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Zhang J, Li W, Li Y, Ma M, Shang K. Evaluating the efficacy of standardized pressure ulcer management protocols in the prevention of pressure injuries among patients undergoing neurosurgical procedures. Int Wound J 2024; 21:e14879. [PMID: 38581264 PMCID: PMC10998278 DOI: 10.1111/iwj.14879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024] Open
Abstract
Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards-Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t-tests and chi-square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post-surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio-cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well-being in neurosurgical settings.
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Affiliation(s)
- Jing Zhang
- Department of Central Operating Room, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's HospitalZhengzhou University People's HospitalZhengzhouChina
| | - Wenxia Li
- Department of Central Operating Room, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's HospitalZhengzhou University People's HospitalZhengzhouChina
| | - Yanyan Li
- Department of Central Operating Room, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's HospitalZhengzhou University People's HospitalZhengzhouChina
| | - Man Ma
- Department of Central Operating Room, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's HospitalZhengzhou University People's HospitalZhengzhouChina
| | - Kun Shang
- Department of Central Operating Room, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's HospitalZhengzhou University People's HospitalZhengzhouChina
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Chen Y, Wang W, Qian Q, Zha Q, Wu B. Explore the effect of pressure and time of compression on the risk of intraoperatively acquired pressure injury based on theoretical framework: A prospective study. Int Wound J 2024; 21:e14809. [PMID: 38613408 PMCID: PMC11015468 DOI: 10.1111/iwj.14809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 04/14/2024] Open
Abstract
Surgery is a high risk factor for the occurrence of pressure injury (PI). On the basis of theoretical research, pressure and duration of pressure are key factors affecting PI. Pressure is affected by the individual pressure redistribution capacity. So our study aims to explore how the surgery time and pressure intensity affect the occurrence of PI and what are the risk factors. A prospective study. A total of 250 patients who underwent elective surgery in a grade-A general hospital from November 2021 to February 2023 were selected and divided into a group of 77 patients with IAPI (intraoperatively acquired pressure injury) and a group of 173 patients with no IAPI. Visual pressure inductive feedback system and body composition analysis technology were used to record the local pressure value and change of patients before and after anaesthesia. Relevant data of the patients were collected to explore the influencing factors. The maximum pressure and average pressure at the pressure site of the same patient changed before and after anaesthesia, and the pressure after anaesthesia was significantly higher than that before anaesthesia. There was no statistical difference in the average pressure after anaesthesia (p > 0.05), but the maximum pressure in the IAPI group was higher than that in the non-occurrence group (p < 0.05). The average pressure multiplied by the operation time in IAPI group is significantly higher than that in the non-IAPI group (p < 0.01). Multiple linear regression analysis (stepwise regression) showed that fat-free weight, age, waist circumference, body mass index (BMI) and gender were taken as independent variables into the regression model, affecting the maximum pressure. In addition, operation time ≥4 h may be a high risk factor for IAPI. In future studies, more objective research tools can be applied to improve the accuracy of predicting the risk of IAPI. In addition to gender and BMI, follow-up studies may consider including measures such as waist circumference and fat-free body weight in IAPI risk assessment to guide the clinical nursing work more scientifically.
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Affiliation(s)
- Yuan Chen
- Department of Nursing, Ruijin Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
| | - Wei Wang
- Department of Nursing, Ruijin Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
| | - QianJian Qian
- Department of Nursing, Ruijin Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
| | - Qinghua Zha
- Department of Nursing, Ruijin Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
| | - BeiWen Wu
- Department of Nursing, Ruijin Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
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Gao L, Yang L, Li X, Chen J, Du J, Bai X, Yang X. The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer. J Clin Nurs 2018; 27:2984-2992. [PMID: 29679411 DOI: 10.1111/jocn.14491] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To screen the factors of intraoperatively acquired pressure ulcer and establish a new risk assessment model of intraoperatively acquired pressure ulcer. DESIGN This is a prospective study. METHODS A total of 1,963 patients who received neurosurgery, orthopaedics, paediatric surgery and cardiac surgery therapy in Sichuan Academy of Medical Science and Provincial People's Hospital in China from October 2015-October 2016 were enrolled in the study, and their clinical parameters were collected. Multivariable logistic regression analysis and decision tree analysis were used to analyse and screen the factors of intraoperatively acquired pressure ulcer and establish the risk assessment model of intraoperatively acquired pressure ulcer. RESULTS The risk factors for intraoperatively acquired pressure ulcer included the application of external force during operation (β = 1.10, OR = 3.20), lean body mass (β = 1.08, OR = 2.95), time of operation ≥6 hr (β = 2.66, OR = 14.30), prone position operation (β = 1.13, OR = 3.10), cardiopulmonary bypass during operation (β = 1.72, OR = 5.59) and intraoperative blood loss (β = 0.67, OR = 1.95). The new risk assessment model showed that the AUC of ROC curve was 0.897 (p < .001). According to the maximum principle of Youden's index, the sensitivity, specificity and Youden's index J of the model were 0.81, 0.88 and 0.69, respectively, when the cut-off point was set at π = 0.025. CONCLUSIONS A new and relatively reliable assessment model for intraoperatively acquired pressure ulcer is established. RELEVANCE TO CLINICAL PRACTICE Pressure ulcers remain a challenge in clinical nursing. A new risk assessment model of pressure ulcers that is applicable to surgical patients is highly recommended.
