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Choragudi S, Andrade LF, Maskan Bermudez N, Burke O, Sa BC, Kirsner RS. Trends in inpatient burden from pressure injuries in the United States: Cross-sectional study National Inpatient Sample 2009-2019. Wound Repair Regen 2024; 32:487-499. [PMID: 38845416 DOI: 10.1111/wrr.13182] [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: 07/24/2023] [Revised: 02/19/2024] [Accepted: 04/01/2024] [Indexed: 07/11/2024]
Abstract
Pressure injuries are a significant comorbidity and lead to increased overall healthcare costs. Several European and global studies have assessed the burden of pressure injuries; however, no comprehensive analysis has been completed in the United States. In this study, we investigated the trends in the burden of pressure injuries among hospitalised adults in the United States from 2009 to 2019, stratified by sociodemographic subgroups. The length of admission, total cost of hospitalisation, and sociodemographic data was extracted from the National Inpatient Sample provided by the Healthcare Cost and Utilisation Project, Agency for Healthcare Research and Quality. Overall, the annual prevalence of pressure injuries and annual mean hospitalisation cost increased ($69,499.29 to $102,939.14), while annual mean length of stay decreased (11.14-9.90 days). Among all races, minority groups had higher average cost and length of hospitalisation. Our findings suggest that while the length of hospitalisation is decreasing, hospital costs and prevalence are rising. In addition, differing trends among racial groups exist with decreasing prevalence in White patients. Further studies and targeted interventions are needed to address these differences, as well as discrepancies in racial groups.
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Affiliation(s)
- Siri Choragudi
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Luis F Andrade
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Narges Maskan Bermudez
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Olivia Burke
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brianna Christina Sa
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Robert S Kirsner
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
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Jung SY, Moon KJ. Pressure Ulcer Management Virtual Reality Simulation (PU-VRSim) for Novice Nurses: Mixed Methods Study. JMIR Serious Games 2024; 12:e53165. [PMID: 38913417 PMCID: PMC11231622 DOI: 10.2196/53165] [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: 09/27/2023] [Revised: 03/26/2024] [Accepted: 04/15/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Pressure ulcers (PUs) are a common and serious complication in patients who are immobile in health care settings. Nurses play a fundamental role in the prevention of PUs; however, novice nurses lack experience in clinical situations. Virtual reality (VR) is highly conducive to clinical- and procedure-focused training because it facilitates simulations. OBJECTIVE We aimed to explore the feasibility of a novel PU management VR simulation (PU-VRSim) program using a head-mounted display for novice nurses and to investigate how different types of learning materials (ie, VR or a video-based lecture) impact learning outcomes and experiences. METHODS PU-VRSim was created in the Unity 3D platform. This mixed methods pilot quasi-experimental study included 35 novice nurses categorized into the experimental (n=18) and control (n=17) groups. The PU-VRSim program was applied using VR in the experimental group, whereas the control group received a video-based lecture. The PU knowledge test, critical thinking disposition measurement tool, and Korean version of the General Self-Efficacy Scale were assessed before and after the intervention in both groups. After the intervention, the experimental group was further assessed using the Clinical Judgment Rubric and interviewed to evaluate their experience with PU-VRSim. RESULTS The results compared before and after the intervention showed significant improvements in PU knowledge in both the experimental group (P=.001) and control group (P=.005). There were no significant differences in self-efficacy and critical thinking in either group. The experimental group scored a mean of 3.23 (SD 0.44) points (accomplished) on clinical judgment, assessed using a 4-point scale. The experimental group interviews revealed that the VR simulation was realistic and helpful for learning about PU management. CONCLUSIONS The results revealed that PU-VRSim could improve novice nurses' learning of PU management in realistic environments. Further studies using VR for clinical training are recommended for novice nurses.
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Affiliation(s)
- Soo Youn Jung
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Kyoung Ja Moon
- College of Nursing, Keimyung University, Daegu, Republic of Korea
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Byrne S, Patton D, Avsar P, Strapp H, Budri A, O'Connor T, Nugent L, Moore Z. Sub epidermal moisture measurement and targeted SSKIN bundle interventions, a winning combination for the treatment of early pressure ulcer development. Int Wound J 2023; 20:1987-1999. [PMID: 36575149 PMCID: PMC10333035 DOI: 10.1111/iwj.14061] [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: 05/19/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/29/2022] Open
Abstract
This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi-experimental observational approach was used. A total of 149 at risk acute hospital patients took part, 78 treatment, and 71 control. SEM deltas were recorded daily for a maximum of 5 days using the SEM Scanner (Bruin Biometrics LLC, Los Angeles, California), on three sites: the sacrum, the right heel, and the left heel, with enhanced and targeted PU prevention interventions occurring in those with an elevated SEM delta scores in the treatment group. Intention to treat analysis was used to guide the final composition of results. SEM PU represents PU development as identified by 2 days of sustained abnormal SEM delta scores, ≥0.5, after day one. The mean number of days completed by participants was just under 4 days, participants had many different comorbidities, with the most common being: hypertension, cancer, and chronic obstructive pulmonary disease. Results showed that following the introduction of SEM guided targeted treatments, participants in the treatment group yielded a statistically significant reduction in mean SEM delta scores (MD: 0.49; 95% CI: 0.59, 0.39; P < .0001), and in the odds of developing a SEM PU (OR: 0.59, 95% CI: 0.24 to 1.00; P = .05). In the treatment group, none of the participants developed a visual PU, whereas, in the control group, 1.41% (n = 1/71) developed a visual PU. Based on all the results, the following is concluded, (1). There was a greater reduction in mean SEM delta scores among those cared for using SEM measurement and targeted PU prevention, versus those cared for using visual skin assessment and usual care, and (2). the mean SEM delta scores was statistically significantly lower at the study end for those who received targeted treatments based on abnormal SEM scores. More research is now needed in other and larger at-risk groups to further validate what was found in this study.
