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Yoshino H, Takechi H. Clinical characteristics of older patients with suspected or diagnosed dementia during hospitalization. Geriatr Gerontol Int 2024; 24:641-645. [PMID: 38656668 DOI: 10.1111/ggi.14885] [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: 11/06/2023] [Revised: 03/13/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
AIM In Japan, an additional system for patients with suspected or diagnosed dementia during hospitalization for physical illness began in 2016. We examined the clinical characteristics of older patients with suspected or diagnosed dementia during hospitalization. METHODS The study participants consisted of 569 patients. Current age, sex, comorbidities, causative disease for admission, body mass index (BMI), blood tests, environment before admission, prescription history before admission and rate of delirium were examined. Simple regression analysis for high-frequency diseases was carried out with the respective risk factors as independent variables. Multiple regression analysis was then carried out. RESULTS Infection had the highest frequency in the causative diseases for admission. A total of 48% of patients had delirium during hospitalization. The delirium group had the highest frequency of being at home. In the infection group, BMI and serum albumin were lower in the non-infection group (BMI 19.0 ± 3.7 vs 20.4 ± 4.1; P < 0.001, albumin 2.1 ± 0.7 vs 3.3 ± 0.6 g/dL; P < 0.001 respectively). White blood cell count and C-reactive protein were higher than in the non-infection group, respectively (white blood cell count 11181.4 ± 6533.3 vs 8765.8 ± 111 424.3/μL; P = 0.007, C-reactive protein 8.6 ± 8.6 vs 3.0 ± 5.2 mg/dL; P < 0.001 respectively). Using independent factors associated with infection, multiple regression analysis was performed. BMI (P = 0.013), serum albumin (P < 0.001) and nursing home care before admission (P < 0.001) had significant correlations. CONCLUSIONS Assessment of delirium and the environment before admission of older patients with suspected or diagnosed dementia when hospitalized are necessary. Furthermore, evaluation of nutrition might also contribute to reducing deterioration due to physical illness. Geriatr Gerontol Int 2024; 24: 641-645.
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Affiliation(s)
- Hiroshi Yoshino
- Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hajime Takechi
- Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Japan
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2
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Mäki-Turja-Rostedt S, Leino-Kilpi H, Koivunen M, Vahlberg T, Haavisto E. Consistent pressure ulcer prevention practice: The effect on PU prevalence and PU stages, and impact on PU prevention-A quasi-experimental intervention study. Int Wound J 2022. [PMID: 36584884 DOI: 10.1111/iwj.14067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
This study evaluates the effect of nursing staff's renewed consistent pressure ulcer (PU) prevention practice on PU prevalence and the PU prevention implemented for residents. A quasi-experimental intervention study was conducted. The data were collected from 232 residents (n = 115 in intervention and 117 in comparison group) in two public long-term older people care (LOPC) facilities in Finland using the Pressure Ulcer Patient instrument (PUP-Instrument). The facilities were chosen with convenience sampling, after which they were randomly allocated as either intervention or comparison facility. Based on international guidelines for PU prevention, the renewed, consistent PU prevention practice with six areas was developed and implemented using the operational model for evidence-based practices (OMEBP). After the intervention, a significant difference between the intervention and the comparison facility was seen in the prevalence of PUs and in the residents' highest stage of PUs in the sacrum, buttock and hip areas, and heels. Between the facilities, a significant difference was seen in the use of PU and nutrition risk assessment instruments and nutritional supplements, time used for repositioning in the daytime and at night-time, lifting belt use, and avoiding shearing or stretching residents' skin. The successful intervention improved skin integrity in LOPC facilities.
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Affiliation(s)
- Sirpa Mäki-Turja-Rostedt
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Central Hospital, Pori, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Marita Koivunen
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
| | - Tero Vahlberg
- Turku University Hospital, Turku, Finland.,Department of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland
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3
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Mobayen M, Karkhah S, Bagheri P, Feizkhah A, Moghadam MT, Mohmmadnia H, Sadeghi M. Hospital-acquired Pressure Ulcers in Trauma Patients: A Retrospective Study of 410 Patients at a Referral Trauma Center in the North of Iran. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2209200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background:
Pressure ulcers (PUs) are among the most common chronic ulcers and complications of hospitalization.
Objective:
The present study aims to evaluate the prevalence of hospital-acquired PUs and their grades in trauma patients, comparing demographic characteristics, clinical features, and outcomes among patients without and with PUs referred to a trauma center in the North of Iran.
Methods:
In a retrospective study, 410 patients with trauma referred to a trauma center in the North of Iran were enrolled. Data were collected using a simple random sampling from March 2019 to September 2019.
Results:
The prevalence of PU in patients with trauma was 27.6%. Grade III (35.5%) and grade I (3.5%) wounds had the highest and lowest frequency of PU, respectively (P<0.001). The mean age of patients with PU was higher than patients without PU (61.73 vs. 47.71 years, P<0.001). The mean hemoglobin level of patients with PU was lower than patients without PU (9.93 vs. 12.25, P<0.001). PUs were more common in smokers compared to non-smokers (P<0.001), with a history of PU (P<0.001), a history of diabetes mellitus (P<0.001), and a history of hypertension (P<0.001). The mean length of stay in the hospital for patients with PU was higher than for patients without PU (13.02 vs. 5.54 days, P<0.001). 74.3% of people with PUs were completely immobile (P<0.001), and 60% of them had mild brain damage (GCS of 13 to 15). Also, the number of people with severe and moderate brain injury among PUs patients was 15% and 24.7%, respectively (P<0.001). Mobility, brain damage, Hemoglobin rate and smoking status were risk factors for pressure ulcers.
Conclusion:
Therefore, it is recommended that health managers and policymakers develop care and treatment plans by considering these risk factors.
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Shao R, Du T, Zhang Y, Li Y, Zhang Q. The effectiveness of drugs combined with individualized management for elderly patients with stage III pressure ulcers. J Cosmet Dermatol 2022; 21:5984-5989. [PMID: 35980648 DOI: 10.1111/jocd.15312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/28/2022] [Accepted: 08/13/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To explore the effect of drugs in combination with individualized management for elderly patients with stage III pressure ulcers. METHODS Sixty patients with stage III pressure sores at our hospital from August 2017 to December 2019 were selected as research subjects. The patients were equally divided between the study group (n = 30) and the control group (n = 30) by the random number table method. All enrolled patients received drug treatment, silver ion alginate and hydrocolloid and foam dressings once every 3 days, according to the patient's wound condition to shorten the healing time. After necrotic tissue and wounds were washed with normal saline, a silver ion alginate dressing was applied and the dressing was changed once a day. The study group had individualized management based on the above drug treatment as well as exercise, nutrition, and psychological management. The pressure ulcer scale for healing (PUSH) score and changes in the pressure ulcer area were compared between the two groups before treatment, at 1, 3, and 5 weeks of treatment. The wound healing rate was then calculated. RESULTS With the progress of treatment time, the PUSH scores and pressure ulcer areas in both groups showed a significantly decreasing trend, and the wound healing rate was significantly increased (p < 0.05). The study group's PUSH scores and pressure ulcer areas were significantly lower when compared with the control group (p < 0.05) after one, three, and 5 weeks of treatment. The wound healing rate of the study group at three and 5 weeks was significantly faster than the control group (p < 0.05). CONCLUSION Based on drug therapy (silver ion alginate, hydrocolloid dressing, and foam dressing) combined with individualized exercise, nutrition, and psychological management, older patients with stage III pressure ulcers had improved therapeutic wound healing.
