Do risk assessment scales for pressure ulcers work?

Anthony, Denis; Papanikolaou, Panos; Parboteeah, Sam; Saleh, Mohammad

doi:10.1016/j.jtv.2009.11.006

Cited by 44 publications

(44 citation statements)

References 16 publications

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“…Little evidence supports such a reduction when current risk assessment tools are used. 16,17,[51][52][53] Many opportunities exist for research on the effects of various prevention strategies, such as support surfaces, fecal containment devices, frequency of repositioning, the use of topical dressings applied to the sacrum to minimize friction/shear, progressive mobility programs, and the use of glide sheets and patient transfer equipment, on the development of pressure ulcers in ICU patients. Ultimately, accurate identification of the risk factors for pressure ulcers and testing and implementing evidence-based prevention strategies can lead to reductions in both the occurrence of pressure ulcers and health care costs and can promote positive health outcomes in critical care patients.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Pressure Ulcers in Adult Critical Care Patients

Cox

2011

American Journal of Critical Care

279

277

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BackgroundPressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate. Currently, consensus is lacking on the most important risk factors for pressure ulcers in critically ill patients, and no risk assessment scale exclusively for pressure ulcers in these patients is available.ObjectiveTo determine which risk factors are most predictive of pressure ulcers in adult critical care patients. Risk factors investigated included total score on the Braden Scale, mobility, activity, sensory perception, moisture, friction/shear, nutrition, age, blood pressure, length of stay in the intensive care unit, score on the Acute Physiology and Chronic Health Evaluation II, vasopressor administration, and comorbid conditions.MethodsA retrospective, correlational design was used to examine 347 patients admitted to a medical-surgical intensive care unit from October 2008 through May 2009.ResultsAccording to direct logistic regression analyses, age, length of stay, mobility, friction/shear, norepinephrine infusion, and cardiovascular disease explained a major part of the variance in pressure ulcers.ConclusionCurrent risk assessment scales for development of pressure ulcers may not include risk factors common in critically ill adults. Development of a risk assessment model for pressure ulcers in these patients is warranted and could be the foundation for development of a risk assessment tool.

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Section: Discussionmentioning

confidence: 99%

Predictors of Pressure Ulcers in Adult Critical Care Patients

Cox

2011

American Journal of Critical Care

279

277

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“…Testing the available paediatric pressure ulcer RASs can give an indication of their predictive ability (validity), however, there in adults no study has shown using even a valid and reliable risk assessment tool reduces the pressure ulcer incidence rate in clinical practice (32,33). However even if they do not reduce incidence of pressure ulcers (and the work has not been done in children so we have no idea if they do or not) they are useful for audit and research purposes.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the performance of the Braden Q and the Glamorgan paediatric pressure ulcer risk assessment scales in general and intensive care paediatric and neonatal units

Willock

Habiballah

Long

et al. 2016

Journal of Tissue Viability

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“…Even with the health care services modernization, PU prevalence remains as a problem to be solved, especially among inpatients, because it culminates in a longer hospitalization period, in the necessity of specialized professionals and products, and also in the increase of the infection risk (1)(2) . PU epidemiological prospect in developed countries is not different from developing ones.…”

Section: Introductionmentioning

confidence: 99%

Comparação de escalas de avaliação de risco para úlcera por pressão em pacientes em estado crítico

Araújo¹,

Araújo²,

Caetano

2011

Acta paul. enferm.

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Objective: To compare the Norton, Braden and Waterlow scales of risk for pressure ulcer in critically ill patients. Methods: An exploratory and longitudinal study covering 42 patients who were evaluated for 15 days or at least 10 consecutive days, in three intensive care units within Fortaleza, Brazil, from March to July 2009. Each patient was evaluated, simultaneously, by three nurses, each of whom was responsible for the application of only one of the scales. Results: There was a 59.5% incidence of ulcers and an increase in score of Norton (p = 0.028) and Braden (p = 0.004) scales, between the 1 st -15 th day, and the Waterlow (p = 0.005) between the 1 st -10 th . When compared to Norton and Braden, the Waterlow scores steadily increased (p <0.001). Patients with high and very high risk, 2% and 92%, respectively, developed ulcers (p = 0.005). Conclusion: The Waterlow scale showed higher scores in the risk assessment for pressure ulcers in relation to the Norton and Braden scales. Descriptors: Pressure ulcer; Risk assessment; Scales RESUMOObjetivo: Comparar as escalas de risco para úlcera por pressão de Norton, Braden e Waterlow entre pacientes em estado crítico. Métodos: Estudo exploratório e longitudial abrangendo 42 pacientesque foram avaliados, por 15 dias ou pelo menos 10 dias consecutivos, em três Unidades de Terapia Intensiva de Fortaleza-Brasil, no período de março a julho de 2009. Cada paciente foi avaliado, simultaneamente, por três enfermeiros, sendo cada um responsável pela aplicação de apenas uma das escalas. Resultados: Houve uma incidência de 59,5% de lesões e um aumento na pontuação das escalas de Norton (p=0,028) e Braden (p=0,004), entre os 1º-15º dias, e de Waterlow (p=0,005) entre os 1º-10º. Quando comparadas a Norton e Braden, os escores de Waterlow aumentaram constantemente (p<0,001). Os pacientes com alto e altíssimo risco, 2% e 92%, respectivamente, desenvolveram lesões (p=0,005). Conclusão: A escala de Waterlow apresentou maiores escores na avaliação do risco para úlcera por pressão em relação às escalas de Norton e Braden. Descritores: Úlcera por pressão; Medição de risco; Escalas RESUMENObjetivo: Comparar las escalas de riesgo para úlcera por presión de Norton, Braden y Waterlow entre pacientes en estado crítico. Métodos: Estudio exploratorio y longitudinal que abarcó a 42 pacientes que fueron evaluados, por 15 días o por lo menos 10 días consecutivos, en tres Unidades de Cuidados Intensivos de Fortaleza-Brasil, en el período de marzo a julio del 2009. Cada paciente fue evaluado, simultáneamente, por tres enfermeros, siendo cada uno responsable por la aplicación de apenas una de las escalas. Resultados: Hubo una incidencia del 59,5% de lesiones y un aumento en la puntuación de las escalas de Norton (p=0,028) y Braden (p=0,004), entre los 1º-15º días, y de Waterlow (p=0,005) entre los 1º-10º. Cuando fueron comparadas la Norton y Braden, los scores de Waterlow aumentaron constantemente (p<0,001). Los pacientes con alto y altísimo riesgo, 2% y 92%, respectivamente, desarrollaron ...

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Do risk assessment scales for pressure ulcers work?

Cited by 44 publications

References 16 publications

Predictors of Pressure Ulcers in Adult Critical Care Patients

Predictors of Pressure Ulcers in Adult Critical Care Patients

A comparison of the performance of the Braden Q and the Glamorgan paediatric pressure ulcer risk assessment scales in general and intensive care paediatric and neonatal units

Comparação de escalas de avaliação de risco para úlcera por pressão em pacientes em estado crítico

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