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Affiliation(s)
| | - Declan Patton
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Faculty of Science, Medicine and HealthUniversity of WollongongWollongongNew South WalesAustralia
| | - Pinar Avsar
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
| | | | - Aglecia Budri
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
| | - Tom O'Connor
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Lida InstituteShanghaiChina
| | - Linda Nugent
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
| | - Zena Moore
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia
- Lida InstituteShanghaiChina
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
- Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
- University of WalesCardiffUK
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound CareMenzies Health Institute QueenslandGriffithQueenslandAustralia
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Hsu MY, Chen YS, Chen YC, Wu YL. Nurse-led coaching of shared decision-making for wound treatment of pressure injury: A pilot study of a randomized trial. Tzu Chi Med J 2023; 35:260-266. [PMID: 37545793 PMCID: PMC10399837 DOI: 10.4103/tcmj.tcmj_256_22] [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: 09/14/2022] [Revised: 12/26/2022] [Accepted: 02/20/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives International guidelines for managing pressure injury (PI) and ulcers recommend that family members and caregivers should be involved in making decisions for appropriate wound care. However, the effect of shared decision-making (SDM) in the context of PI remains unknown. This study investigated the efficacy of nurse-led medical SDM for PI treatment. Materials and Methods We constructed a patient decision aid (PDA) for PI treatment on the basis of nursing evidence. Subsequently, we conducted a pilot randomized controlled trial to evaluate the efficacy of SDM compared with that of usual care (control group, [CG]) for PI treatment. Participants with stage 3, stage 4, or unstageable PI were included and randomized into two groups. In the SDM group (SDMG), 10 participants received the SDM intervention for PI before treatment. All participants were followed up for 4 weeks. Primary outcomes were measured using the nine-item SDM Questionnaire (SDM-Q-9) and Decisional Conflict Scale (DCS). Secondary outcomes included wound size and cost of wound management. Results The expert validity (medical professors and general population) of the PDA designed for PI was measured, and the content validity index was 0.96-0.97. A total of 20 participants were enrolled (10 received SDM and 10 received usual care). The mean age of the participants was 55.7 ± 8.8 years. No significant difference in baseline characteristics (sex, age, staging, or wound area) was observed between the two groups. The SDMG had higher SDM-Q-9 (P < 0.001) and DCS (P < 0.01) scores than did the CG. For the secondary outcomes, the SDMG had a decreased change of wound size and lower wound management costs than did the CG; nevertheless, the differences were not statistically significant. Conclusion We constructed a PDA for PI treatment, which can be applied in clinical care. The pilot test results revealed that the participants had a lower cost related wound treatment and decreasing wound size in SDMG than CG after the intervention of SDM-PI for 4 weeks. In the future, clinical studies should conduct large-scale randomized trials based on the results of this pilot study.