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Affiliation(s)
- Rui Shao
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - TingTing Du
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - YongQiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Yan Li
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
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5
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Andersson J, Imberg S, Rosengren K. Documentation of pressure ulcers in medical records at an internal medicine ward in university hospital in western Sweden. Nurs Open 2022; 10:1794-1802. [PMID: 36303218 PMCID: PMC9912387 DOI: 10.1002/nop2.1439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/10/2022] [Accepted: 10/09/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Pressure ulcers cause suffering, prolong care periods, and increase mortality. The aim was to describe and analyze the documentation of pressure ulcers and focused on the medical records from an internal medicine ward in a university hospital in western Sweden. METHODS A quantitative, retrospective review of medical records was conducted for all care events (n = 1,458) with descriptive statistics. RESULTS Documentation of the pressure ulcers in care plans was 2.1% (n = 31) compared to 6.7 % (n = 46) within final notes written by registered nurses (RN), a lower result compared to PPM (n = 3/14, 21.4%). Risk assessments were carried out in 68 (4.7%) care events, and 31 care plans included pressure ulcers. Moreover, 198 cases of tissue damage were documented, 43 (21.7%) defined as pressure ulcers, the other 147 (74.2%) lacked definition. CONCLUSIONS Differences (2.1%-21.4%) highlight improvements; knowledge and communication of pressure ulcers ensure reliable documentation in medical records.
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Affiliation(s)
- Julia Andersson
- Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Sara Imberg
- Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Kristina Rosengren
- Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Centre for Person‐centred Care (GPCC), Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Internal MedicineSahlgrenska University HospitalMölndalSweden
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6
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Sari SP, Everink IHJ, Lohrmann C, Amir Y, Sari EA, Halfens RJG, Beeckman D, Schols JMGA. Development and psychometric evaluation of an instrument to assess Knowledge, Attitude and Practice of Family Caregivers at Preventing Pressure Injuries (KAP-PI) in Indonesian community-dwelling older adults. BMC Nurs 2022; 21:222. [PMID: 35948976 PMCID: PMC9367027 DOI: 10.1186/s12912-022-00957-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background The prevalence of pressure injuries among community-dwelling older adults in countries worldwide is still a serious problem. In Indonesia, older adults mostly rely on family members for (medical) care. Therefore, involving family members in the prevention and treatment of pressure injuries (PIs) could potentially decrease its prevalence rates. However, family members are usually not trained for such tasks. Hence, it is essential to first get more insight into the current state of affairs on family members’ knowledge, attitude and actual practice of preventing PIs. Due to the lack of an existing instrument to measure knowledge, attitude and practice of family caregivers in preventing PIs, this study focuses on the development and evaluation of psychometric properties of such an instrument. Methods Three phases of instrument development and evaluation were used, including item generation, instrument construction and psychometric testing of the instrument. A total of 372 family caregivers of community-dwelling older adults who randomly selected participated in this study. Principal factor analysis, confirmatory factor analysis and Cronbach’s alpha were performed to evaluate factor structure and internal consistency of the Knowledge, Attitude and Practice of Family Caregivers at Preventing Pressure Injuries (KAP-PI) instrument. Results The final version of the KAP-PI-instrument consists of a 12-item knowledge domain, a 9-item attitude domain, and a 12-item practice domain with Cronbach’s Alpha values of 0.83, 0.93 and 0.89, respectively. The instrument appeared to be both reliable and valid. Conclusion The KAP-PI instrument can be used in family nursing or community nursing practice, education, and research to assess knowledge, attitude and practice of pressure injury prevention of family caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00957-4.
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Affiliation(s)
- Sheizi Prista Sari
- Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Sumedang KM. 21 Jatinangor, Bandung, West Java, Indonesia. .,Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands.
| | - Irma H J Everink
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
| | - Christa Lohrmann
- Department of Nursing Science, Medical University of Graz, Graz, Austria
| | | | - Eka Afrima Sari
- Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Sumedang KM. 21 Jatinangor, Bandung, West Java, Indonesia
| | - Ruud J G Halfens
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden.,School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,School of Nursing and Midwifery, Monash University, Clayton, Australia
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, The Netherlands.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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7
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Amini M, Mansouri F, Vafaee K, Janbakhsh A, Mahdavikian S, Moradi Y, Fallahi M. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: Retrospective cohort study. Int Wound J 2022; 19:2039-2054. [PMID: 35322547 PMCID: PMC9111574 DOI: 10.1111/iwj.13804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
The pandemic of coronavirus (COVID‐19) has significantly increased the admission of patients with extensive complications, especially for respiratory support, to intensive care units (ICUs) worldwide. These patients also suffer from pressure ulcers (PUs) as another complication that occurs due to increased length of hospitalisation and acute conditions of patients. Therefore, this study aimed to evaluate the incidence and prevalence of PU and the factors affecting it in COVID‐19 patients admitted to ICUs. This cohort retrospective study used registry data in Imam Reza Hospital located in west of Iran. Four hundred and forty‐five COVID‐19 patients older than 20 years hospitalised in corona ICUs from 20 March 2020 to 30 December 2020, with a Braden score of less than 14 were included in the study. To investigate the relationship between variables in rate prevalence, univariate logistic regression analysis was used to calculate odds ratio, and for incidence rate in estimating PU risk generated in ICUs, hazard ratio was calculated using cox regression. One hundred and eighty‐three (41.12%) patients were male. The mean age of patients was 63 (SD = ±9.78) years. A total of 1152 cases of PU were generated, with the highest prevalence of PU with 234 cases in the sacrum. One hundred and seventy‐six (55.87%) patients underwent non‐invasive ventilation ulcers. The prevalence of PU was 79.7%. The highest prevalence was found in people over 80 years with 90.67%. The incidence ratio was 46.74%. The highest number of new cases was seen in diabetic patients with 60.96%. First‐degree ulcers were the most common degree of ulceration in 252 (55.38%) patients. Incidence and prevalence excluding first‐degree wounds were 24.04% and 49.66%, respectively. Age, Braden score, BMI, comorbidity, diabetes mellitus, stool incontinence, Glasgow coma scale, vasopressor, and length of hospital stay were significantly associated with PU (P < .05). The incidence and prevalence of PU in patients were high in this study. The length of hospitalisation and Braden score were the most important factors in the development of PU. The widespread prevalence of COVID‐19 and the relatively long stay of patients in the ICU created unfavourable conditions for patients and the treatment system, therefore, it emphasised the use of appropriate measures to prevent PU to avoid double costs and longer stays.
