1
|
Caggiari S, Aylward-Wotton N, Kent B, Worsley PR. Characterising mobility and pressure exposure in community dwelling residents with pressure ulcers using monitoring technology and intelligent algorithm. J Tissue Viability 2024:S0965-206X(24)00110-4. [PMID: 39084958 DOI: 10.1016/j.jtv.2024.07.005] [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: 05/16/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
AIM Individuals in the community with reduced mobility are at risk of exposure to prolonged lying and sitting postures, which may cause pressure ulcers. The present study combines continuous pressure monitoring technology and intelligent algorithms to evaluate posture, mobility, and pressure profiles in a cohort of community dwelling patients, who had acquired pressure ulcers. MATERIALS AND METHODS This study represents a secondary analysis of the data from the Quality Improvement project 'Pressure Reduction through COntinuous Monitoring In the community SEtting (PROMISE)'. 22 patients with pressure ulcers were purposely selected from 105 recruited community residents. Data were collected using a commercial continuous pressure monitoring system over a period of 1-4 days, and analysed with an intelligent algorithm using machine learning to determine posture and mobility events. Duration and magnitude of pressure signatures of each static posture and exposure thresholds were identified based on a sigmoid relationship between pressure and time. RESULTS Patients revealed a wide range of ages (30-95 years), BMI (17.5-47 kg/m2) and a series of co-morbidities, which may have influenced the susceptibility to skin damage. Posture, mobility, and pressure data revealed a high degree of inter-subject variability. Largest duration of static postures ranged between 1.7 and 19.8 h, with 17/22 patients spending at least 60 % of their monitoring period in static postures which lasted >2 h. Data revealed that many patients spent prolonged periods with potentially harmful interface pressure conditions, including pressure gradients >60 mmHg/cm. CONCLUSION This study combined posture, mobility, and pressure data from a commercial pressure monitoring technology through an intelligent algorithm. The community residents who had acquired a pressure ulcer at the time of monitoring exhibited trends which exposed their skin and subdermal tissues to prolonged high pressures during static postures. These indicators need further validation through prospective clinical trials.
Collapse
Affiliation(s)
- Silvia Caggiari
- Skin Sensing Research Group, School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Nicci Aylward-Wotton
- Skin Sensing Research Group, School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK; Cornwall Partnership NHS Foundation Trust, Carew House, Beacon Technology Park, Dunmere Rd, Bodmin PL31 2QN, UK
| | - Bridie Kent
- School of Nursing and Midwifery, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Peter R Worsley
- Skin Sensing Research Group, School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| |
Collapse
|
2
|
Müller R, Oette C, Oette C, Schreff L, Abel R. Sitting Pressure Measurements in Wheelchair Users-Can the Effects of Daily Relief Activities Be Depicted? SENSORS (BASEL, SWITZERLAND) 2024; 24:3806. [PMID: 38931590 PMCID: PMC11207960 DOI: 10.3390/s24123806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Seat pressure measurements in wheelchair users have been available for some time; however, repeated measurements from a commercially available pressure mat over 90 min did not differ in the pressure-loaded measurement area or the coordinates of the center of pressure, even in participants who were able to reposition themselves in the wheelchair. The question therefore arises: to what extent are there other parameters that reflect the activity of wheelchair users with the pressure mat? To investigate this, a commercial pressure mat (BodiTrak®) was used to perform the measurements of pressure of 33 adult wheelchair-dependent people with spinal cord injury after 30 and 90 min sitting on the cushion. In addition to the standard output of the pressure mat, graph-based surface analyses (calculation of the area of maximum pressure, calculation of the pressure-loaded measurement area, and pressure-area ratio) was performed retrospectively using Python 3.7. The analysis of the measurements after 30 and 90 min was performed by distinguishing the participants between those who could actively change their position (N = 24) and those who could not (N = 9). The parameters of the pressure mat and the graph-based analyses remained unchanged for active participants. In participants who were unable to actively change their position, the area of maximum pressure and the pressure-area ratio (ratio of maximum pressure area and total pressure-loaded area) increased. Significant differences between minutes 30 and 90 are only found for the pressure-area ratio. Thus, when measuring the seat pressure of wheelchair users, the pressure-area ratio should be taken into account as it reflects the daily relief activities of wheelchair users.