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Affiliation(s)
- Mei-Yu Hsu
- Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Sin Chen
- Department of Nursing, Kuang Tien General Hospital, Taichung, Taiwan
| | - Ying-Chun Chen
- Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Lin Wu
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Yeo H, Hwang J, Lee M, No D, Jang I. Effect of a prophylactic dressing for sacral pressure injuries in non-critically ill patients after general surgery: A randomized controlled trial. Worldviews Evid Based Nurs 2023. [PMID: 37183386 DOI: 10.1111/wvn.12651] [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: 11/22/2022] [Revised: 03/29/2023] [Accepted: 04/23/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Hospital-acquired pressure injuries are strongly associated with surgeries performed under general anesthesia. AIMS The aim of this study was to evaluate the effects of using a prophylactic multi-layer soft silicone foam dressing in non-critically ill patients with a Braden Scale score of ≤18 after undergoing routine surgery without sacral pressure injuries. METHODS This randomized controlled trial included 156 patients who were admitted for surgery under general anesthesia in a tertiary general hospital. The patients were divided into a control group and an intervention group. A 5-layer soft silicone foam dressing was applied to the sacrum of patients in the intervention group immediately after surgery. For the control group, standard pressure injury prevention activities were performed alongside standard care without preventive dressings. RESULTS There were no significant differences in general and clinical characteristics between the two groups; however, the incidence of pressure injury and blanching erythema was higher in the control group, showing a significant difference from the experimental group. Factors influencing the development of pressure injuries and blanching erythema through multivariate regression analysis were prophylactic dressing application and Braden Scale score at the time of admission. A statistically significant difference was noted in survival time from pressure injury between both groups. LINKING EVIDENCE TO ACTION The incidence of pressure injuries and blanching erythema was lower when the prophylactic dressing was applied with standard protocol for general ward patients after surgery. Accurate evaluation of the patient's skin condition and pressure injury risk assessment before surgery are important. Progressive prophylactic dressings to prevent pressure injuries are effective, and tailored nursing interventions based on accurate assessment of patient's skin condition and risk factors are essential for maintaining skin integrity.
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Affiliation(s)
- Hyunjung Yeo
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - Jihyeon Hwang
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - Miju Lee
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - Dayeong No
- Department of Nursing, Asan Medical Center, Seoul, South Korea
| | - Insil Jang
- Department of Nursing, Chung-Ang University, Seoul, South Korea
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Nelson EE, Rousseau MA, Mohr CA, Rashid RM. A New-Onset Facial Lesion in a Hospitalized COVID-19 Patient. Cureus 2023; 15:e38442. [PMID: 37273295 PMCID: PMC10234417 DOI: 10.7759/cureus.38442] [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] [Accepted: 04/23/2023] [Indexed: 06/06/2023] Open
Abstract
Pressure ulcers form when skin is compressed against a bony prominence, often in the context of prolonged supine or prone-based care. Hospitalized, bedridden patients are at the highest risk of this complication, especially when preventative measures like regular rotational bed treatment are not employed. In this case report, we present a rare case of a COVID-19-related facial pressure ulcer that occurred in the context of regular rotational bed treatment. The lesion was managed by wound care and allowed to heal by secondary intention. Ultimately, we hope that this manuscript will raise awareness for this atypical ulcer location, especially as prone-position treatment approaches take hold.
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Affiliation(s)
- Emelie E Nelson
- Dermatology, John P. and Kathrine G. McGovern Medical School at UTHealth, Houston, USA
| | - Morgan A Rousseau
- Dermatology, John P. and Kathrine G. McGovern Medical School at UTHealth, Houston, USA
| | - Cassandra A Mohr
- Dermatology, John P. and Kathrine G. McGovern Medical School at UTHealth, Houston, USA
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Vera Salmerón E, Mota Romero E, Domínguez Nogueira C, Rutherford C, Tudela Vázquez MP. [Spanish translation and cross-cultural adaptation of the Pressure Ulcer Quality of Life Questionnaire (PU-QOL).]. Rev Esp Salud Publica 2023; 97:e202304032. [PMID: 37114484 PMCID: PMC10540906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/17/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE Pressure ulcers (PU) are the most prevalent of the dependency-related injuries, affecting the quality of life of the patients who suffer them. However, there are no instruments adapted to the Spanish context to evaluate this quality of life. The use of specific tools in Spanish to evaluate the quality of life perceived by patients with PUs is considered an indispensable element for healthcare decisions. The aim of this paper was to translate and culturally adapt the Pressure Ulcer Quality of Life Questionnaire (PU-QOL) into Spanish for the measurement of health-related quality of life in patients with pressure ulcers. METHODS A translation, back-translation, and pre-test method was used on the target population to obtain an adapted version of the original PU-QOL instrument. The area was Primary Care. The participants were fifteen Primary Care patients. Main steps: 1) Direct translation; 2) Synthesis and concordance of versions by an expert committee; 3) Back translation; 4) Consistency of the back translation with the author from the original questionnaire; and 5) Analysis of comprehensibility through cognitive interviews with a sample of patients. RESULTS An instrument to measure perceived quality of life in patients with PU was obtained, composed of ten scales and eighty-three items. The scales and items of the original questionnaire were maintained. Conceptual and semantic analysis produced adjustments in wording, clarification and reformulations adapted to the Spanish context. CONCLUSIONS We present this first phase of translation and cross-cultural adaptation of the PU-QOL questionnaire in Spanish, which could be a useful tool for decision-making on health care in patients with PUs.