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Affiliation(s)
- Mahin Amini
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Feizollah Mansouri
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kamran Vafaee
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Somayeh Mahdavikian
- Nursing Department, Nursing and Midwifery School, Kermanshah University of Medical Sciences Sciences, Kermanshah, Iran
| | - Yasaman Moradi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Fallahi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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López M, Fernández-Castro M, Martín-Gil B, Muñoz-Moreno MF, Jiménez JM. Auditing completion of nursing records as an outcome indicator for identifying patients at risk of developing pressure ulcers, falling, and social vulnerability: An observational study. J Nurs Manag 2022; 30:1061-1068. [PMID: 35266605 DOI: 10.1111/jonm.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/23/2022] [Accepted: 02/20/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the completion of nursing records through scheduled audits to analyse risk outcome indicators. BACKGROUND Nursing records support clinical decision-making and encourage continuity of care, hence the importance of auditing their completion in order to take corrective action where necessary. METHOD This was an observational descriptive study carried out from February to November 2020 with a sample of 1131 electronic health records belonging to patients admitted to COVID-19 hospital units during three observation periods: pre-pandemic, first wave, and second wave. RESULTS A significant reduction in nursing record completion rates was observed between pre-pandemic period and first and second waves: Braden scale 40.97%, 28.02%, and 30.99%; Downton scale: 43.74%, 22.34%, and 33.91%; Gijón scale: 40.12%, 26.23%, and 33.64% (p < 0.001). There was an increase in the number of records completed between the first and second waves following the measures adopted after the quality audit. CONCLUSIONS The use of scheduled audits of nursing records as quality indicators facilitated the detection of areas for improvement, allowing timely corrective actions. IMPLICATIONS FOR NURSING MANAGEMENT Support from nursing managers at health care facilities to implement quality assessment programmes encompassing audits of clinical record completion will encourage the adoption of measures for corrective action.
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Affiliation(s)
- María López
- Nursing Faculty, University de Valladolid, Valladolid, Spain
| | | | - Belén Martín-Gil
- Department of Nursing Care Information Systems, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María Fe Muñoz-Moreno
- Research Support Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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9
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Kwak C, Ko Y. Influencing factors of pressure injury healing in an acute care setting: A retrospective cohort study. J Tissue Viability 2021; 31:152-157. [PMID: 34758923 DOI: 10.1016/j.jtv.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
AIM This study aimed to investigate the factors that influence healing during acute care hospitalization by examining the differences in pressure injury (PI) status between admission and discharge. MATERIAL AND METHODS A total of 371 patients who met the study's inclusion criteria were divided into two groups (aggravated or improved) based on the PI status observed at admission and discharge. We used bivariate analyses to compare demographics and clinical factors associated with wound severity and aggravation/improvement of wound condition. Using multiple logistic regression, we identified and examined independent predictors for significant association with aggravation/improvement of the wound status. RESULTS The prevalence rate of PI at acute hospital admission was 12.5%. By the time of discharge, only 5.4% of PI patients had improved PI, whereas 12.6% had aggravated PI. The significant aggravating factors of PI during acute care hospitalization were the patient's consciousness level, use of foley catheter, creatinine level, and Braden Scale scores (p < .05). Residential place prior to admission were found to be associated with the healing. CONCLUSIONS Nurses providing prophylactic management require close attention to patients who are admitted from long-term facilities to prevent aggravation of PI during acute care hospitalization.
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Affiliation(s)
- Chanyeong Kwak
- School of Nursing, Hallym University, Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, South Korea.
| | - Young Ko
- College of Nursing, Gachon University, 191 Hambakmoeiro, Yeonsu-Gu, Incheon, 21936, Republic of Korea.
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10
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Dube A, Sidambe V, Verdon A, Phillips E, Jones S, Lintern M, Radford M. Risk factors associated with heel pressure ulcer development in adult population: A systematic literature review. J Tissue Viability 2021; 31:84-103. [PMID: 34742635 DOI: 10.1016/j.jtv.2021.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/29/2021] [Accepted: 10/22/2021] [Indexed: 12/01/2022]
Abstract
AIMS The main aim of this systematic literature review was to identify risk factors for development of heel pressure ulcers and quantify their effect. BACKGROUND Pressure ulcers remain one of the key patient safety challenges across all health care settings and heels are the second most common site for developing pressure ulcers after the sacrum. DESIGN Quantitative systematic review. METHODS Data sources: Electronic databases were searched for studies published between 1809 to March 2020 using keywords, Medical Subject Headings, and other index terms, as well as combinations of these terms and appropriate synonyms. STUDY ELIGIBILITY CRITERIA Previous systematic literature reviews, cohort, case control and cross-sectional studies investigating risk factors for developing heel pressure ulcers. Only articles published in English were reviewed with no restrictions on date of publication. PARTICIPANTS patients aged 18 years and above in any care setting. Study selection, data extraction, risk of bias and quality assessment were completed by two independent reviewers. Disagreements were resolved by discussion. RESULTS Thirteen studies met the eligibility criteria and several potential risk factors were identified. However, eligible studies were mainly moderate to low quality except for three high quality studies. CONCLUSIONS There is a paucity of high quality evidence to identify risk factors associated with heel pressure ulcer development. Immobility, diabetes, vascular disease, impaired nutrition, perfusion issues, mechanical ventilation, surgery, and Braden subscales were identified as potential risk factors for developing heel pressure ulcers however, further well-designed studies are required to elucidate these factors. Other risk factors may also exist and require further investigation. PROSPERO ID PROSPERO International prospective register of systematic reviews: CRD42017071459.
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Affiliation(s)
- Alisen Dube
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK; School of Health, Science, and Wellbeing, Staffordshire University, Staffordshire, UK; University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK.
| | - Viola Sidambe
- University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Amy Verdon
- University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Sarahjane Jones
- School of Health, Science, and Wellbeing, Staffordshire University, Staffordshire, UK
| | - Maxine Lintern
- Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - Mark Radford
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK; Health Education England, Birmingham, UK; NHS England and NHS Improvement, Birmingham, UK
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11
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The Impact of COVID-19 on Levels of Adherence to the Completion of Nursing Records for Inpatients in Isolation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111262. [PMID: 34769780 PMCID: PMC8583626 DOI: 10.3390/ijerph182111262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. AIM To describe the impact of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing pressure ulcers, falling, and social vulnerability among hospitalised patients in isolation. METHODS Observational pre-post comparison study. Comparison between nursing records (the Braden, Downton, and Gijón scales) belonging to 1205 inpatients took place in two phases. Phase 1: 568 patients admitted in February 2020, prior to the COVID-19 pandemic, vs. phase 2: 637 patients hospitalised with COVID-19 in March-April 2020, during the peak of the first wave of the pandemic. This research adheres to the STROBE guidelines for the reporting of observational studies. RESULTS The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 vs. phase 1 (p < 0.001). The mean Downton and Gijón scale scores for patients admitted in phase 1 were higher compared to those of patients admitted in phase 2 (p < 0.001). The mean Braden scale score in phase 2 was higher than in phase 1 (p < 0.05). CONCLUSION During the COVID-19 pandemic, there was a decrease in the completion of nursing records in the clinical records of patients in isolation. The levels of risk of developing PUs, falling, and social vulnerability of patients admitted to hospital were lower during the first wave of the pandemic.
