Pressure Ulcer Prevention in Critical Care: State of the Art

1990 ◽  
Vol 1 (3) ◽  
pp. 602-613 ◽  
Author(s):  
Connie Glavis ◽  
Susan Barbour
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Critically Ill Patient ◽  
Predictive Tool ◽  
Pressure Relief ◽  
Pressure Ulcer Prevention ◽  
Increased Risk ◽  
Ulcer Prevention

Prevention of pressure ulcers in the critically ill patient is a major responsibility of the critical care nurse. The authors review the causes of pressure ulcer development and the methods of identifying the patient at increased risk. Pressure relief strategies for use in critical care are presented, and currently available pressure reduction and relief devices are discussed. Because few research studies address pressure ulcer prevention in the critical care setting, future research in this area is needed to develop a reliable predictive tool for use with the critically ill patient. Level of risk needs to be linked with intervention to assist the nurse in managing the pressure relief options available in today’s market. In the meantime, prevention of pressure ulcers in critical care patients requires vigilance and the best use of available knowledge in the field

Pediatric Skin Failure

2017 ◽  
Vol 26 (4) ◽  
pp. 320-328 ◽  
Author(s):  
Katie E. Cohen ◽  
Matthew C. Scanlon ◽  
Amin Bemanian ◽  
Christine A. Schindler
Keyword(s):  
Critically Ill ◽  
Organ Dysfunction ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Pediatric Population ◽  
Critically Ill Children ◽  
Skin Injury ◽  
Pressure Ulcer Prevention ◽  
Skin Injuries ◽  
Ulcer Prevention

Background The phenomenon of skin failure as distinct from pressure ulcers has been documented in the adult literature. However, in the pediatric population, skin injury continues to be grouped indiscriminately as various types of pressure ulcers. Objective To identify and describe the phenomenon of skin failure in critically ill children. Methods Retrospective chart review of 19 patients who had serious skin injuries develop. Organ dysfunction scores, medications, pressure ulcer prevention techniques used, and laboratory values in the 7 days leading up to the development of a skin lesion were evaluated. Results At the start of the evaluation period, all patients (N = 19) had pressure ulcer prevention measures in place before the development of a serious skin injury. All of the skin lesions were full-thickness injuries on the day they were identified (as opposed to the more gradual progression from simple to complex skin injuries typically seen in pressure ulcers). As predicted, 18 of 19 patients had multiple organ dysfunction syndrome (MODS) in the week leading up to the skin injury. All patients with MODS had at least 2 dysfunctional systems, and 12 patients had 4 or more dysfunctional systems. Of the 19 patients, 8 (42%) progressed to death, compared with 1.8% in our general pediatric intensive care unit population. Conclusion Although the traditional paradigm is that pressure ulcers are preventable, a subset of pressure ulcers in critically ill children may actually represent acute skin failure as a consequence of MODS.

scholarly journals Povezave med razjedo zaradi pritiska in ohranjanjem integritete kože pacienta v intenzivni zdravstveni obravnavi: pregled literature

2015 ◽  
Vol 49 (4) ◽  
Author(s):  
Dragica Emeđi ◽  
Brigita Skela-Savič
Keyword(s):  
Critical Care ◽  
Quality Of Care ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Pressure Ulcer Prevention ◽  
Skin Integrity ◽  
Prevention And Treatment ◽  
Critical Care Patients ◽  
Ulcer Prevention

Uvod: Namen raziskave je prikazati večdimenzionalne potrebe in možne dejavnike tveganja za razjedo zaradi pritiska pri odraslih pacientih v intenzivni zdravstveni obravnavi. Metode: Uporabili smo analizo in sintezo pregleda dokazov iz zbirke podatkov EMERALD, CINAHL, PubMed in ProQuest. Ključne iskalne besedne zveze so bile: »quality of care«, »pressure ulcer«, »prevention and treatment of pressure ulcers«, »skin integrity critical care patients«. Omejitveni kriteriji iskanja so bili: obdobje 2010 do 2013, celotno besedilo člankov v angleščini. Začetna merila je izpolnjevalo 280 zadetkov in 40 izbranih ustreznih prispevkov. Potek raziskave je prikazan v skladu z načeli Cochranove zbirke, ocena kakovosti dokazov pa v hierarhiji dokazov. Rezultati: Identificiranih je 191 kod, ki so združene v 11 vsebinskih kategorij: okolje intenzivne terapije – značilnosti nekaterih dejavnikov tveganja, čas bivanja v enoti, vazoaktivne učinkovine, spol, starost, administrativno diagnostična kategorija, postelja, ležišče, lestvica Waterlow, razjeda zaradi pritiska in pomen prve stopnje razjede. Diskusija in zaključek: Raziskava pokaže pomen uvedbe proaktivnih ukrepov za ohranjanje integritete kože pacienta. Osredotoča se na vitalnost tkiva in promocijo kakovostne zdravstvene oskrbe z vidika teorije. Potrebne so raziskave, ki bi za boljše razumevanje pojasnjevale številna druga tveganja in učinkovite programe za vitalnost kože.