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Affiliation(s)
- Ling Gao
- Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu, Sichuan, China
| | - Lina Yang
- Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu, Sichuan, China
| | - Xiaoqin Li
- Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu, Sichuan, China
| | - Jin Chen
- Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu, Sichuan, China
| | - Juan Du
- Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu, Sichuan, China
| | - Xiaoxia Bai
- Sichuan Academy of Medical Science and Provincial People's Hospital, Chengdu, Sichuan, China
| | - Xianjun Yang
- Department of Health Statistics, Prevention and Control Centre of Disease of Chengdu Military Command, Chengdu, Sichuan, China
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de Oliveira KF, Nascimento KG, Nicolussi AC, Chavaglia SRR, de Araújo CA, Barbosa MH. Support surfaces in the prevention of pressure ulcers in surgical patients: An integrative review. Int J Nurs Pract 2017. [PMID: 28643855 DOI: 10.1111/ijn.12553] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the scientific evidence about the types of support surfaces used in intraoperative surgical practice in the prevention of pressure ulcers due to surgical positioning. METHOD This is an integrative literature review. The electronic databases Cochrane, PubMed, Web of Science, Scopus, Lilacs, and CINAHL were used. The descriptors surgical patients, support surfaces, perioperative care, patient positioning, and pressure ulcer were used in the search strategy. Articles that addressed the use of support surfaces intraoperatively, published between 1990 and 2016, were selected. The PRISMA guidelines were used to structure the review. RESULTS Of 18 evaluated studies, most were in English, followed by Portuguese and Spanish; most were performed by nurses. The most commonly cited support surfaces were viscoelastic polymer, micropulse mattresses, gel based mattresses, and foam devices. CONCLUSION There are gaps in knowledge regarding the most efficient support surfaces and the specifications of the products used to prevent pressure ulcers due to surgical positioning.
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Spruce L, Van Wicklin SA. Back to basics: positioning the patient. AORN J 2015; 100:298-305. [PMID: 25172564 DOI: 10.1016/j.aorn.2014.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/09/2014] [Indexed: 11/24/2022]
Abstract
Positioning the surgical patient requires special attention from the entire surgical team because anesthetized or sedated patients are not able to reposition themselves when needed to relieve discomfort or alert team members of the need for repositioning. Perioperative nurses must pay attention to positioning details and the possibility of injury at all times during the patient's procedure. This includes assessing the patient's circulatory, respiratory, integumentary, musculoskeletal, and neurological structures to help ensure that the patient is properly positioned and safe from injury. Working as a member of the surgical team, the perioperative RN is key to speaking up when positioning issues need to be addressed and helping to minimize the risk of injury to the patient. This "Back to Basics" article discusses positioning the patient in the prone position.