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12
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Tervo-Heikkinen TA, Heikkilä A, Koivunen M, Kortteisto TR, Peltokoski J, Salmela S, Sankelo M, Ylitörmänen TS, Junttila K. Pressure injury prevalence and incidence in acute inpatient care and related risk factors: A cross-sectional national study. Int Wound J 2021; 19:919-931. [PMID: 34605185 PMCID: PMC9013578 DOI: 10.1111/iwj.13692] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 02/02/2023] Open
Abstract
The aim of this national cross‐sectional study was to explore the prevalence of pressure injuries and incidence of hospital‐acquired pressure injuries, and the relating factors in somatic‐specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow‐up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital‐acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital‐acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital‐acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals.
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Affiliation(s)
| | - Anniina Heikkilä
- Group Administration, Nursing, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marita Koivunen
- Research and Development Unit, Satakunta Hospital District, Pori, Finland.,University of Turku, Turku, Finland
| | | | - Jaana Peltokoski
- Administration Services, Central Finland Health Care District, Jyväskylä, Finland
| | - Susanne Salmela
- Unit of Research and Development, Vaasa Central Hospital, Vaasa, Finland
| | - Merja Sankelo
- University of Turku, Turku, Finland.,Department of Nursing Administration, Hospital District of South Ostrobothnia, Seinäjoki, Finland
| | - Tuija Sinikka Ylitörmänen
- Health and Welfare, Strategic support services, Development and operations, South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Kristiina Junttila
- University of Turku, Turku, Finland.,Nursing Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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13
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Tuz MA, Mitchell A. The influence of anaemia on pressure ulcer healing in elderly patients. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S32-S38. [PMID: 34379458 DOI: 10.12968/bjon.2021.30.15.s32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Anaemia is a common and multifactorial blood disorder in elderly individuals. This condition may be a significant barrier to pressure ulcers healing as it is associated with a decreased level of oxygen being supplied to body tissues. Some nutritional deficiencies such as iron, vitamin B12 and folate may also cause anaemia and have a negative impact on pressure ulcer healing. An increased iron demand in hard-to-heal pressure ulcers is a significant factor associated with the risk of anaemia of chronic disease in elderly patients. Anaemia screening and correction may need to be considered as well as iron supplementation if required in pressure ulcer prevention and management.
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Affiliation(s)
| | - Aby Mitchell
- Senior Lecturer, Adult Nursing, University of West London
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14
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Su S, Ding X, Zou H, Lin Y, Huang J, Xiong D, Kuan J, Zhang Y, Xie R. Wound Management of Multi-Site Pressure Ulcer at Different Stages in Elderly Patients. Clin Cosmet Investig Dermatol 2021; 14:747-751. [PMID: 34234500 PMCID: PMC8254520 DOI: 10.2147/ccid.s316694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022]
Abstract
Objective The present study aims to explore the individualized treatment options for multisite pressure ulcer (PU) at various stages in elderly patients with multiple medical conditions. Methods Stages 1 and 2 PU at 146 sites were treated with closed negative pressure suction combined with continuous micro-oxygen perfusion and the local application of foam dressings, silver ion dressings, and moist burn cream. Stages 3 and 4 PU in the sacrococcygeal region were treated with skin or myocutaneous flap transplantation. Results Stages 1 and 2 PU healed after treatment with closed negative pressure suction combined with continuous micro-oxygen perfusion and dressing changes. One case died during hospitalization due to an illness. Skin or myocutaneous flap repair was conducted in 34 cases of stage 3 or 4 PU in the sacrococcygeal area. Of these cases, 28 achieved primary healing, and 6 required two or three surgeries, 5 of which received micro-skin implantation. In addition, 10 small deep PU at other sites were repaired by direct excision and suturing or local flap repair. Seven cases were transferred to other departments or hospitals due to concomitant diseases or were discharged automatically without surgical treatment. Conclusion Home care for geriatric patients is difficult. PU often occur at multiple sites because of the duration of various pressures, and different sites may demonstrate different stages because of varying degrees of pressure. When actively treating stages 3 and 4 PU, the trauma management of stages 1 and 2 PU should not be neglected.
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Affiliation(s)
- Shunqing Su
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Xiumei Ding
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Huijuan Zou
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Yuechun Lin
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Jianmin Huang
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Disheng Xiong
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Jinan Kuan
- Department of Burn&Plast, Dalang Hospital of Dongguan, Dongguang, Guangdong, 523780, People's Republic of China
| | - Yanhong Zhang
- Department of Wound Repair, Hongmei Hospital of Dongguan, Dongguang, Guangdong, 523160, People's Republic of China
| | - Rurong Xie
- Department of Wound Repair, Hongmei Hospital of Dongguan, Dongguang, Guangdong, 523160, People's Republic of China
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15
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Drerup C, Ullrich N, Schlarb D. Dekubitusdeckung durch eine gluteale Lappenplastik mit deepithelialisiertem Hautanker. J Dtsch Dermatol Ges 2021; 19:790-792. [PMID: 33979065 DOI: 10.1111/ddg.14461_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nora Ullrich
- Klinik für Hautkrankheiten, Universitätsklinikum Münster
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16
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Song J, Gao Y, Yin P, Li Y, Li Y, Zhang J, Su Q, Fu X, Pi H. The Random Forest Model Has the Best Accuracy Among the Four Pressure Ulcer Prediction Models Using Machine Learning Algorithms. Risk Manag Healthc Policy 2021; 14:1175-1187. [PMID: 33776495 PMCID: PMC7987326 DOI: 10.2147/rmhp.s297838] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose Build machine learning models for predicting pressure ulcer nursing adverse event, and find an optimal model that predicts the occurrence of pressure ulcer accurately. Patients and Methods Retrospectively enrolled 5814 patients, of which 1673 suffer from pressure ulcer events. Support vector machine (SVM), decision tree (DT), random forest (RF) and artificial neural network (ANN) models were used to construct the pressure ulcer prediction models, respectively. A total of 19 variables are included, and the importance of screening variables is evaluated. Meanwhile, the performance of the prediction models is evaluated and compared. Results The experimental results show that the four pressure ulcer prediction models all achieve good performance. Also, the AUC values of the four models are all greater than 0.95. Besides, the comparison of the four models indicates that RF model achieves a higher accuracy for the prediction of pressure ulcer. Conclusion This research verifies the feasibility of developing a management system for predicting nursing adverse event based on big data technology and machine learning technology. The random forest and decision tree model are more suitable for constructing a pressure ulcer prediction model. This study provides a reference for future pressure ulcer risk warning based on big data.