From the Cochrane Library: Foam surfaces for preventing pressure ulcers (Preprint)

2021 ◽  
Author(s):  
Yvonne Nong ◽  
Torunn Sivesind ◽  
Robert P. Dellavalle
Keyword(s):  
Systematic Review ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Cochrane Library ◽  
Cochrane Systematic Review ◽  
Pressure Ulcer Prevention ◽  
The Cochrane Library ◽  
Ulcer Prevention

UNSTRUCTURED This article summarizes an important Cochrane systematic review on the evidence of foam surfaces for pressure ulcer prevention.

Pressure Ulcer Prevention and Management

2002 ◽  
Vol 20 (1) ◽  
pp. 35-61 ◽  
Author(s):  
COURTNEY H. LYDER
Keyword(s):  
Pressure Ulcer ◽  
Applied Research ◽  
Pressure Ulcers ◽  
Pressure Ulcer Prevention ◽  
Randomized Control ◽  
Support Surfaces ◽  
The Cost ◽  
The Impact ◽  
Unpublished Research ◽  
Ulcer Prevention

This chapter reviews 218 published and unpublished research reports of pressure ulcer prevention and management by nurse researchers and researchers from other disciplines. The electronic databases MEDLINE (1966-July 2001), CINAHL (1982-June 2001), AMED (1985-July 2001), and El Compedex*Plus (1980-June 2001) were selected for the searches because of their focus on health and applied research. Moreover, evaluations of previous review articles and seminal studies that were published before 1966 are also included. Research conducted worldwide and published in English between 1930 and 2001 was included for review. Studies using descriptive, correlational, longitudinal, and randomized control trials were included. This review found that numerous gaps remain in our understanding of effective pressure ulcer prevention and management. Moreover, the majority of pressure ulcer care is derived from expert opinion rather than empirical evidence. Thus, additional research is needed to investigate pressure ulcer risk factors of ethnic minorities. Further studies are needed that examine the impact of specific preventive interventions (e.g., turning intervals based on risk stratification) and the cost-effectiveness of comprehensive prevention programs to prevent pressure ulcers. Finally, an evaluation is needed of various aspects of pressure ulcer management (e.g., use of support surfaces, use of adjunctive therapies) and healing of pressure ulcers.

scholarly journals Nurses’ knowledge and practices regarding prevention and management of pressure ulcer for hospitalized patient

2020 ◽  
Vol 6 (2) ◽  
pp. 237-243
Author(s):  
Hasan Mahfuz Reza ◽  
Chinmoy Kanti Das ◽  
China Rani Mittra ◽  
Ashees Kumar Saha
Keyword(s):  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Heart Diseases ◽  
Moderate Level ◽  
College Hospital ◽  
Pressure Ulcer Prevention ◽  
Level Of Knowledge ◽  
Knowledge And Practice ◽  
Ulcer Prevention ◽  
Nurses Knowledge

Pressure ulcers have been labelled as one of the most expensive and physically debilitating complications in the 20th century. After cancer and heart diseases pressure ulcers are the third most expensive disorder. Several studies have indicated that nurses' knowledge and practices about pressure ulcer prevention and management are inadequate. This is a descriptive co-relational study aimed to assess nurses‟ knowledge and practices related to pressure ulcer prevention and management. It also examines the relationships between nurses‟ knowledge and practice with respect to pressure ulcer prevention and management. The subjects were nurses working at Rajshahi Medical College Hospital. Three hundred nurses were selected for this study, two hundred and ninety four nurses were completed the questionnaire and response rate was 98%. Three tools were used for data collection: Demographic, Knowledge and Practice questionnaire. Data were analysed by descriptive and Pearson product-moment correlation statistics. The findings showed that nurses had a moderate level of knowledge and a moderate level of practice when we categorized the findings according to their age, working experience and educational level they scored low level of knowledge. There was a significant correlation was found between nurses knowledge and practice regarding pressure ulcer prevention and management (r =.136, p>.05). Findings of the present study suggest that nurses need to increase knowledge on pressure ulcer prevention and management in order to improve nursing practice in this. Asian J. Med. Biol. Res. June 2020, 6(2): 237-243

scholarly journals Nurses’ Knowledge, Practices, and Barriers in Care of Patients with Pressure Ulcers in a Ugandan Teaching Hospital

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ivan Mwebaza ◽  
Godfrey Katende ◽  
Sara Groves ◽  
Joyce Nankumbi
Keyword(s):  
Teaching Hospital ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Assessment Tools ◽  
Critical Parameters ◽  
Cross Sectional ◽  
Pressure Ulcer Prevention ◽  
Staff Shortage ◽  
Ulcer Prevention ◽  
Nurses Knowledge

Pressure ulcers have been identified as a major burden of hospitalization worldwide, and nurses are at the forefront of prevention. The purpose of this study was to determine the nurses’ knowledge and practices regarding risk factors, prevention, and management of pressure ulcers at a teaching hospital in Uganda. The study employed a descriptive cross-sectional design. Fifty-six Ugandan registered practicing nurses were sampled. A composite self-administered questionnaire and an observation checklist were utilized. The nurses had limited knowledge about critical parameters of pressure ulcers. Prevention practices were observed to be unreliable and uncoordinated related to a significant shortage of staff and logistics for pressure ulcer prevention. Nurses had poor access to current literature on pressure ulcer prevention. Translation of nurses’ knowledge into practice is possible if barriers like staff shortage, pressure relieving devices provision, and risk assessment tools are addressed at Mulago.

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