Collapse
Affiliation(s)
- Roy Müller
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, 95445 Bayreuth, Germany; (C.O.); (L.S.); (R.A.)
- Bayreuth Center of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany
- University Hospital Erlangen, Friedrich-Alexander-University Erlangen, 91054 Erlangen, Germany
| | - Clara Oette
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, 95445 Bayreuth, Germany; (C.O.); (L.S.); (R.A.)
| | - Cedric Oette
- Hawk Intelligent Technologies GmbH, Schafäckerlein 23, 91413 Neustadt an der Aisch, Germany
| | - Lucas Schreff
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, 95445 Bayreuth, Germany; (C.O.); (L.S.); (R.A.)
- Bayreuth Center of Sport Science, University of Bayreuth, Universitätsstraße 30, 95447 Bayreuth, Germany
| | - Rainer Abel
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, 95445 Bayreuth, Germany; (C.O.); (L.S.); (R.A.)
- University Hospital Erlangen, Friedrich-Alexander-University Erlangen, 91054 Erlangen, Germany
| |
Collapse
|
3
|
Oette C, Müller R, Schreff L, Abel R. How Do Everyday Life Activities Affect Seating Pressure Measurements? Int J Spine Surg 2023; 17:698-705. [PMID: 37704379 PMCID: PMC10623680 DOI: 10.14444/8530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Pressure measurements to detect risks for pressure injuries in wheelchair users with spinal cord injury (SCI) have been available for quite some time. Unfortunately, knowledge of how postural changes during longer periods of daily life activity affecting the results is still limited. In the present study, the authors expected to note shifts in the center of pressure as well as in the pressure distribution, especially in patients who were able to change their position actively. METHODS A seat pressure mat (BodiTrak2) was used to perform measurements of 34 SCI wheelchair users after initial transfer into the wheelchair as well as 30 and 90 minutes later. Mean pressure, maximum pressure, pressure-loaded measuring surface, and the coordinates of the center of pressure were analyzed, and findings were statistically analyzed using the t test and Intraclass Correlation Coefficient. To quantify the drift of the measurement system, recordings with a reference weight were performed. RESULTS The analyzed parameters from the initial measurement differed significantly from the later measurements at 30 and 90 minutes, whereas the parameters were stable after 30 minutes. The measurements with the reference weight showed the same measurement course. CONCLUSIONS The measurements after 30 and 90 minutes were consistent, contrary to expectations. The activity of the participant between measurements did not appear to be of much importance. CLINICAL RELEVANCE Relief maneuvers appear to provide relief only while the maneuver is being performed. Thus, relief activities must be frequent enough and long enough to allow adequate blood flow to the tissues.
Collapse
Affiliation(s)
- Clara Oette
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, Bayreuth, Germany
| | - Roy Müller
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, Bayreuth, Germany
- Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Lucas Schreff
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, Bayreuth, Germany
- Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Rainer Abel
- Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, Bayreuth, Germany
| |
Collapse
|
4
|
Nurmambetova E, Pan J, Zhang Z, Wu G, Lee S, Southern DA, Martin EA, Ho C, Xu Y, Eastwood CA. Developing an Inpatient Electronic Medical Record Phenotype for Hospital-Acquired Pressure Injuries: Case Study Using Natural Language Processing Models. JMIR AI 2023; 2:e41264. [PMID: 38875552 PMCID: PMC11041460 DOI: 10.2196/41264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 01/01/2023] [Accepted: 01/15/2023] [Indexed: 06/16/2024]
Abstract
BACKGROUND Surveillance of hospital-acquired pressure injuries (HAPI) is often suboptimal when relying on administrative health data, as International Classification of Diseases (ICD) codes are known to have long delays and are undercoded. We leveraged natural language processing (NLP) applications on free-text notes, particularly the inpatient nursing notes, from electronic medical records (EMRs), to more accurately and timely identify HAPIs. OBJECTIVE This study aimed to show that EMR-based phenotyping algorithms are more fitted to detect HAPIs than ICD-10-CA algorithms alone, while the clinical logs are recorded with higher accuracy via NLP using nursing notes. METHODS Patients with HAPIs were identified from head-to-toe skin assessments in a local tertiary acute care hospital during a clinical trial that took place from 2015 to 2018 in Calgary, Alberta, Canada. Clinical