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Affiliation(s)
- Jie Song
- Medical School of Chinese PLA, Beijing, People's Republic of China
| | - Yuan Gao
- First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Pengbin Yin
- Fouth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yi Li
- Medical School of Chinese PLA, Beijing, People's Republic of China
| | - Yang Li
- First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jie Zhang
- Sixth Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Qingqing Su
- Medical School of Chinese PLA, Beijing, People's Republic of China
| | - Xiaojie Fu
- First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hongying Pi
- Medical Service Training Center, Chinese PLA General Hospital, Beijing, People's Republic of China
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17
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Drerup C, Ullrich N, Schlarb D. Coverage of sacral decubital ulcer with a gluteal rotation flap and anchored deepithelialized tip. J Dtsch Dermatol Ges 2021; 19:790-792. [PMID: 33617146 DOI: 10.1111/ddg.14461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Nora Ullrich
- Klinik für Hautkrankheiten, Universitätsklinikum Münster
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18
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Yang KL, Chen L, Kang YY, Xing LN, Li HL, Cheng P, Song ZH. Identification of risk factors of developing pressure injuries among immobile patient, and a risk prediction model establishment: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e23640. [PMID: 33350742 PMCID: PMC7769295 DOI: 10.1097/md.0000000000023640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUD Pressure injuries (PIs) bring a considerable physical and mental burden on immobile patients, and have put families and government under tremendous pressure to cover the cost of treatment. Therefore, this protocol proposes to identify risk factors of developing PIs in immobile patients from systematic reviews (SRs) and clinical practice guidelines (CPGs), in order to establish a risk prediction model for developing PIs and identify individual risk factors that can be modified to aid prevention. METHODS Electronic databases and specific databases for CPGs and SRs will be searched. Study selection and data collection will be performed independently by two reviewers. All included SRs and CPGs will be subject to critical appraisal. RevMan 5.3 will be used to calculate the pooled odds ratio (ORP) after appraising the quality of eligible studies, and the risk predictive model will be established using logistic regression model. A narrative synthesis, evidence summary table, and Sankey diagram will also be performed. RESULTS The results of this study will be submitted to a peer-reviewed journal for publication. CONCLUSION This systematic review will provide a risk prediction model of PI developing. INSPLAY REGISTRATION NUMBER INPLASY2020100097.
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Affiliation(s)
- Ke-Lu Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University
| | - Lin Chen
- Gansu trauma Orthopedic hospital
| | - Ying-Ying Kang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou
| | - Li-Na Xing
- School of Basic Medical Sciences, Lanzhou University, Lanzhou
| | | | - Peng Cheng
- Department of Orthopaedics, the Second Hospital of Lanzhou University
| | - Zong-Hui Song
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
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19
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Shiferaw WS, Aynalem YA, Akalu TY. Prevalence of pressure ulcers among hospitalized adult patients in Ethiopia: a systematic review and meta-analysis. BMC DERMATOLOGY 2020; 20:15. [PMID: 33160351 PMCID: PMC7649003 DOI: 10.1186/s12895-020-00112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/30/2020] [Indexed: 12/02/2022]
Abstract
Background Globally, PUs are recognized as one of the five most frequent causes of harm to clients. With millions affected globally, the national pooled prevalence of pressure ulcers in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to determine the prevalence of pressure ulcers among hospitalized clients in Ethiopia. Methods Studies were retrieved through search engines in PubMed, Scopus, WHO Afro Library, Google Scholar, Africa Journals Online, and Web of Science. Heterogeneity between-studies were checked using the I2 test. A funnel plot and Egger’s regression test was used to assess the presence of publication bias. The random-effect model was fitted to estimate summary effects and 95% confidence intervals (CIs) across studies. The analyses were performed using STATA™ Version 14 software. Results The pooled prevalence of pressure ulcer in Ethiopia was assessed using seven studies involving a total of 1881 participants. The pooled prevalence of pressure ulcers in Ethiopia was 11.7% (95% CI: 7.28, 16.13). The subgroup analysis showed that the estimated magnitude of pressure ulcers was 15.89% (95% CI: 13.32, 18.46); among studies, their sample size was greater than or equal to 250. Conclusion The current review reported that the pooled prevalence of pressure ulcers in Ethiopia was relatively high. Hence, policymaker and healthcare providers should give attention to reduce the magnitude of pressure ulcers. Furthermore, further a meta-analysis study could be conducted to identify individual and health care service-related factors related to the occurrence of pressure ulcers.
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Affiliation(s)
| | - Yared Asmare Aynalem
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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20
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Silva DPD, Cruz EDDA, Batista J, Maurício AB, Nazário SDS, Silva GPD. Risk of pressure injury among users of emergency care units. Rev Gaucha Enferm 2020; 41:e20190334. [PMID: 33111826 DOI: 10.1590/1983-1447.2020.20190334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To identify the risk of pressure injury in patients of emergency care units. METHOD Descriptive, cross-sectional, and quantitative by applying the Braden scale to 377 patients from eight units in Paraná, between April and September 2016. Descriptive statistics and Spearman's correlation were used, with a significance of 0.1% for analysis. RESULTS There was a prevalence of risk-free patients (64.5%; n=243) and of older adults (54.6%; n=206); those at high risk for pressure injury were in the emergency department. Most of the variables were preserved, with emphasis on sensory perception (65.3%; n=246). The Spearman's correlation coefficient was at least 0.93 and indicated a strong linear relation between the results obtained in the variables and in the scale; it was verified that the risk for pressure injury increases with age. CONCLUSIONS Most of the patients were not at risk; however, the older adults and those treated in the emergency department were at high risk of developing pressure injuries.
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Affiliation(s)
| | | | - Josemar Batista
- Universidade Federal do Paraná (UFPR), Departamento de Enfermagem. Curitiba, Paraná, Brasil
| | - Aline Batista Maurício
- Universidade Federal do Paraná (UFPR), Departamento de Enfermagem. Curitiba, Paraná, Brasil
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21
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Neutrophil to lymphocte ratio and mean platelet volume may predict the development of the pressure ulcers. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.739227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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22
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López-Franco MD, Parra-Anguita L, Comino-Sanz IM, Pancorbo-Hidalgo PL. Development and Psychometric Properties of the Pressure Injury Prevention Knowledge Questionnaire in Spanish Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093063. [PMID: 32354041 PMCID: PMC7246611 DOI: 10.3390/ijerph17093063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 02/07/2023]
Abstract
Pressure injuries (PIs) are a major health problem with severe implications for patients. Professionals who care for people at risk should have high knowledge about PIs prevention. The actual knowledge can be measured using different tools, but we have found no questionnaire to measure the knowledge on PIs prevention developed and validated for Spanish-speaking countries. The aim of this study was to develop a questionnaire in Spanish to measure the knowledge about PIs prevention based on current international guidelines. Content validity was evaluated by 12 experts in wound care. A convenience sample of 438 nursing professionals from Spain participated to evaluate the questionnaire using item analysis, Rasch model, and known-groups validity. The PI Prevention Knowledge (PIPK) questionnaire shows good discrimination and difficulty indices. The 31-item PIPK shows good fit and reliability of 0.98 for items and 0.72 for people; also, it has enough evidence for construct validity. Because the questionnaire has been developed based on the recommendations from international guidelines, the English version of this questionnaire could be used in further studies to test its psychometric properties.