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Gao XL, Hu JJ, Ma Q, Wu HY, Wang ZY, Li TT, Shen JH, Yang Y. Design and research on reliability-validity for 3S intraoperative risk assessment scale of pressure sore. ACTA ACUST UNITED AC 2015; 35:291-294. [DOI: 10.1007/s11596-015-1426-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 03/13/2015] [Indexed: 11/30/2022]
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Lumbley JL, Ali SA, Tchokouani LS. Retrospective review of predisposing factors for intraoperative pressure ulcer development. J Clin Anesth 2014; 26:368-74. [PMID: 25113424 DOI: 10.1016/j.jclinane.2014.01.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 12/30/2013] [Accepted: 01/10/2014] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE To evaluate the comorbidities and surgical factors involved in the genesis of intraoperative pressure ulcers. DESIGN Retrospective chart review. SETTING Anesthesiology department of a university medical center. MEASUREMENTS The charts of 222 patients with varying illness, who underwent an operation of at least two hours' duration, were analyzed retrospectively. Data on surgery type, case length, comorbidities, intraoperative surgical position, and area of ulceration were recorded. MAIN RESULTS Risk factors for intraoperative pressure ulcer development include surgical times of 4 hours or longer; comorbidities affecting tissue perfusion (namely, diabetes, hypertension, and nonspecific cardiac issues); supine placement during surgery; and abdominal, noncardiac thoracic, and orthopedic operations. Regions of the body most at risk for ulceration include the coccygeal/sacral region, the buttocks, genitalia, and heels. CONCLUSIONS Pressure ulcers are a costly, debilitating, and avoidable complication of surgery.
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Affiliation(s)
- Joshua L Lumbley
- Department of Anesthesiology, Ohio State Univeristy (OSU) Wexner Medical Center, Columbus, OH 43210-1267, USA.
| | - Syed A Ali
- Department of Anesthesiology, Ohio State Univeristy (OSU) Wexner Medical Center, Columbus, OH 43210-1267, USA; Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Loic S Tchokouani
- Department of Anesthesiology, Ohio State Univeristy (OSU) Wexner Medical Center, Columbus, OH 43210-1267, USA; Ohio State University College of Medicine, Columbus, OH 43210, USA
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Incidence and predicted risk factors of pressure ulcers in surgical patients: experience at a medical center in Taipei, Taiwan. BIOMED RESEARCH INTERNATIONAL 2014; 2014:416896. [PMID: 25057484 PMCID: PMC4099038 DOI: 10.1155/2014/416896] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/03/2014] [Accepted: 06/03/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To explore the context of incidence of and associated risk factors for pressure ulcers amongst the population of surgical patients. METHODS The initial study cohort was conducted with a total of 297 patients admitted to a teaching hospital for a surgical operation from November 14th to 27th 2006 in Taipei, Taiwan. The Braden scale, pressure ulcers record sheet, and perioperative patient outcomes free from signs and symptoms of injury related to positioning and related nursing interventions and activities were collected. RESULTS The incidence of immediate and thirty-minute-later pressure ulcers is 9.8% (29/297) and 5.1% (15/297), respectively. Using logistic regression model, the statistically significantly associated risk factors related to immediate and thirty-minute-later pressure ulcers include operation age, type of anesthesia, type of operation position, type of surgery, admission Braden score, and number of nursing intervention after adjustment for confounding factors. CONCLUSION Admission Braden score and number of nursing intervention are well-established protected factors for the development of pressure ulcers. Our study shows that older operation age, type of anesthesia, type of operation position, and type of surgery are also associated with the development of pressure ulcers.
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Nageswaran S, Vijayakumar R, Sivarasu S. Design Evaluation of an Automated Bed for Early Detection and Prevention of Decubitus Ulcers in Nonambulatory Patients1. J Med Device 2014. [DOI: 10.1115/1.4027025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sharmila Nageswaran
- School of Bio Sciences and Technology, VIT University, Vellore 632014, India
| | - Rekha Vijayakumar
- School of Bio Sciences and Technology, VIT University, Vellore 632014, India
| | - Sudesh Sivarasu
- MRC/MIRU—Division of Biomedical Engineering, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa e-mail:
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Valente PMD, Deva A, Ngo Q, Vickery K. The increased killing of biofilms in vitro by combining topical silver dressings with topical negative pressure in chronic wounds. Int Wound J 2014; 13:130-6. [PMID: 24712658 DOI: 10.1111/iwj.12248] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 01/31/2014] [Accepted: 02/03/2014] [Indexed: 12/23/2022] Open
Abstract
Chronic wounds remain a significant medical and financial burden in hospitals of today. A major factor in the transition from an acute to a chronic wound is its bacterial bioburden. Developments in molecular techniques have shown that chronic wounds remain colonised by many species of bacteria and that the bacteria within these chronic wounds exist in two forms. Treatments of chronic wounds have maintained a challenging field and significant ongoing research is being conducted. With the development of an in vitro wound model, we applied topical negative pressure (TNP) dressings to a spectrum of common bacterial biofilms found in chronic wounds and studied the synergistic efficacy between the application of TNP and silver-impregnated foam against these biofilms. This synergistic response was seen within the laboratory strains of staphylococcal biofilms over a 3-day treatment period but lost following the 5 days of treatment. However, combining topical pressure dressings and silver foam lead to a synergistic inactivation in Pseudomonas species over both 3-day and 5-day treatments.