notes documented during the trial were extracted from the EMR database after the linkage with the discharge abstract database. Different combinations of several types of clinical notes were processed by sequential forward selection during the model development. Text classification algorithms for HAPI detection were developed using random forest (RF), extreme gradient boosting (XGBoost), and deep learning models. The classification threshold was tuned to enable the model to achieve similar specificity to an ICD-based phenotyping study. Each model's performance was assessed, and comparisons were made between the metrics, including sensitivity, positive predictive value, negative predictive value, and F1-score. RESULTS Data from 280 eligible patients were used in this study, among whom 97 patients had HAPIs during the trial. RF was the optimal performing model with a sensitivity of 0.464 (95% CI 0.365-0.563), specificity of 0.984 (95% CI 0.965-1.000), and F1-score of 0.612 (95% CI of 0.473-0.751). The machine learning (ML) model reached higher sensitivity without sacrificing much specificity compared to the previously reported performance of ICD-based algorithms. CONCLUSIONS The EMR-based NLP phenotyping algorithms demonstrated improved performance in HAPI case detection over ICD-10-CA codes alone. Daily generated nursing notes in EMRs are a valuable data resource for ML models to accurately detect adverse events. The study contributes to enhancing automated health care quality and safety surveillance.
Collapse
Affiliation(s)
- Elvira Nurmambetova
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jie Pan
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Zilong Zhang
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Guosong Wu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Seungwon Lee
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Edmonton, AB, Canada
| | - Danielle A Southern
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Elliot A Martin
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Edmonton, AB, Canada
| | - Chester Ho
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Yuan Xu
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
- Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada
| | - Cathy A Eastwood
- Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
5
|
Peng M, Southern DA, Ocampo W, Kaufman J, Hogan DB, Conly J, Baylis BW, Stelfox HT, Ho C, Ghali WA. Exploring data reduction strategies in the analysis of continuous pressure imaging technology. BMC Med Res Methodol 2023; 23:56. [PMID: 36859239 PMCID: PMC9976437 DOI: 10.1186/s12874-023-01875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Science is becoming increasingly data intensive as digital innovations bring new capacity for continuous data generation and storage. This progress also brings challenges, as many scientific initiatives are challenged by the shear volumes of data produced. Here we present a case study of a data intensive randomized clinical trial assessing the utility of continuous pressure imaging (CPI) for reducing pressure injuries. OBJECTIVE To explore an approach to reducing the amount of CPI data required for analyses to a manageable size without loss of critical information using a nested subset of pressure data. METHODS Data from four enrolled study participants excluded from the analytical phase of the study were used to develop an approach to data reduction. A two-step data strategy was used. First, raw data were sampled at different frequencies (5, 30, 60, 120, and 240 s) to identify optimal measurement frequency. Second, similarity between adjacent frames was evaluated using correlation coefficients to identify position changes of enrolled study participants. Data strategy performance was evaluated through visual inspection using heat maps and time series plots. RESULTS A sampling frequency of every 60 s provided reasonable representation of changes in interface pressure over time. This approach translated to using only 1.7% of the collected data in analyses. In the second step it was found that 160 frames within 24 h represented the pressure states of study participants. In total, only 480 frames from the 72 h of collected data would be needed for analyses without loss of information. Only ~ 0.2% of the raw data collected would be required for assessment of the primary trial outcome. CONCLUSIONS Data reduction is an important component of big data analytics. Our two-step strategy markedly reduced the amount of data required for analyses without loss of information. This data reduction strategy, if validated, could be used in other CPI and other settings where large amounts of both temporal and spatial data must be analysed.