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23
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Moore Z, Avsar P, Conaty L, Moore DH, Patton D, O'Connor T. The prevalence of pressure ulcers in Europe, what does the European data tell us: a systematic review. J Wound Care 2020; 28:710-719. [PMID: 31721669 DOI: 10.12968/jowc.2019.28.11.710] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The main aim of this systematic review was to establish the prevalence of pressure ulcers (PU) within published studies from Europe. METHOD Using systematic review methodology, quantitative design studies which explored prevalence data and/or the epidemiology of PUs in Europe were considered. The primary outcome was PU prevalence. The search, conducted in April 2019, using Cochrane, Medline, Embase, CINAHL, PubMed, Scopus and Web of Science databases, returned 3065 records, of which 79 met the inclusion criteria. Data were extracted using a pre-designed extraction tool, and validity analysis was undertaken using the Evidence-Based Librarianship (EBL) Critical Appraisal Checklist. RESULTS We included 79 articles in this review. Across the studies, the median prevalence was 10.8% (standard deviation: 7%; range: 4.6-27.2%). The highest PU prevalence reported was from the Netherlands (27.2%; n=17,494 participants), and the lowest was reported from Finland (4.6%; n=629 participants). Almost 32.4% (n=151,195) of the PUs were category I and the most common site for PUs was the sacrum. CONCLUSION The prevalence data is consistently high. These data indicate the continued need for further resource allocation into PU prevention and management.
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Affiliation(s)
- Zena Moore
- School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI).,Skin Wounds and Trauma (SWaT) Research Centre, RCSI.,Adjunct Professor, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Professor Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.,Honorary Professor, Lida Institute, Shanghai, China.,Senior Tutor, University of Wales
| | - Pinar Avsar
- School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI).,Skin Wounds and Trauma (SWaT) Research Centre, RCSI
| | | | | | - Declan Patton
- School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI).,Skin Wounds and Trauma (SWaT) Research Centre, RCSI
| | - Tom O'Connor
- School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI).,Skin Wounds and Trauma (SWaT) Research Centre, RCSI
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Team V, Bouguettaya A, Richards C, Turnour L, Jones A, Teede H, Weller CD. Patient education materials on pressure injury prevention in hospitals and health services in Victoria, Australia: Availability and content analysis. Int Wound J 2020; 17:370-379. [PMID: 31850664 PMCID: PMC7948898 DOI: 10.1111/iwj.13281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/22/2019] [Accepted: 11/24/2019] [Indexed: 12/14/2022] Open
Abstract
Pressure injuries (PIs) are a common quality indicator for hospital care, and preventing PIs often requires patient engagement; as such, Australian consensus research has recommended that high-quality education materials be made to patients for PIs via hospital networks. The purpose of the present study was to assess the availability and accuracy of patient education materials on PIs in publicly available hospital websites in Victoria, Australia. Two independent coders assessed 212 websites for content on PI prevention and management, analysing availability and accuracy of PI definitions, risk factors, preventive strategies, referral, visual tools, consumer endorsement, information for family/carers, and translation on community languages. A greater proportion of hospitals did not have any patient education materials on PI prevention publicly available, with private hospitals (compared with public) and metropolitan hospitals (compared to rural) more likely to have materials available on their sites. The available materials contained accurate messages on PI defining characteristics and risk factors for PIs, although there was considerable variability on the availability of other information. Our findings suggest a significant deficit in the availability of educational materials for acute care patients and their families. There is a need for evidence-based, consumer-endorsed, uniform materials on all hospital websites to prevent PIs in acute care.
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Affiliation(s)
- Victoria Team
- Monash Nursing and MidwiferyMonash UniversityMelbourneVictoriaAustralia
- Monash Partners Academic Health Science Centre, 43‐51 Kanooka Grove ClaytonVictoriaAustralia
| | - Ayoub Bouguettaya
- Monash Nursing and MidwiferyMonash UniversityMelbourneVictoriaAustralia
| | - Catelyn Richards
- Monash Nursing and MidwiferyMonash UniversityMelbourneVictoriaAustralia
| | - Louise Turnour
- Monash Nursing and MidwiferyMonash UniversityMelbourneVictoriaAustralia
| | - Angela Jones
- Monash Partners Academic Health Science Centre, 43‐51 Kanooka Grove ClaytonVictoriaAustralia
| | - Helena Teede
- Monash Partners Academic Health Science Centre, 43‐51 Kanooka Grove ClaytonVictoriaAustralia
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Fritz A, Gericke L, Höch A, Josten C, Osterhoff G. Time-to-treatment is a risk factor for the development of pressure ulcers in elderly patients with fractures of the pelvis and acetabulum. Injury 2020; 51:352-356. [PMID: 31843198 DOI: 10.1016/j.injury.2019.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/05/2019] [Accepted: 12/08/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Fractures of the pelvis and acetabulum are associated with pain and immobilization and, hence, pose the risk of developing a pressure ulcer - especially in elderly patients. In the literature, information on risk factors for the occurrence of pressure ulcers related to geriatric pelvic or acetabulum fractures is missing. METHODS Consecutive in-hospital patients aged 55 years or older treated for closed pelvis and/or acetabulum fractures between 2013 and 2017 were retrospectively identified from an institutional prospective database. Epidemiologic characteristics and patient specifics with special focus on the time from admission to treatment, duration of hospitalization and comorbidities were retrospectively assessed by chart review. RESULTS During the evaluated interval, 407 patients with isolated fractures of the pelvis or acetabulum (mean age 78 years, range 55 to 101 years, 69,3% female) were treated. A new pressure ulcer that developed during the hospitalization was observed in 46/407 patients (11.3%). This included pressure ulcers of stage 1 in 18/46 cases (39%), stage 2 in 24/46 cases (52%), and stage 3 in 4/46 cases (9%). No stage 4 ulcers were seen in this cohort. The mean duration of hospitalization was longer in patients with a pressure ulcer (25 days, SD 17) than in patients with no ulcers (12 days, SD 9; p < .001). Patients who developed a pressure ulcer, had waited significantly longer for treatment of their pelvis/acetabulum fracture when compared to patients without an ulcer (5 days, SD 5 vs. 3 days SD 4, p = =.001). A logistic regression analysis confirmed "time to treatment" as an independent risk factor for the occurrence of a pressure ulcer during hospitalization. In an analysis adjusted for the confounders age, male gender, diabetes and malignancy, the odds ratio to develop a pressure ulcer remained 1.10 (CI 1.03 to 1.19; c-value = 0.774, p = .008) for each day of waiting treatment. CONCLUSION "Time to treatment" is an independent risk factor for the occurrence of a pressure ulcer during hospitalization after a pelvis/acetabulum fracture in elderly patients. Each day of waiting treatment increases the risk of developing a pressure ulcer by 10%.
