Nursing decision making in daily practice needs to be based on scientific knowledge. Evidence-based practice establishes the use of research results in clinical practice, with integrative literature review as one of its resources. This integrative review aimed to find and evaluate the available evidence on efficient nursing care interventions for the prevention of skin injuries in surgical patients, during or as a result of the perioperative period. To select the articles, we used two databases, Cinahl and Medline, resulting in a sample of 14 articles. The results of this analysis indicated that the devices considered most efficient in the prevention of skin injuries were, in decreasing order, the multi-cell pulsating dynamic mattress system, a dry visco-elastic polymer pad and gel cushions.
Nursing decision making in daily practice needs to be based on scientific knowledge. Evidence-based practice establishes the use of research results in clinical practice, with integrative literature review as one of its resources. This integrative review aimed to find and evaluate the available evidence on efficient nursing care interventions for the prevention of skin injuries in surgical patients, during or as a result of the perioperative period. To select the articles, we use two databases, Cinalh and Medline, resulting in a sample of 14 articles, which mainly dealt with the use of support surfaces. The results of this analysis indicated that the devices considered most efficient in the prevention of skin injuries were, in decreasing order, the multi-cell pulsating dynamic mattress system, a dry visco-elastic polymer pad and gel cushions. DESCRIPTORS: perioperative nursing; nursing care; decubitus ulcer.
Objective: To identify the occurrence of stages II, III and IV pressure ulcers in patients undergoing elective surgery. Methods: A quantitative approach, with non-experimental research design, of a descriptive and prospective type. The sample consisted of 148 adult patients of both genders, undergoing elective surgery, according to predetermined selection criteria. Results: Of the sample evaluated, 108 patients were discharged from hospital, three patients died and 37 developed pressure ulcers. These patients presented 44 lesions, the majority of which were diagnosed as stage II (56.8%), followed by stage I (40.9%) and stage III (2.3%) lesions. The body areas most affected were the sacral / gluteal region (68.2%), the heels (18.1%), dorsal region (9%) and the external ear (4.6%). Conclusion: The occurrence of pressure ulcers was 25%, indicating the need for implementation of effective interventions for the prevention of these adverse events in the perioperative period. Keywords: Pressure ulcer/epidemiology; Perioperative nursing; Surgical procedures, elective; Incidence RESUMOObjetivo: Identificar a ocorrência de úlcera por pressão em pacientes submetidos a cirurgias eletivas de porte II, III e IV. Métodos: Estudo de abordagem quantitativa, com delineamento de pesquisa não experimental, tipo descritivo e prospectivo. A amostra foi composta por 148 pacientes adultos, de ambos os gêneros, submetidos à cirurgia eletiva, conforme os critérios de seleção determinados previamente. Resultados: Da amostra avaliada, 108 pacientes receberam alta hospitalar, três faleceram e 37 desenvolveram úlceras por pressão. Esses pacientes apresentaram 44 lesões, sendo a maioria diagnosticada de estágio II (56,8%), seguida por lesões de estágio I (40,9%) e estágio III (2,3%). As áreas corporais mais acometidas foram a região sacro/glútea (68,2%), calcâneos (18,1%), região dorsal (9%) e o pavilhão auricular (4,6%). Conclusão: A ocorrência de úlcera por pressão foi de 25% indicando a necessidade de implementação de intervenções efetivas para a prevenção desse evento adverso no perioperatório. Descritores: Úlcera por pressão/epidemiologia; Enfermagem perioperatória; Procedimentos cirúrgicos eletivos; Incidência RESUMEN Objetivo: Identificar la ocurrencia de úlcera por presión en pacientes sometidos a cirugías electivas de porte II, III y IV. Métodos: Estudio de abordaje cuantitativo, con delineamiento de investigación no experimental, tipo descriptivo y prospectivo. La muestra estuvo compuesta por 148 pacientes adultos, de ambos géneros, sometidos a la cirugía electiva, conforme los criterios de selección determinados previamente. Resultados: De la muestra evaluada, 108 pacientes recibieron alta hospitalaria, tres fallecieron y 37 desarrollaron úlceras por presión. Esos pacientes presentaron 44 lesiones, siendo la mayoría diagnosticada de estadío II (56,8%), seguida por lesiones de estadío I (40,9%) y estadío III (2,3%). Las áreas corporales más afectadas fueron la región sacro/glútea (68,2%), calcáneos (18,1%), región dorsal (9%...
Avaliação do desenvolvimento de úlceras por pressão em pacientes cirúrgicos RIBEIRÃO PRETO 2010
Reprocessing single-use devices to cut costs is a common practice in hospitals around the world. In Brazil, there are few studies of reprocessing hemodynamic catheters and thus, this study aimed to evaluate the effectiveness of reprocessing hemodynamic catheters before and after biofilm formation in vitro using a continuous flow model. We used a sterility test and Scanning Electron Microscopy (SEM) to assess the presence of microorganisms, residue and integrity of a New (NC) and Reprocessed (RC) hemodynamic catheter, before and after in vitro biofilm formation by a clinical isolate of Enterococcus faecium (strain 155). NC was considered the negative control. The sterility test did not show the presence of microorganisms in either catheters used as a negative control (NC and RC). On the other hand, changes in integrity were observed by SEM in the RC, with a large number of microcracks and recesses, indicating that this would get worse after reprocessing. After biofilm formation and subsequent sterilization by ethylene oxide, both catheters were examined by SEM and RC showed a dense array of exopolysaccharide and substantial organic waste material, which was not evident in NC, showing changes in surface integrity. Ethylene oxide sterilization is very efficient in the sterilization process but the reprocessed catheters after biofilm formation by strain 155, showed marked surface changes, which increases the adhesion of organic matter and compromises the cleaning process in reprocessing. The results can be used as a parameter for hospitals and companies that reprocess catheters, to develop protocols for standardized and systematic surveillance in reusing materials recommended for single use to prevent infections.
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