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Affiliation(s)
- Eugenio Vera Salmerón
- Centro de Salud Salvador Caballero, Distrito Sanitario Granada-Metropolitano, Servicio Andaluz de Salud. Servicio Andaluz de SaludGranadaSpain
- Instituto de Investigación Biosanitaria (ibs.GRANADA).Instituto de Investigación Biosanitaria (ibs.GRANADA).GranadaSpain
| | - Emilio Mota Romero
- Centro de Salud Salvador Caballero, Distrito Sanitario Granada-Metropolitano, Servicio Andaluz de Salud. Servicio Andaluz de SaludGranadaSpain
- Instituto de Investigación Biosanitaria (ibs.GRANADA).Instituto de Investigación Biosanitaria (ibs.GRANADA).GranadaSpain
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada.Universidad de GranadaGranadaSpain
| | - Carmen Domínguez Nogueira
- Consejería de Salud y Familias, Delegación Territorial de Granada, Inspección Provincial de Servicios Sanitarios.Inspección Provincial de Servicios SanitariosGranadaSpain
| | - Claudia Rutherford
- Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Cancer Care Research Unit (CCRU), The University of Sydney.The University of SydneySidneyAustralia
- Faculty of Science, School of Psychology, Sydney Quality of Life Office, The University of Sydney.The University of SydneySidneyAustralia
| | - María Pilar Tudela Vázquez
- Departamento de Trabajo Social y Servicios Sociales, Facultad de Trabajo Social, Universidad de Granada.Universidad de GranadaGranadaSpain
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Chang WP, Weng PW. Retrospective study on the factors influencing the severity of pressure injuries among intensive care unit patients. J Clin Nurs 2023; 32:243-252. [PMID: 35034404 DOI: 10.1111/jocn.16213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES This study investigated the factors of pressure injuries in patients in intensive care units (ICU). BACKGROUND Pressure injuries among patients in ICUs can be prevented by the early assessment of risk factors and taking appropriate preventative measures. DESIGN A retrospective study. METHODS ICU patients who suffered from pressure injuries between January 2016 and August 2018 at a hospital in Taiwan were selected. Patient medical histories and data associated with pressure injuries and medical treatment were collected from electronic medical records. A total of 256 patients were included in our analysis. The study adhered to the STROBE checklist. RESULTS A multivariate model of multinomial logistic regression analysis indicated that when compared to Stage 1 pressure injuries, Stage 2-4 pressure injuries were associated with albumin levels. Patients with lower albumin levels were at greater odds of Stage 2-4 pressure injuries than Stage 1 pressure injuries. In addition, when compared to unstageable pressure injuries or deep tissue injuries, Stage 1 pressure injuries were associated with the use of fentanyl and haemoglobin levels. Patients using fentanyl were more likely to suffer from unstageable pressure injuries, and those with lower haemoglobin levels were more likely to suffer from unstageable pressure injuries or deep tissue injuries. CONCLUSION When patients were simultaneously on ventilators and taking midazolam or fentanyl, the incidence of pressure injuries with greater severity became higher. Furthermore, ICU patients with lower albumin and haemoglobin levels were more likely to suffer from pressure injuries of greater severity. RELEVANCE TO CLINICAL PRACTICE For critically ill patients on ventilators, it is recommended to devise a means of assessing each patient daily as well as systematically reduce their dosage of midazolam or fentanyl. Furthermore, regularly monitoring albumin and haemoglobin levels to understand their nutritional status is necessary.
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Affiliation(s)
- Wen-Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pei-Wei Weng
- Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
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Ahmadipour M, Lashkari M, Ahmadinejad M. Comparison of Morbidity, Mortality, and Costs of VAP Patients with Non-VAP Patients in the Tertiary Referral Hospital of Kerman, Iran. TANAFFOS 2023; 22:61-69. [PMID: 37920318 PMCID: PMC10618589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 10/01/2022] [Indexed: 11/04/2023]
Abstract
Background Ventilator-associated pneumonia is the most common type of nosocomial infection in ICUs. Hence, this study shall focus on the morbidity, mortality, and costs associated with this infection among ICU patients. Materials and Methods The current research is a prospective descriptive-analytical study. The study population included patients admitted to the Tertiary Referral Hospital of Kerman University of Medical Sciences who were enrolled in the study according to inclusion criteria and demographic characteristics data, length of stay in ICU and general wards, and direct and indirect medical expenses such as unemployment and rehabilitation cost, etc. Results Nine of the 144 patients studied died. (4 in the Ventilator-Associated Pneumonia (VAP) group and 5 in the non-VAP group). Among them, the prevalence of Acinetobacter Baumannii was significantly higher than other bacteria (P-Value=0.001). The duration of hospitalization in the ICU (18±9 vs. 9.5±6 days) and recovery time (21.6±9 9.6 vs. 13.2±7 days) were higher in the VAP group (P-Value<0.05). Moreover, the duration of hospitalization in the general ward was 15.4±8 days in the VAP group and 10.6±6 days in the non-VAP group (P-Value<0.05). The cost of treatment in the VAP group ($7952.28) was significantly higher than in the non-infected group ($4400.98). The average rehabilitation cost in the VAP group was $2571.42 and in the non-affected group was $1530.88. The financial loss due to the delay in work starting was $482 in the non-VAP group which was significantly less than the VAP group ($792). Conclusion Having VAP can significantly increase mortality, length of stay in the ICU as well as increase direct and indirect costs for patients.
