Influencing Factors of Pressure Ulcer in Critically Ill Patients

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.

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Guideline implementation results in a decrease of pressure ulcer incidence in critically ill patients*

Critical Care Medicine ◽

10.1097/01.ccm.0000257072.10313.56 ◽

2007 ◽

Vol 35 (3) ◽

pp. 815-820 ◽

Cited By ~ 63

Author(s):

Erik H. de Laat ◽

Peter Pickkers ◽

Lisette Schoonhoven ◽

André L. Verbeek ◽

Ton Feuth ◽

...

Keyword(s):

Critically Ill ◽

Pressure Ulcer ◽

Critically Ill Patients ◽

Guideline Implementation

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Nurses Practice and Influencing Factors regarding Physical Restraint use in the Intensive Care Units in Northwest Ethiopia

10.21203/rs.3.rs-16391/v2 ◽

2020 ◽

Author(s):

Tilahun Kassew ◽

Ambaye Dejen Tilahun ◽

Bikis Liyew

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Critically Ill ◽

Influencing Factors ◽

Critically Ill Patients ◽

Physical Restraint ◽

Northwest Ethiopia ◽

Evidence Based ◽

Restraint Use ◽

Level Of Knowledge

Abstract Background: Physical restraint is a common clinical practice in intensive care units. Even though physical restraint is used to prevent the removal of life support tubes and risk of a patient’s falling injure; complications such as edema, laceration, and pain at the restrained site, restricted circulation, worsening of agitation or delirium that may end with death are frequently encountered. Despite the sensitivity of the problem, there are gaps in nurses’ evidence-based practice in Ethiopia. Before developing protocols and guidelines relevant evidence-based practices of nurses are required. So, this study aimed to assess the practice and influencing factors of nurses regarding physical restraint use in the intensive care units in northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from July to August 2019 at Amhara regional state referral hospitals, Northwest Ethiopia. A total of 260 nurses in the intensive care units were invited to take part in the study by a convenience sampling technique. The Level of Knowledge, Attitudes, and Practices of Staff Regarding Physical Restraints Questionnaire was used to assess the nurses’ knowledge, attitude, and practice. Linear regression analysis was computed to examine the influencing factors of nurses' practice. An adjusted unstandardized beta (β) coefficient with a 95% confidence interval was used to report the result of association. Statistical significance was declared at p-value<0.05. Result: The mean score of the nurses’ practice regarding physical restraint use among critically ill patients was 30.94±5.44. This mean score is above the scale midpoint nearer to the higher range that implies the majority of nurses have a satisfactory practice regarding physical restraint. Less than or equal to 2 years of work experience [β= -1.34, 95% CI (-2.47, -0.21)] was significantly associated with poor nurses practice; received training regarding restraints [β= 1.49, 95% CI (0.16, 2.82)], higher level of knowledge [β=0.40, 95% CI (0.03, 0.78)] and better attitude scores [β=0.37, 95% CI (0.27, 0.47)] were associated with good nurses practice regarding physical restraint use.Conclusion: Nurses working in the intensive care units had a satisfactory practice regarding physical restraint use on critically ill patients. So developing and providing educational and in-service training to the nurses on the alternative strategies, complications, and risks of physical restraint are important to strengthening the quality of nursing care for critically ill patients.

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