Medical conditions as risk factors for pressure ulcers in an outpatient setting

Margolis, David J.; Knauss, Jill; Bilker, Warren B.; Baumgarten, Mona

doi:10.1093/ageing/32.3.259

Cited by 117 publications

(86 citation statements)

References 27 publications

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“…1 The number of individuals who needed long-term care at Japanese home under Japan-specific long-term care insurance system was determined to be 5.8 million in 2015; this was approximately three times higher than it was when the system was implemented in 2000. 2,3 Most of the individuals have specific medical conditions that are associated with pressure injury development; 4 consequently, the number of individuals at risk of developing pressure injuries at home in Japan appears to be increasing. Reportedly, this incidence rate was 13%, 5 which was higher than that in patients admitted to university and general hospitals.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and practice for pressure injury prevention among care managers in a home care setting: a cross-sectional study

Kohta¹,

Kameda²,

Morita³

2017

CWCMR

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Purpose: Previous studies on pressure injury prevention using questionnaire surveys have targeted physicians and nurses working in hospitals. However, few have administered surveys to social welfare professionals at home care. Thus, this study aimed to investigate the current level of knowledge and practice regarding pressure injury prevention among Japanese care managers. Patients and methods: A cross-sectional study among care managers working in a Japanese city was performed from June to July 2016. Data were collected using a questionnaire to assess the participants' knowledge of and practice for pressure injury prevention. The questionnaire included 1) measures of demographic characterization, 2) measures of knowledge, 3) measures of practice, and 4) measures of the difficulties of using pressure injury risk assessment scales. Results: A total of 48 participants were analyzed (response rate: 55%). The overall knowledge and practice scores were 78.6% and 61.8%, respectively. The percentages of participants who knew the risk assessment scales were 38%, 26%, and 13% for the Braden scale, the Ohura-Hotta scale, and the University of Kanazawa scale, respectively. We also observed that 50% of the participants in this study believed that the use of risk assessment scales in daily practice in home care may be difficult. Conclusion: Through the results of this questionnaire survey, we concluded that the current levels of knowledge and practice regarding pressure injury prevention among the care managers participating in our study were "moderate" and "low", respectively. Low scores were obtained for knowledge with respect to the question, "Using risk assessment scales". We will develop a new risk assessment scale as a bridge between both medical professionals and social welfare professionals. Practically, the authors recommend care managers should receive continuous education and practical training for pressure injury prevention in a home care setting.

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Section: Introductionmentioning

confidence: 99%

Knowledge and practice for pressure injury prevention among care managers in a home care setting: a cross-sectional study

Kohta¹,

Kameda²,

Morita³

2017

CWCMR

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“…31 Margolis discussed multiple medical conditions in regression analysis as risk factors for PUs in an outpatient setting. 32 These studies highlight distinct systemic factors (aging-related conditions, diseases, and frailty dysfunction) contributing to the development of PU.…”

Section: Systemic Medical Factorsmentioning

confidence: 99%

Multidisciplinary and comprehensive approaches to optimal management of chronic pressure ulcers in the elderly

Jaul¹

2014

CWCMR

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Abstract:The occurrence of pressure ulcers (PUs) is common and poses serious problems for the frail elderly, with implications for functional disability and reduced quality of life. PUs are preventable in a majority of cases. The increase in PU occurrence, however, appears regardless of higher awareness in prevention and improvement through utilization of pressure relieving devices. Multiple changes in the elderly body systems occur over time including aging, multiple chronic conditions, and functional impairment, potentially culminating in the final pathways of geriatric syndrome, unless awareness to the development of PUs is reversible and prevented. The assumption is that the development of PUs is based on multifactorial causes (extrinsic and intrinsic factors); thus, the optimal management for elderly patients requires a comprehensive approach in all medical settings (community, hospital, and at the long term care [LTC] level). Comprehensiveness signifies looking beyond the wounds, assisting the patient through both local (wound) and systemic (medical condition) treatment, using a strategy of prevention and supporting quality of life. Within the multidisciplinary involvement team approach, each professional discipline contributes its own task in coordination with other disciplines to address PU prevention, assessment, and treatment. The entire medical staff and the multidisciplinary team work together and communicate frequently in order to prevent, halt at an early stage, and provide healing in a timely fashion. Limiting the formation of PUs is facilitated through early identification, treating contributing causes, eliminating all unnecessary medications, instituting supportive interventions which include the family. Understanding the relationship between the formation of PUs and the vulnerability of the elderly patient is key to the optimal approach for the prevention and management of PUs.