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Affiliation(s)
- Maryam Ahmadipour
- Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran
| | - Marzieh Lashkari
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Ahmadinejad
- Department of Anesthesia, Kerman University of Medical Sciences, Kerman, Iran
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10
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Zhu Y, Luo M, Liu Q, Liu H. Preventive effect of cluster nursing on pressure ulcers in orthopedic patients and predictive value of serum IL-6 and TNF-α for the occurrence of pressure ulcers. Am J Transl Res 2023; 15:1140-1149. [PMID: 36915758 PMCID: PMC10006788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/20/2022] [Indexed: 03/16/2023]
Abstract
OBJECTIVE To determine the effect of cluster nursing on pressure ulcer prevention and comfort of orthopedic patients. METHODS A total of 124 orthopedic inpatients admitted to the Seventh Affiliated Hospital of Sun Yat-sen University from July 2018 to June 2021 were retrospectively analyzed. Among them, 66 cases received cluster nursing who were assigned into the observation group and the other 58 cases received routine nursing and were assigned into the control group. The incidence of pressure ulcers, the degree of pressure the ulcer, quality of life-brief (QOL-BREF), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores of the two groups at 7 days after surgery were compared, and the comfort score and nursing satisfaction of the two groups were evaluated and compared. The expression and predictive value of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with pressure ulcers before operation were analyzed via enzyme-linked immunosorbent assay (ELISA). The levels of IL-6 and TNF-α were compared between the two groups before and after nursing. RESULTS After nursing, the observation group had significantly lower IL-6, TNF-α, SAS score, and SDS scores than the control group, and showed significantly higher QOL-BREF score, nursing satisfaction and comfort scores than the control group. In addition, the observation group showed a significantly lower incidence of pressure ulcers and a significantly lower severity level than the control group after nursing. Patients with pressure ulcers showed significantly higher serum IL-6 and TNF-α levels before surgery, and receiver operating characteristic curve (ROC) showed that IL-6 and TNF-α had certain value in forecasting the occurrence of pressure ulcers. CONCLUSION Cluster nursing can substantially lower the incidence of pressure ulcers in hospitalized orthopedic patients and improve their comfort.
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Affiliation(s)
- Yan Zhu
- Orthopedics and Traumatology, The Seventh Affiliated Hospital of Sun Yat-sen University Shenzhen 518107, Guangdong, China
| | - Minghua Luo
- Cardiovascular Center, The Seventh Affiliated Hospital of Sun Yat-sen University Shenzhen 518107, Guangdong, China
| | - Qiongshan Liu
- Medical Division, The Seventh Affiliated Hospital of Sun Yat-sen University Shenzhen 518107, Guangdong, China
| | - Hankun Liu
- Department of Critical Care Medicine, The Seventh Affiliated Hospital of Sun Yat-sen University Shenzhen 518107, Guangdong, China
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11
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Mazzetti G, Sciolino L, Guglielmi D, Mongardi M, Nielsen K, Dawson J. Organizational citizenship behaviour as a protective factor against the occurrence of adverse nursing-sensitive outcomes: A multilevel investigation. J Nurs Manag 2022; 30:4294-4303. [PMID: 36190738 PMCID: PMC10092892 DOI: 10.1111/jonm.13827] [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: 06/07/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 12/30/2022]
Abstract
AIMS This study aimed to investigate the association between organizational citizenship behaviour enacted by nurses and the occurrence of adverse nursing-sensitive patient outcomes. BACKGROUND Managing psychosocial factors (i.e., aspects concerning the work environment) is key to ensure patient safety, to prevent exacerbation of case complexity and to cope with critical shortages in human and financial resources. METHODS Self-report measures of nurses' organizational citizenship behaviour were combined with objective data on the incidence of adverse nursing-sensitive outcomes (i.e., pressure ulcers and restraint use) collected through patients' medical records. Participants were 11,345 patients and 1346 nurses across 52 teams working in 14 Italian hospitals. Data were analysed using multilevel binary logistic regression models. RESULTS A negative relationship between nurses' organizational citizenship behaviour and restraint use was identified, with an odds ratio of 0.11. Thus, for a one-unit higher organizational citizenship behaviour score, the odds of using restraints shrink to about one eighth of the previous level. CONCLUSIONS Intervention strategies to foster the implementation of organizational citizenship behaviour among nurses may inhibit the occurrence of critical outcomes affecting patients' health and well-being (i.e., using restraint devices). IMPLICATIONS FOR NURSING MANAGEMENT In health care organizations, shaping a psychosocial environment encouraging organizational citizenship behaviour can mitigate the occurrence of adverse nursing-sensitive outcomes such as restraint use on patients.