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Affiliation(s)
| | - Anand Deva
- Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia
| | - Quan Ngo
- Department of Plastic and Reconstructive Surgery, Liverpool Hospital, Sydney, NSW, Australia
| | - Karen Vickery
- Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia
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Ursi ES, Galvão CM. Ocorrência de úlcera por pressão em pacientes submetidos a cirurgias eletivas. ACTA PAUL ENFERM 2012. [DOI: 10.1590/s0103-21002012005000023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Identificar a ocorrência de úlcera por pressão em pacientes submetidos a cirurgias eletivas de porte II, III e IV. MÉTODOS: Estudo de abordagem quantitativa, com delineamento de pesquisa não experimental, tipo descritivo e prospectivo. A amostra foi composta por 148 pacientes adultos, de ambos os gêneros, submetidos à cirurgia eletiva, conforme os critérios de seleção determinados previamente. RESULTADOS: Da amostra avaliada, 108 pacientes receberam alta hospitalar, três faleceram e 37 desenvolveram úlceras por pressão. Esses pacientes apresentaram 44 lesões, sendo a maioria diagnosticada de estágio II (56,8%), seguida por lesões de estágio I (40,9%) e estágio III (2,3%). As áreas corporais mais acometidas foram a região sacro/glútea (68,2%), calcâneos (18,1%), região dorsal (9%) e o pavilhão auricular (4,6%). CONCLUSÃO: A ocorrência de úlcera por pressão foi de 25% indicando a necessidade de implementação de intervenções efetivas para a prevenção desse evento adverso no perioperatório.
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Bulfone G, Marzoli I, Quattrin R, Fabbro C, Palese A. A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres. J Perioper Pract 2012; 22:50-6. [PMID: 22724304 DOI: 10.1177/175045891202200202] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To explore the incidence of intraoperative pressure sores, the associated risk factors and the preventive strategies adopted by nurses, we adopted a longitudinal study in a 900-bed teaching hospital with multiple operating theatres, located in the North of Italy. Patients who underwent major surgery were evaluated four times: at the moment of operating theatre admission, at operating theatre discharge, and on their third and sixth postoperative day. Of the patients included (n = 102) who had an average age of 62.3 years (range 20-87), 12.7% (13/102) developed a pressure ulcer in the operating theatre; 46.1% (6/13) of these ulcers were still present on the third postoperative day. Some health conditions (diabetes mellitus, cardiac diseases) and intra-operative factors (lying on the operating table for more than 6.15 hours, intraoperative hypothermia) are associated with the occurrence of pressure sores.
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Tschannen D, Bates O, Talsma A, Guo Y. Patient-specific and surgical characteristics in the development of pressure ulcers. Am J Crit Care 2012; 21:116-25. [PMID: 22381988 DOI: 10.4037/ajcc2012716] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Implementation of the ruling on the Inpatient Prospective Payment System by the Centers for Medicare and Medicaid has challenged nurses to focus on the prevention of pressure ulcers. Despite years of research, pressure ulcers are still one of the most common complications experienced by patients in health care facilities. OBJECTIVE To examine the relationship between patients' characteristics (age, sex, body mass index, history of diabetes, and Braden Scale score at admission) and care characteristics (total operating room time, multiple surgeries, and vasopressor use) and the development of pressure ulcers. METHODS In a cohort study, data from the electronic medical records of 3225 surgical patients admitted to a Midwest hospital, from November 2008 to August 2009 were analyzed statistically to determine predictors of pressure ulcers. RESULTS A total of 12% of patients (n = 383) had at least 1 pressure ulcer develop during their hospitalization. According to logistic regression analysis, scores on the Braden Scale at admission (P < .001), low body mass index (P < .001), number of vasopressors (P = .03), multiple surgeries during the admission (P < .001), total surgery time (P < .001), and risk for mortality (P < .001) were significant predictors of pressure ulcers. CONCLUSION Scores on the Braden Scale at admission can be used to identify patients at increased risk for pressure ulcers. For other high-risk factors, such as low body mass index and long operative procedures, appropriate clinical interventions to manage these conditions can help prevent pressure ulcers.