Collapse
Affiliation(s)
- Mingkai Peng
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Danielle A Southern
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Wrechelle Ocampo
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada
| | - Jaime Kaufman
- W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada
| | - David B Hogan
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - John Conly
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Foothills Medical Centre, Special Services Building, Ground Floor, AGW5, Calgary, AB, T2N 2T9, Canada
| | - Barry W Baylis
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Foothills Medical Centre, Special Services Building, Ground Floor, AGW5, Calgary, AB, T2N 2T9, Canada
| | - Henry T Stelfox
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Alberta, Canada
| | - Chester Ho
- Department of Medicine, Division of Physical Medicine & Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - William A Ghali
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. .,W21C Research and Innovation Centre, Cumming School of Medicine, GD01 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive, Calgary, NW, Canada. .,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Division of General Internal Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| |
Collapse
|
6
|
Mamom J, Rungroungdouyboon B, Daovisan H, Sri-Ngernyuang C. Electronic Alert Signal for Early Detection of Tissue Injuries in Patients: An Innovative Pressure Sensor Mattress. Diagnostics (Basel) 2023; 13:diagnostics13010145. [PMID: 36611437 PMCID: PMC9818190 DOI: 10.3390/diagnostics13010145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Monitoring the early stage of developing tissue injuries requires intact skin for surface detection of cell damage. However, electronic alert signal for early detection is limited due to the lack of accurate pressure sensors for lightly pigmented skin injuries in patients. We developed an innovative pressure sensor mattress that produces an electronic alert signal for the early detection of tissue injuries. The electronic alert signal is developed using a web and mobile application for pressure sensor mattress reporting. The mattress is based on body distributions with reference points, temperature, and a humidity sensor to detect lightly pigmented skin injuries. Early detection of the pressure sensor is linked to an electronic alert signal at 32 mm Hg, a temperature of 37 °C, a relative humidity of 33.5%, a response time of 10 s, a loading time of 30 g, a density area of 1 mA, and a resistance of 7.05 MPa (54 N) at 0.87 m3/min. The development of the innovative pressure sensor mattress using an electronic alert signal is in line with its enhanced pressure detection, temperature, and humidity sensors.
Collapse
Affiliation(s)
- Jinpitcha Mamom
- Center of Excellence in Creative Engineering Design and Development, Faculty of Engineering, Thammasat University, Pathum Thani 12121, Thailand
- Department of Adult Nursing and the Aged, Faculty of Nursing, Thammasat University, Pathum Thani 12121, Thailand
- Correspondence: (J.M.); (H.D.)
| | - Bunyong Rungroungdouyboon
- Center of Excellence in Creative Engineering Design and Development, Faculty of Engineering, Thammasat University, Pathum Thani 12121, Thailand
| | - Hanvedes Daovisan
- Human Security and Equity Centre of Excellence, Social Research Institute, Chulalongkorn University, Bangkok 10330, Thailand
- Correspondence: (J.M.); (H.D.)
| | - Chawakorn Sri-Ngernyuang
- Institute of Field Robotics, King Mongkut’s University of Technology Thonburi, Bangkok 10140, Thailand
| |
Collapse
|
7
|
Ocampo W, Sola DY, Baylis BW, Conly JM, Hogan DB, Kaufman J, Kiplagat L, Stelfox HT, Ghali WA, Ho C. Healthcare provider and patient/family perceptions of continuous pressure imaging technology for prevention of pressure injuries: A secondary analysis of patients enrolled in a randomized control trial. PLoS One 2022; 17:e0278019. [PMID: 36445905 PMCID: PMC9707747 DOI: 10.1371/journal.pone.0278019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/08/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Despite the availability of various pressure injury (PI) prevention strategies (e.g., risk identification, use of pressure re-distribution surfaces, frequent repositioning), they persist as a significant issue for healthcare systems worldwide. Continuous pressure imaging (CPI) is a novel technology that could be integrated within a comprehensive approach to the prevention of PIs. We studied the perceptions of healthcare providers and patients/families to identify facilitators and barriers to the use of this technology. METHODS Hospitalized patients/family members from a randomized controlled trial assessing the efficacy of CPI in preventing PIs completed a survey after 72 hours (or upon discharge from hospital) of CPI monitoring. They were asked questions about prior and current experience with CPI technology. For healthcare providers, perceptions on the use of the device and its impact on care were explored through a survey distributed by email or hard copies. RESULTS A total of 125 healthcare providers and 525 patients/family members completed the surveys. Of the healthcare providers, 95% either agreed/strongly agreed that the CPI technology was easy to use and 65% stated that the device improved how they provided pressure relief for patients. Identified issues with the device were cost, the fitting of the mattress cover, and the fixation of the patients/families on the device. Over a quarter of the patient/family respondents agreed/strongly agreed that the device influenced how pressure relief was provided. This response was statistically associated with whether the monitor was turned on (intervention arm; 52.7%) or off (control arm; 4.2%). DISCUSSION AND CONCLUSION CPI technology was positively perceived by healthcare providers. Most patients/families felt it influenced care when the CPI monitor was turned on. Concerns raised around cost and the ease of use of these devices by healthcare providers may affect the decisions of healthcare system administrators to adopt and implement this technology.