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Affiliation(s)
- Greta Mazzetti
- Department of Education Studies, University of Bologna, Bologna, Italy
| | - Lorenzo Sciolino
- Hospital Care Service, General Direction for People Care, Health and Welfare, Emilia-Romagna Region, Bologna, Italy
| | - Dina Guglielmi
- Department of Education Studies, University of Bologna, Bologna, Italy
| | - Maria Mongardi
- Infectious Diseases Division, Diagnostics and Public Health Department, University of Verona, Verona, Italy
| | - Karina Nielsen
- Sheffield University Management School, The University of Sheffield, Sheffield, UK
| | - Jeremy Dawson
- Sheffield University Management School, The University of Sheffield, Sheffield, UK.,School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
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12
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Gheorghita D, Grosu E, Robu A, Ditu LM, Deleanu IM, Gradisteanu Pircalabioru G, Raiciu AD, Bita AI, Antoniac A, Antoniac VI. Essential Oils as Antimicrobial Active Substances in Wound Dressings. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15196923. [PMID: 36234263 PMCID: PMC9570933 DOI: 10.3390/ma15196923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 05/13/2023]
Abstract
Wound dressings for skin lesions, such as bedsores or pressure ulcers, are widely used for many patients, both during hospitalization and in subsequent treatment at home. To improve the treatment and shorten the healing time and, therefore, the cost, numerous types of wound dressings have been developed by manufacturers. Considering certain inconveniences related to the intolerance of some patients to antibiotics and the antimicrobial, antioxidant, and curative properties of certain essential oils, we conducted research by incorporating these oils, based on polyvinyl alcohol/ polyvinyl pyrrolidone (PVA/PVP) biopolymers, into dressings. The objective of this study was to study the potential of a polymeric matrix for wound healing, with polyvinyl alcohol as the main material and polyvinyl pyrrolidone and hydroxypropyl methylcellulose (HPMC) as secondary materials, together with additives (plasticizers poly(ethylene glycol) (PEG) and glycerol), stabilizers (Zn stearate), antioxidants (vitamin A and vitamin E), and four types of essential oils (fennel, peppermint, pine, and thyme essential oils). For all the studied samples, the combining compatibility, antimicrobial, and cytotoxicity properties were investigated. The obtained results demonstrated a uniform morphology for almost all the samples and adequate barrier properties for contact with suppurating wounds. The results show that the obtained samples containing essential oils have a good inhibitory effect on, or antimicrobial properties against, Staphylococcus aureus ATCC 25923, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, and Candida albicans ATCC 10231. The MTT assay showed that the tested samples were not toxic and did not lead to cell death. The results showed that the essential oils used provide an effective solution as active substances in wound dressings.
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Affiliation(s)
- Daniela Gheorghita
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei Street, 060042 Bucharest, Romania
| | - Elena Grosu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei Street, 060042 Bucharest, Romania
| | - Alina Robu
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei Street, 060042 Bucharest, Romania
| | - Lia Mara Ditu
- Faculty of Biology, University of Bucharest, 1-3 Intr. Portocalelor Street, 060101 Bucharest, Romania
| | - Iuliana Mihaela Deleanu
- Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1-7 Polizu Street, 011061 Bucharest, Romania
| | - Gratiela Gradisteanu Pircalabioru
- Research Institute of the University of Bucharest, 90 Sos. Panduri, 050663 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei Street, 050094 Bucharest, Romania
| | - Anca-Daniela Raiciu
- Faculty of Pharmacy, Titu Maiorescu University, 22 Dambovnicului Street, 040441 Bucharest, Romania
- S.C. Hofigal Import Export S.A., 2 Intrarea Serelor Street, 042124 Bucharest, Romania
| | - Ana-Iulia Bita
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei Street, 060042 Bucharest, Romania
- Correspondence:
| | - Aurora Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei Street, 060042 Bucharest, Romania
| | - Vasile Iulian Antoniac
- Faculty of Material Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei Street, 060042 Bucharest, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei Street, 050094 Bucharest, Romania
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13
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Orlov A, Gefen A. Effective negative pressure wound therapy for open wounds: The importance of consistent pressure delivery. Int Wound J 2022; 20:328-344. [PMID: 35818745 PMCID: PMC9885467 DOI: 10.1111/iwj.13879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/14/2022] [Indexed: 02/03/2023] Open
Abstract
Two distinct design concepts exist for single-use negative pressure wound therapy systems: Canister-based versus canisterless. The canister-based technology provides intrinsic stable delivery of the intended negative pressure, because exudate is constantly transferred from the wound into a canister, thereby preventing dressing saturation. In contrast, with a canisterless system, where delivery of the negative pressure depends on continuous evaporation of wound fluids from its dressing, loss of the intended wound-bed pressure may occur due to dressing saturation. To investigate whether these two designs differ in their mechanobiological effect with respect to magnitudes and distributions of tissue strain fields under the absorptive dressing, termed the influence zone, we integrated computational modelling with an animal study. This influence zone must be of biologically influential strain levels and extend sufficiently into the peri-wound for stimulating fibroblasts to migrate and progress the healing. We found that an effective influence zone requires continuous delivery of the intended pressure to the wound-bed. Loss of negative pressure at the wound-bed below 40 mmHg adversely lowered the peri-wound stimulation around a 120 × 70 mm sized wound to less than one-third of the baseline stimulation, and further pressure decreases to 20 mmHg or lower resulted in complete lack of peri-wound mechano-stimulation.