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Affiliation(s)
- Annemarie Fritz
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig 04103, Germany
| | - Laura Gericke
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig 04103, Germany
| | - Andreas Höch
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig 04103, Germany
| | - Christoph Josten
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig 04103, Germany
| | - Georg Osterhoff
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig 04103, Germany.
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Børsting TE, Kristensen N, Hanssen I. Student nurses' learning outcomes through participation in a clinical nursing research project: A qualitative study. Nurse Educ Pract 2020; 43:102727. [PMID: 32062531 DOI: 10.1016/j.nepr.2020.102727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/22/2020] [Accepted: 01/26/2020] [Indexed: 10/25/2022]
Abstract
100 bachelor students participated in a research project integrated in their clinical placements. They assessed patients admitted at a certain date/time regarding pain/pain intensity and risk of decubitus, falling and nutritional problems. In the current study is examined the students' learning experiences from participating in this project through focus group interviews. Data analysis of electronically recorded and transcribed interviews following Braun and Clarke's six phases of thematic analysis. Although pressed for time the students felt able to adapt their communication to patients' various situations, explain about the project, receive a signed consent form, and do the data collection. During the project they had honed their communicative skills, become more confident, and able to utilise their theoretical knowledge to reflect, observe, assess, and act. They were able to attune their communication to the various patients and create a trusting relationship which made the assessments possible in spite of the brevity of their meetings. In spite of this mainly interpersonal focus we trust that this first empirical research experience will enhance their ability to read and understand research papers. Furthermore, the students found they had learned a lot and acquired greater understanding of the connection between theory and practical patient work.
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Affiliation(s)
| | - Nina Kristensen
- Lovisenberg Diaconal Hospital, Lovisenberggata 17, N-0456, Oslo, Norway.
| | - Ingrid Hanssen
- Lovisenberg Diaconal University College, Lovisenberggata 15b, N-0456, Oslo, Norway.
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Barriers and facilitators for caregiver involvement in the home care of people with pressure injuries: A qualitative study. PLoS One 2019; 14:e0226359. [PMID: 31869363 PMCID: PMC6927621 DOI: 10.1371/journal.pone.0226359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/24/2019] [Indexed: 11/22/2022] Open
Abstract
Aim To explore the barriers and facilitators perceived by home caregivers regarding their involvement in the home care of people with pressure injuries. Background Although home caregivers are key in the process of caring for people with pressure injuries, little is known about their perceptions regarding their involvement in the same. Methods A qualitative study based on grounded theory involving a theoretical sample of 15 home caregivers of people with pressure injuries within the health district of Puertollano, Spain. Results This study identified three barriers (feminization of care, necessary life adaptations as a home caregiver, and the organization of health services) and three facilitators (the perceived family duty for caring, willingness to provide care, and satisfaction with the care received on behalf of primary care services) associated with caregiver involvement in the home care of pressure injuries. Conclusions The care of a person with pressure injuries is perceived as a duty and requires important adaptations affecting the home caregiver’s personal, social and work life. The emotional closeness and trust that develops between a patient and the primary care staff equals an involvement which, in turn, also has positive results for both the home caregiver and the patient.
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Tariq G, Hamed J, George B, Cruz S, Jose J. Pressure ulcer prevalence and prevention rates in Abu Dhabi: an update. J Wound Care 2019; 28:S4-S11. [PMID: 30975061 DOI: 10.12968/jowc.2019.28.sup4.s4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This article compares the results from a recent pressure ulcer (PU) prevalence audit at the Sheikh Khalifa Medical City (SKMC) hospital in Abu Dhabi to identify the impact of new prevention initiatives introduced around 2013 and establish the effectiveness of PU prevention strategies, judged quality of nursing care, and costs associated with patients developing a hospital-acquired pressure ulcer (HAPU). METHOD The methods used were based on a previous point prevalence study involving 441 acute care patients, who were assessed using the International Pressure Ulcer Prevalence (IPUP) Survey. Following pre-selection of a 24-hour period for data capture, hospital staff collected PU data. Hill-Rom provided SKMC with an electronic report comprising various epidemiological and financial outputs. RESULTS PU prevalence was 10.4% in 2018 versus 6.4% in 2013. The 2018 HAPU prevalence was 1.8% versus 2% in 2013. The 2018 findings were in line with IPUP's international benchmarks. In 2018, 99% of patients had their skin assessed and PU risk documented within 24 hours of admission, leading to rapid implementation of a prevention care plan. Most patients who developed a HAPU (n=8) were female (62%) and aged 20-29 years old (25%) or 70-79 years old (25%). All HAPU patients lay on three layers of linen, most on their side (88%) and 75% were hospitalised for >30 days. Costs were estimated for the eight HAPU patients; weighted average cost (per case) was around US$8035.32, giving a total estimated cost of US$64,282.54. Total annual cost (average length of stay basis) for the eight patients was estimated at US$1,830,082.32. CONCLUSION The PU prevention plan at SKMC proved to be effective, reflected by a low HAPU prevalence rate, suggesting an excellent quality of patient care.
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Affiliation(s)
- Gulnaz Tariq
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Jassin Hamed
- Facharzt Internal Medicine, Emergency Medicine, Critical Care, Diabetology, International Interprofessional Wound Care Course (IIWCC) Abu Dhabi, United Arab Emirates
| | - Beji George
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Salvacion Cruz
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Jasmine Jose
- Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Manderlier B, Van Damme N, Verhaeghe S, Van Hecke A, Everink I, Halfens R, Beeckman D. Modifiable patient-related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses. J Adv Nurs 2019; 75:2773-2785. [PMID: 31287188 DOI: 10.1111/jan.14149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/05/2019] [Accepted: 05/29/2019] [Indexed: 12/26/2022]
Abstract
AIM To explore factors associated with the presence of category I-IV pressure ulcers on the sacrum and heels. DESIGN Cross-sectional, secondary data analysis using data collected from the Landelijke Prevalentiemeting Zorgproblemen (LPZ) project, a multicentre prevalence study including nursing home residents and community care clients (N = 4,842) in the Netherlands in 2017. METHODS A single binary logistic regression model was designed to identify factors associated with the presence of pressure ulcers. Additionally, a multiple binary logistic regression model including modifiable explanatory factors associated with the presence of pressure ulcers was designed. RESULTS Impaired mobility, friction and shear (evaluated using the Braden Scale) are significantly associated with the presence of both sacral and heel category I-IV pressure ulcers. Incontinence-associated dermatitis is significantly associated with category I-IV sacral pressure ulcers. CONCLUSION In pressure ulcer prevention, nursing interventions should focus on frequent repositioning and mobilization while avoiding exposure of the skin to friction and shear. The need to consider incontinence-associated dermatitis, incontinence and moisture as important factors in pressure ulcer risk assessment is confirmed. IMPACT Pressure ulcers occur when skin and tissues are deformed between bony prominences and the support surface in a sitting or lying position. They are the result of a complex interaction between direct causal factors and a wide range of indirect factors. Recognition of these factors influences risk assessment guidance and practice. Knowledge of skin-specific factors at the patient level, modifiable by nursing interventions, enables a better targeted and tailored preventive approach.