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“…Studies have shown that there are several risk factors that are associated with the development of pressure ulcers (Margolis, Knauss, Bilker, and Baumgarten, 2003). While there is still some lack of clarity relating to the cause and risk factors for pressure ulcers development, most researchers concur that the origin of this problem relates to two categories; intrinsic risk factors and extrinsic risk factors (Cannon and Cannon, 2004;and Magalhdes et al 2007).…”

Section: Causes Of Pressure Ulcersmentioning

confidence: 99%

“…Conditions that have been implicated by multivariate analysis as causes or risk factors for pressure ulcer development include, hypotension, peripheral vascular disease, cerebo-vascular disease, heart failure, diabetes, obstructive pulmonary disease, and stroke (Allman, Goode, Patrick, Burst, and Bartolucci, 1995;Bergstrom and Braden, 1992;Ducker, 2002;Garcia and Thomas, 2006;Margolis, Knauss, Bilker, and Baumgarten, 2003). In a cohort study to evaluate the risk of pressure ulcer development in the presence of certain medical conditions in older ambulatory patients, Margolis, Knauss, Bilker, and Baumgarten (2003) studied 75,168 older individuals from an outpatient record database in the United Kingdom.…”

Section: Physical Factorsmentioning

confidence: 99%

“…In a cohort study to evaluate the risk of pressure ulcer development in the presence of certain medical conditions in older ambulatory patients, Margolis, Knauss, Bilker, and Baumgarten (2003) studied 75,168 older individuals from an outpatient record database in the United Kingdom. Results indicate that from the 1,211 individuals who developed pressure ulcer, Alzheimer's disease, congestive heart failure, chronic obstructive pulmonary disease, cerebral vascular accident, diabetes, deep venous thrombosis, hip fracture, hip surgery, angina, hypertension, and pneumonia were inversely associated with the development of a pressure ulcer.…”

Section: Physical Factorsmentioning

confidence: 99%

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Pressure ulcers and nutritional deficits in elderly long-term care patients : effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients

Allen¹

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Allen, Beverlin, "Pressure ulcers and nutritional deficits in elderly long-term care patients : effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients" (2010 The dissertation of Beverlin Allen is approved. The elderly are at the highest risk of developing pressure ulcers that result in prolonged hospitalization, high health care costs, increased mortality, and decreased quality of life. The burden of pressure ulcers will intensify because of a rapidly increasing elderly population in the United States (US). Poor nutrition is a major predictor of pressure ulcer formation. The purpose of this study was to examine the effects of a comprehensive, interdisciplinary nutritional protocol on: 1) pressure ulcer wound healing 2) length of hospital stays, and 3) charges for pressure ulcer management. Interim Dean Sharon PontiusUsing a pre-intervention/post intervention quasi-experimental design the study sample was composed of 100 patients 60 years or older, admitted with or acquiring a pressure ulcer. A pre-intervention group (n= 50) received routine pressure ulcer care (standard diet, dressing changes, and equipment). A post-intervention group received routine care plus an interdisciplinary nutrition intervention (physical therapy, speech therapy, occupational therapy, added protein and calories to the diet). Research questions were vi analyzed using descriptive statistics, frequencies, Chi-Square Tests, and T-tests.

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Medical conditions as risk factors for pressure ulcers in an outpatient setting

Cited by 117 publications

References 27 publications

Knowledge and practice for pressure injury prevention among care managers in a home care setting: a cross-sectional study

Knowledge and practice for pressure injury prevention among care managers in a home care setting: a cross-sectional study

Multidisciplinary and comprehensive approaches to optimal management of chronic pressure ulcers in the elderly

Pressure ulcers and nutritional deficits in elderly long-term care patients : effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients

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