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Affiliation(s)
- Aleksei Orlov
- Department of Biomedical Engineering, Faculty of EngineeringTel Aviv UniversityTel AvivIsrael
| | - Amit Gefen
- Department of Biomedical Engineering, Faculty of EngineeringTel Aviv UniversityTel AvivIsrael
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14
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Walther F, Heinrich L, Schmitt J, Eberlein-Gonska M, Roessler M. Prediction of inpatient pressure ulcers based on routine healthcare data using machine learning methodology. Sci Rep 2022; 12:5044. [PMID: 35322109 PMCID: PMC8943147 DOI: 10.1038/s41598-022-09050-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/09/2022] [Indexed: 11/20/2022] Open
Abstract
Despite the relevance of pressure ulcers (PU) in inpatient care, the predictive power and role of care-related risk factors (e.g. anesthesia) remain unclear. We investigated the predictability of PU incidence and its association with multiple care variables. We included all somatic cases between 2014 and 2018 with length of stay ≥ 2d in a German university hospital. For regression analyses and prediction we used Bayesian Additive Regression Trees (BART) as nonparametric modeling approach. To assess predictive accuracy, we compared BART, random forest, logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) using area under the curve (AUC), confusion matrices and multiple indicators of predictive performance (e.g. sensitivity, specificity, F1, positive/ negative predictive value) in the full dataset and subgroups. Analysing 149,006 cases revealed high predictive variable importance and associations between incident PU and ventilation, age, anesthesia (≥ 1 h) and number of care-involved wards. Despite high AUCs (range 0.89–0.90), many false negative predictions led to low sensitivity (range 0.04–0.10). Ventilation, age, anesthesia and number of care-involved wards were associated with incident PU. Using anesthesia as a proxy for immobility, an hourly repositioning is indicated. The low sensitivity indicates major challenges for correctly predicting PU based on routine data.
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Affiliation(s)
- Felix Walther
- Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany. .,Quality and Medical Risk Management, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Luise Heinrich
- Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Maria Eberlein-Gonska
- Quality and Medical Risk Management, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - Martin Roessler
- Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
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15
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Awoke N, Tekalign T, Arba A, Lenjebo TL. Pressure injury prevention practice and associated factors among nurses at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia: a cross-sectional study. BMJ Open 2022; 12:e047687. [PMID: 35288379 PMCID: PMC8921857 DOI: 10.1136/bmjopen-2020-047687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE The prevention of pressure injury is of great importance in providing quality care to patients, as it has been reported that approximately 95% of all pressure injury are preventable. Nurses working in clinical settings play a key role in identifying patients at risk and administering preventative care. Therefore, this study examines pressure injury prevention practices among nurses. DESIGN Cross-sectional study design. SETTING Wolaita Sodo University Teaching and Referral Hospital, Ethiopia. PARTICIPANTS 240 nurses. MAIN OUTCOME MEASURES Pressure injury prevention practices among nurses. RESULT Among nurses, 37.9% had good pressure injury prevention practices. The factors associated with pressure injury prevention practices included having a bachelor's degree or higher (adjusted odds ratio (AOR)=2.18; 95% CI 1.12 to 4.25), having more than 10 years of nursing experience (AOR=3.44; 95% CI 1.41 to 8.37), lacking subject knowledge (AOR=0.49; 95% CI 0.27 to 0.91) and being over the age of 40 (AOR=0.55; 95% CI 0.09 to 0.35). CONCLUSION The majority of nurses reported having a limited level of pressure injury prevention practice. Since pressure ulcer prevention practice is majorly the role of nurses. Upgrading the educational level of the nurses through continuous professional development opportunities can improve the preventive practice of pressure ulcer injury by increasing the knowledge and skill gained during the vocational training.