Collapse
Affiliation(s)
- Wrechelle Ocampo
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Darlene Y. Sola
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Barry W. Baylis
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - John M. Conly
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
- Synder Institute for Chronic Diseases, Cumming School of Medicine, Calgary, AB, Canada
| | - David B. Hogan
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jaime Kaufman
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Linet Kiplagat
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Henry T. Stelfox
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
- Departments of Critical Care Medicine and Community Health Sciences, Calgary, AB, Canada
| | - William A. Ghali
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Chester Ho
- W21C, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
- Division of Physical Medicine & Rehabilitation, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
8
|
Textile-Based Pressure Sensing Matrix for In-Bed Monitoring of Subject Sleeping Posture and Breathing Activity. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11062552] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
According to current trends in healthcare sensing technologies, we describe a textile-based pressure sensing matrix that can be integrated in the mattress of a smart bed to characterize sleeping posture/movement of a subject and to extract breathing activity. The pressure mapping layer is developed as a matrix of 195 piezoresistive sensors, it is entirely made of textile materials, and it is the basic component of a smart bed that can perform sleep analysis, can extract physiological parameters, and can detect environmental data related to subject’s health. In this paper, we show the principle of the pressure mapping layer and the architecture of the dedicated electronic system that we developed for signal acquisition. In addition, we describe the algorithms for posture/movement classification (dedicated artificial neural network) and for extraction of the breathing rate (frequency domain analysis). We also perform validation of the system to quantify the accuracy/precision of the posture classification and the statistical analysis to compare our breathing rate estimation with the gold standard.
Collapse
|
9
|
A sensitivity analysis to evaluate the performance of temporal pressure - related parameters in detecting changes in supine postures. Med Eng Phys 2019; 69:33-42. [DOI: 10.1016/j.medengphy.2019.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/21/2019] [Accepted: 06/07/2019] [Indexed: 11/20/2022]
|
10
|
Shakibamehr J, Rad M, Akrami R, Rad M. Effectiveness of Tragacanth Gel Cushions in Prevention of Pressure Ulcer in Traumatic Patients: a Randomized Controlled Trial. J Caring Sci 2019; 8:45-49. [PMID: 30915313 PMCID: PMC6428161 DOI: 10.15171/jcs.2019.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/22/2018] [Indexed: 12/26/2022] Open
Abstract
Introduction: Introduction: Pressure ulcer is one of the most common and painful complications in patients admitted to intensive care units (ICUs). This study aimed to compare the effects of tragacanth gel cushions and foam-filled ones on the prevention of pressure ulcers. Methods: This triple-blind, randomized, clinical trial was performed on 94 patients admitted to the ICU of Taleqhani Hospital of Mashhad, Iran. The participants were divided into two groups of tragacanth gel pad and foam (n=47 for each group). Both groups received all the routine care. The participants were examined on a daily basis during a ten-day period. We considered sacral region as the most affected site, and the patients with erythema were excluded from the study. To analyze the data, Chi-squared test, Fisher's exact test, and t-test were run, using Stata version 12. Results: The data showed significant differences in terms of the incidence of skin redness in the tragacanth gel cushions group and foam cushion group, respectively, 6.84 (1.58) and 5.67 (1.26) days after admission. In addition, in the tragacanth gel cushions group 14 patients (29.7%) did not have skin redness compared with the foam cushion group (8.51%), which indicated a significant difference. Conclusion: This study showed that the use of tragacanth gel cushion is effective in the prevention of pressure ulcers in ICU patients. Cushions filled with tragacanth gel also delayed the onset of erythema. Considering their cost-effectiveness and naturalness, the use of tragacanth gel cushions is recommended to improve the sacral skin health and prevent pressure ulcers.