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Affiliation(s)
- Dana Tschannen
- Dana Tschannen is a clinical assistant professor and AkkeNeel Talsma is an assistant professor at University of Michigan, School of Nursing, Ann Arbor, Michigan. Ondrea Bates is a clinical manager at Oakwood Hospital and Medical Center, Dearborn, Michigan. Ying Guo was a doctoral student at the University of Michigan School of Public Health when the study was done; she is now a biometrician at Merck Research Laboratories, Merck & Co., Inc, Rahway, New Jersey
| | - Ondrea Bates
- Dana Tschannen is a clinical assistant professor and AkkeNeel Talsma is an assistant professor at University of Michigan, School of Nursing, Ann Arbor, Michigan. Ondrea Bates is a clinical manager at Oakwood Hospital and Medical Center, Dearborn, Michigan. Ying Guo was a doctoral student at the University of Michigan School of Public Health when the study was done; she is now a biometrician at Merck Research Laboratories, Merck & Co., Inc, Rahway, New Jersey
| | - AkkeNeel Talsma
- Dana Tschannen is a clinical assistant professor and AkkeNeel Talsma is an assistant professor at University of Michigan, School of Nursing, Ann Arbor, Michigan. Ondrea Bates is a clinical manager at Oakwood Hospital and Medical Center, Dearborn, Michigan. Ying Guo was a doctoral student at the University of Michigan School of Public Health when the study was done; she is now a biometrician at Merck Research Laboratories, Merck & Co., Inc, Rahway, New Jersey
| | - Ying Guo
- Dana Tschannen is a clinical assistant professor and AkkeNeel Talsma is an assistant professor at University of Michigan, School of Nursing, Ann Arbor, Michigan. Ondrea Bates is a clinical manager at Oakwood Hospital and Medical Center, Dearborn, Michigan. Ying Guo was a doctoral student at the University of Michigan School of Public Health when the study was done; she is now a biometrician at Merck Research Laboratories, Merck & Co., Inc, Rahway, New Jersey
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Scarlatti KC, Michel JLM, Gamba MA, Gutiérrez MGRD. Úlcera por pressão em pacientes submetidos à cirurgia: incidência e fatores associados. Rev Esc Enferm USP 2011; 45:1372-9. [DOI: 10.1590/s0080-62342011000600014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 07/11/2011] [Indexed: 11/21/2022] Open
Abstract
As úlceras por pressão constituem um dos principais indicadores da qualidade do cuidado na assistência perioperatória. Este é um estudo longitudinal, do tipo série de casos, com o objetivo de estimar a incidência de úlceras por pressão em pacientes submetidos a cirurgias de médio e grande portes; classificá-las segundo estágio e localização, verificar a associação das variáveis sexo, idade, índice de massa corpórea, comorbidades, posição cirúrgica, tempo cirúrgico, anestesia e uso de dispositivos de posicionamento com a presença ou ausência de úlceras por pressão. Os dados foram coletados em 2007, em São Paulo, com 199 pacientes, dos quais 20,6% apresentaram úlceras por pressão, 98,6% nos estágios I e II, com localização predominante no tronco frontal (35,1%). As variáveis: posição, tempo cirúrgico, anestesia geral e uso de dispositivos apresentaram associação estatística significativa. Concluiu-se que a incidência de úlceras por pressão em pacientes cirúrgicos é elevada, demandando ações que visem à redução desse tipo de lesão.
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Abstract
Following implementation of a programme to eradicate hospital-acquired pressure ulcers in one US hospital, prevalence fell from 9.5% in 2007 to zero in December 2008. Central to its success is that the programme was a management priority.
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Affiliation(s)
- I Bales
- Medical Center of Illinois, Peoria, Illinois, USA.
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Clinical Issues. AORN J 2008. [DOI: 10.1016/j.aorn.2008.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Denholm B, Downing D. Clinical Issues. AORN J 2008. [DOI: 10.1016/j.aorn.2008.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Prevention and Early Detection of Pressure Ulcers in Hospitalized Patients. J Wound Ostomy Continence Nurs 2008; 35:65-75; discussion 76-8. [DOI: 10.1097/01.won.0000308620.78884.88] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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King CA, Bridges E. Comparison of Pressure Relief Properties of Operating Room Surfaces. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.cpen.2006.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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