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Affiliation(s)
- Bénédicte Manderlier
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Nele Van Damme
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Irma Everink
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Ruud Halfens
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
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Xu X, Ma Y, Yao Z, Zhao Y. Prevalence and Risk Factors for Pressure Ulcers in Patients with Enterocutaneous Fistula: A Retrospective Single-Center Study in China. Med Sci Monit 2019; 25:2591-2598. [PMID: 30964125 PMCID: PMC6476408 DOI: 10.12659/msm.913261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/20/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Prevalence and associated risk factors for pressure ulcers (PU) vary in different body areas and diseases. Few studies have focused on PU in patients with enterocutaneous fistula (ECF). The aim of the present study was to investigate the prevalence and risk factors for PU in patients with ECF. MATERIAL AND METHODS From January 2016 to June 2016, medical records of 140 patients with ECF who were transferred to the Enterocutaneous Fistula Treatment Center, Jinling Hospital, were reviewed and analyzed. The prevalence of PU was investigated. To evaluate the risk factors for PU in patients with ECF, 5 patients with PU before admission were excluded, and the remaining 135 patients were divided into 2 groups: the PU group and the non-PU group. The risk factors for PU were confirmed by multivariate logistic regression analysis of characteristics on admission. RESULTS There were 42 cases with PU (5 cases with PU before admission, 37 cases with PU in the treatment after admission), and the prevalence of PU in patients with ECF was 30%. In addition, Braden risk score <19 (OR=9.33, CI: 2.80-31.08, p<0.001); underweight (BMI<18.5) (OR=5.21, CI: 1.65-16.39, p=0.005); onset of duodenal fistula (OR=4.86, CI: 1.33-17.78, p=0.017); diabetes (OR=4.95, CI: 1.03-23.85, p=0.046); and APACHE II score (OR=1.34, CI: 1.04-1.72, p=0.019) were associated with PU. CONCLUSIONS The PU prevalence was 30% in patients with ECF. Braden risk score <19, underweight, onset of duodenal fistula, diabetes, and APACHE II score were risk factors for PU in patients with ECF.
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Liu Y, Wu X, Ma Y, Li Z, Cao J, Jiao J, Liu G, Li F, Song B, Jin J, Liu Y, Wen X, Cheng S, Lin F. The prevalence, incidence, and associated factors of pressure injuries among immobile inpatients: A multicentre, cross-sectional, exploratory descriptive study in China. Int Wound J 2019; 16:459-466. [PMID: 30672116 DOI: 10.1111/iwj.13054] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to assess the prevalence, incidence, and the associated factors of pressure injuries (PIs) among immobile hospitalised patients in China. Being immobile during hospitalisation put these patients at a higher risk of PIs. There is little literature about pressure injury (PI) prevalence or PI incidence in immobile hospitalised patients in hospitals in China. This was a multicentre, cross-sectional, exploratory descriptive study. A total of 23 985 immobile patients were recruited from 25 general hospitals in six provinces of China from November 1, 2015 to March 18, 2016. Information was collected on demographic characteristics, physical assessment information, and treatment and nursing care measures. The PI period prevalence was 3.38%, and the PI cumulative incidence was 1.23%. Most PIs (84.03%) were Stage 1 or Stage 2. A total of 48.22% of PIs occurred in the sacrum or heel region. In the multivariate analysis, the following factors were associated with higher PI prevalence: age, gender, length of immobility, type of hospital, modified Braden Scale score, urinary incontinence, faecal incontinence, low serum albumin, the usage of fixation or restraint devices, and patient's discharge diagnosis (lower limb fracture, malnutrition, and spinal cord injury). PI prevalence for immobile hospitalised patients in the study was lower than those reported in literature. However, because of the large population in China, the number of patients who suffer with PIs can be very high. The relating factors of higher PI prevalence identified in this study were consistent with current literature. Patients with a higher number of these associated factors should be monitored more closely, and preventative measures should be taken to prevent PI occurrence in high-risk populations.
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Affiliation(s)
- Ying Liu
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Xinjuan Wu
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Yufen Ma
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Zhen Li
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Jing Cao
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Jing Jiao
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Ge Liu
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Fangfang Li
- Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Baoyun Song
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jingfen Jin
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yilan Liu
- Department of Nursing, Wuhan Union Hospital, Wuhan, China
| | - Xianxiu Wen
- Department of Nursing, Sichuan Provincial People's Hospital, Chengdu, China
| | - Shouzhen Cheng
- Department of Nursing, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Frances Lin
- Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Queensland, Australia
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Lerdal A, Sigurdsen LW, Hammerstad H, Granheim TI, Gay CL. Associations between patient symptoms and falls in an acute care hospital: A cross-sectional study. J Clin Nurs 2018; 27:1826-1835. [DOI: 10.1111/jocn.14364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Anners Lerdal
- Department of Nursing Science; Institute of Health and Society; Faculty of Medicine; University of Oslo; Oslo Norway
- Department for Patient Safety and Research; Lovisenberg Diaconal Hospital; Oslo Norway
| | | | | | | | - Caryl L Gay
- Department for Patient Safety and Research; Lovisenberg Diaconal Hospital; Oslo Norway
- Department of Family and Health Care Nursing; University of California; San Francisco CA USA
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Koivunen M, Hjerppe A, Luotola E, Kauko T, Asikainen P. Risks and prevalence of pressure ulcers among patients in an acute hospital in Finland. J Wound Care 2018; 27:S4-S10. [DOI: 10.12968/jowc.2018.27.sup2.s4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marita Koivunen
- Nursing Director, Adjunct Professor, Department of Nursing Science, University of Turku, Satakunta Hospital District
| | - Anna Hjerppe
- Chief Physician, Clinical Teacher, Department of Dermatology, Satakunta Hospital District, and Department of Medicine, University of Turku
| | - Eija Luotola
- Authorised Wound Care Nurse, Satakunta Hospital District
| | - Tommi Kauko
- Biostatistician, Satakunta Hospital District
| | - Paula Asikainen
- Administrative Nursing Director, Adjunct Professor, Department of Biostatistics, University of Turku, and School of Health Sciences, University of Tampere, Satakunta Hospital District
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