Collapse
Affiliation(s)
- Javad Shakibamehr
- Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mojtaba Rad
- Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Rahim Akrami
- Department of Epidemiology & Biostatistics, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mostafa Rad
- Department of Nursing, Nursing and Midwifery School, Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
| |
Collapse
|
11
|
Duvall J, Karg P, Brienza D, Pearlman J. Detection and classification methodology for movements in the bed that supports continuous pressure injury risk assessment and repositioning compliance. J Tissue Viability 2018; 28:7-13. [PMID: 30598376 DOI: 10.1016/j.jtv.2018.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/07/2018] [Accepted: 12/22/2018] [Indexed: 11/17/2022]
Abstract
Pressure injuries are costly to the healthcare system and mostly preventable, yet incidence rates remain high. Recommendations for improved care and prevention of pressure injuries from the Joint Commission revolve around continuous monitoring of prevention protocols and prompts for the care team. The E-scale is a bed weight monitoring system with load cells placed under the legs of a bed. This study investigated the feasibility of the E-scale system for detecting and classifying movements in bed which are relevant for pressure injury risk assessment using a threshold-based detection algorithm and a K-nearest neighbor classification approach. The E-scale was able to detect and classify four types of movements (rolls, turns in place, extremity movements and assisted turns) with >94% accuracy. This analysis showed that the E-scale could be used to monitor movements in bed, which could be used to prompt the care team when interventions are needed and support research investigating the effectiveness of care plans.
Collapse
Affiliation(s)
- Jonathan Duvall
- University of Pittsburgh, Department of Rehabilitation Science and Technology, 6425 Penn Ave, Suite 401, Pittsburgh, PA, 15206, USA.
| | - Patricia Karg
- University of Pittsburgh, Department of Rehabilitation Science and Technology, 6425 Penn Ave, Suite 401, Pittsburgh, PA, 15206, USA
| | - David Brienza
- University of Pittsburgh, Department of Rehabilitation Science and Technology, 6425 Penn Ave, Suite 401, Pittsburgh, PA, 15206, USA
| | - Jon Pearlman
- University of Pittsburgh, Department of Rehabilitation Science and Technology, 6425 Penn Ave, Suite 401, Pittsburgh, PA, 15206, USA
| |
Collapse
|
12
|
Bueno de Camargo WH, Pereira RDC, Tanita MT, Heko L, Grion IC, Festti J, Mezzaroba AL, Carvalho Grion CM. The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial. Crit Care Res Pract 2018; 2018:3712067. [PMID: 30662770 PMCID: PMC6312579 DOI: 10.1155/2018/3712067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 11/15/2018] [Accepted: 12/02/2018] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To analyze whether a viscoelastic mattress support surface can reduce the incidence of stage 2 pressure injuries compared to a standard hospital mattress with pyramidal overlay in critically ill patients. METHOD A randomized clinical trial with intention-to-treat analysis was carried out recruiting patients with Braden scale ≤14 on intensive care unit admission from April 2016 to April 2017. Patients were allocated into two groups: intervention group (viscoelastic mattress) and control group (standard mattress with pyramidal overlay). The level of significance adopted was 5%. RESULTS A total of 62 patients were included in the study. There was a predominance of males (53%) and the mean age was 67.9 (SD 18.8) years. There were no differences in clinical or severity characteristics between the patients in the control group and the intervention group. Pressure injuries occurred in 35 patients, with a median time of 7 days (ITQ 4-10) from admission. The frequency of pressure injuries was higher in the control group (80.6%) compared to the intervention group (32.2%; p < 0.001). CONCLUSIONS Viscoelastic support surfaces reduced the incidence of pressure injuries in moderate or higher risk critically ill patients when compared to pyramidal support surfaces.
Collapse
Affiliation(s)
| | | | - Marcos T. Tanita
- Post-graduate Student, Universidade Estadual de Londrina, Londrina, Brazil
| | - Lidiane Heko
- Registered Nurse, Associação Evangélica Beneficente de Londrina, Londrina, Brazil
| | | | - Josiane Festti
- Professor, Department of Internal Medicine, Universidade Estadual de Londrina, Londrina, Brazil
| | | | | |
Collapse
|
13
|
|