by some form of intelligent algorithm, to provide healthcare professionals with knowledge that improves the decision-making process when dealing with a patient at risk of developing pressure ulcers. We used a systematic approach to select 21 studies that were thoroughly reviewed and summarized, considering which sensors and algorithms were used, the most relevant data features, the recommendations provided, and the results obtained after deployment. This review allowed us not only to describe the state of the art regarding the previous items, but also to identify the three main stages where intelligent algorithms can bring meaningful improvement to pressure ulcer prevention and mitigation. Finally, as a result of this review and following discussion, we drew guidelines for a general architecture of an intelligent pressure ulcer prevention system.

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