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Affiliation(s)
- Nefsu Awoke
- School of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Aseb Arba
- School of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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16
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Nasir NJM, Corrias A, Heemskerk H, Ang ET, Jenkins JH, Sebastin SJ, Tucker-Kellogg L. The panniculus carnosus muscle: a missing link in the chronicity of heel pressure ulcers? J R Soc Interface 2022; 19:20210631. [PMID: 35193390 PMCID: PMC8864364 DOI: 10.1098/rsif.2021.0631] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Chronic and recurring pressure ulcers (PUs) create an unmet need for predictive biomarkers. In this work, we examine the panniculus carnosus, a thin cutaneous muscle, traditionally considered vestigial in humans, and ask whether the panniculus may play a role in the chronicity and reinjury of heel PUs. To determine whether humans have a panniculus muscle layer at the heel, we dissected eight cadavers. To assess the influence of the panniculus layer on PU, we performed computational simulations of supine weight bearing. Finally, we assessed panniculus regeneration in fluorescent mice. Results show a panniculus layer present in all cadavers examined. Simulations show a thin layer of panniculus muscle causes a dramatic decrease in the volume of soft tissue experiencing high strain and stress, compared to a heel without a panniculus. Importantly, in the mouse model, the panniculus fails to regenerate after PU, even when other cutaneous layers had fully regenerated. Our work shows that the panniculus is able to redistribute load around the heel bone, which might allow it to prevent PUs. Moreover, it is highly susceptible to incomplete regeneration after PU. Poor panniculus regeneration after PU might be a predictive anatomical biomarker for recurrence, and this biomarker should be evaluated prospectively in future clinical trials.
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Affiliation(s)
- N Jannah M Nasir
- Cancer and Stem Cell Biology and Centre for Computational Biology, Duke-NUS Medical School, Singapore
| | - Alberto Corrias
- Department of Biomedical Engineering, National University of Singapore
| | - Hans Heemskerk
- Cancer and Stem Cell Biology and Centre for Computational Biology, Duke-NUS Medical School, Singapore
| | - Eng Tat Ang
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Julia H Jenkins
- Cancer and Stem Cell Biology and Centre for Computational Biology, Duke-NUS Medical School, Singapore
| | - S J Sebastin
- Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore
| | - Lisa Tucker-Kellogg
- Cancer and Stem Cell Biology and Centre for Computational Biology, Duke-NUS Medical School, Singapore
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17
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Woźniak A, Smółka I, Dusińska A, Misiąg W, Chabowski M. Pressure Ulcer Incidence and Blood Lactate Levels in Intensive Care Unit Patients. J Inflamm Res 2022. [DOI: 10.2147/jir.s352402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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18
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Abstract
There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). Globally, the number of prevalent cases of decubitus ulcers in 2019 is 0.85 (95% UI 0.78 to 0.94) million. The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the > 95 age group among men and women. At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI. Malaysia, Saudi Arabia, and Thailand experienced the most significant increases in age-standardized prevalence rates at the national level. Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries.
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19
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Li Z, Marshall AP, Lin F, Ding Y, Chaboyer W. Pressure injury prevention practices among medical surgical nurses in a tertiary hospital: An observational and chart audit study. Int Wound J 2021; 19:1165-1179. [PMID: 34729917 PMCID: PMC9284631 DOI: 10.1111/iwj.13712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022] Open
Abstract
Pressure injuries are frequently occurring adverse events in hospitals, negatively impacting patient safety and quality of care. Most pressure injuries are avoidable if effective prevention strategies are used. However, the extent to which various settings influence their use of prevention strategies is unknown. The aim of this study was to describe and compare pressure injury prevention strategies used by medical and surgical nurses in the Chinese context. In this observational study, we used semi-structured observations with chart audits to collect data in two medical and two surgical wards in a tertiary hospital from June to December 2020. Observations were patient-focused; any prevention practices the patient received were recorded, and a chart audit was used to identify documented prevention strategies. The frequency of each prevention strategy was reported, and differences between medical and surgical wards were analysed using independent t-test or χ2 test. A total of 577 patients (n = 294, 50.9% medical; n = 283, 49.1% surgical) were observed and their charts audited. Risk assessment was completed on admission for all patients. Repositioning was the most frequently used strategy, with about 84% (n = 486) patients being repositioned regularly. However, skin care, nutritional risk screening and the use of support surfaces were suboptimal. Patient education was not commonly observed but was documented in 75% (n = 433) of audited charts. More medical patients' skin was kept clean and hydrated, but more surgical patients received barrier creams, had a support surface and received more nutrition support and if a prone position was used, they were more likely to be turned after 2 hr and to be repositioned after sitting in a chair for an hour. Prevention strategies were more likely to be documented in surgical patients' charts. Despite pressure injury prevention guideline recommendations provided various prevention strategies for nurses to apply, the observed use of some strategies such as nutrition, skin care and support surfaces was not ideal. Nurses relied heavily on repositioning for pressure injury prevention. Most pressure injury prevention practices need improvement although surgical patients generally received better preventative care. These findings can facilitate clinicians and nurse managers when tailoring future pressure injury prevention work.
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Affiliation(s)
- Zhaoyu Li
- School of Nursing and Midwifery, Griffith University, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Andrea P Marshall
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,Nursing and Midwifery Education and Research Unit, Gold Coast Health, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Frances Lin
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Yanming Ding
- Nursing Department, Peking University First Hospital, Beijing, China
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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