Prevention and Early Detection of Pressure Ulcers in Hospitalized Patients

Padula, Cynthia; Osborne, Evelyn; Williams, Joyce

doi:10.1097/01.won.0000308620.78884.88

Cited by 25 publications

(19 citation statements)

References 45 publications

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“…It was found to be 20% (18) and 18.7% (12) in two studies from the United States, 20.1% (10) in one study from Belgium, 16.7% (19) in one study from Turkey, and 16% (13) in one study from Spain in patients on MV in ICUs. The PU rate in patients not on MV in ICUs in Turkey varies from 15% to 29% (6)(7)(8)24).…”

Section: Discussionmentioning

confidence: 99%

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The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

et al. 2016

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IntroductionA pressure ulcer (PU) is localized tissue damage in the dermis and subdermis caused by compression, friction, shearing, and other factors (1). It is commonly encountered in all hospitalized patients, especially those in intensive care units (ICUs) (2). The incidence of PU was found to increase from 4% to 49% in Denmark and vary from 38% to 24% in Germany (3) and from 14% to 42% in the United States (4,5). Studies from Turkey showed that the incidence of PU varied between 15% and 29% (6-8).Mobilization, sensorial perceptions, and consciousness in patients in ICUs are impaired due to the administration of sedative and anesthetic agents (9-11). It has been shown that vasopressin administered to maintain sufficient cardiac output in ICUs leads to constriction in the capillary circulation, which prevents oxygen and blood supply to the skin. This creates a risk of PU (12). Changes in metabolism resulting from such conditions as major surgery, burns, major trauma, and sepsis in ICUs increase the risk of PU development (9-13). In addition, the risk of PU is increased due to impairment of hemodynamic status, cardiovascular diseases, circulatory failure, impaired oxygenation, diabetes mellitus, anemia, infection, edema, catabolic disorders, and pressure (4,10,11,14). In a systematic review, it was reported that PU is not caused by a single factor, but rather develops due Background/aim: This study aimed to determine the incidence of pressure ulcers in patients on mechanical ventilation and selected risk factors likely to play a role in pressure ulcer development. Materials and methods:The study included 110 patients recruited from an anesthesia critical care unit of a university hospital. Data were collected with a demographic and clinical characteristics form. The form was composed of questions about demographic characteristics and clinical features including diagnosis, duration of mechanical ventilation, general well-being, oxygenation, perfusion, and skin condition. Results:The incidence of pressure ulcer was 15.5%. Duration of mechanical ventilation was longer and the body mass index was higher in patients developing pressure ulcers than in those without pressure ulcers. Additionally, 90.11% of patients with pressure ulcers had edema and 82.35% of patients with pressure ulcers received vasopressin. The patients with pressure ulcers had higher PH levels, lower PaO2 levels, higher PCO2 levels, lower SaO2 levels, and higher urine output. Conclusion:It can be recommended that nurses and other health professionals should be aware of factors playing a role in pressure ulcer development and should be able to conduct appropriate interventions to prevent pressure ulcers.

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Section: Discussionmentioning

confidence: 99%

“…PU leads to pain and an inflammatory response, which increases the risk of systemic infection, mortality, length of stay in the hospital, and health costs and decreases the quality of life (10,18,19). Prevention of PU has been a nursing concern for many years.…”

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The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

et al. 2016

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“…Most of the research 2,5,10 to date has centered on tools to assess a patient's risk. Few specific data 4,11,12 are available on factors associated with the development of occipital pressure ulcers (OPUs), the type most common in infants and children.…”

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Factors Associated With Occipital Pressure Ulcers in Hospitalized Infants and Children

Manning¹,

Gauvreau²,

Curley³

2015

American Journal of Critical Care

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Background The occiput is a common location for development of pressure ulcers in hospitalized infants and young children. However, risk factors associated with occurrence of the ulcers have not been fully described. Objective To identify factors associated with development of occipital pressure ulcers in acutely ill infants and children. Methods Charts of all patients with occipital pressure ulcers reported in a computerized safety event reporting system since its implementation in 2005 and of any patients with such ulcers recalled by members of the skin care special interest group were reviewed retrospectively. Results During a 4-year period, 60 cases of occipital pressure ulcers were identified: 40% stage I, 12% stage II, 30% unstageable, and 18% deep tissue Injury. The median age of the sample was 12 months. Among the patients, 86% were in the intensive care unit with cardiovascular or pulmonary problems. A total of 68% had comorbid conditions. Most of the patients were less than 1 year old; were critically ill, requiring high-risk therapies; and had multiple medical devices in place. Patients with the ulcers were commonly treated with mechanical ventilation (83%) and sedation (74%) and were described as agitated (42%). Many of these patients were receiving vasoactive medications (50%) and had vascular access devices in the neck that restricted head movement (45%). When documented, the median Braden Q score was 16. Conclusions Infants and children at risk for occipital pressure ulcers can be prospectively identified, allowing implementation of nursing interventions to prevent these ulcers.

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“…[1][2][3][4] Regardless of these numerous evidence-based approaches, the incidence of hospital-acquired PUs (HAPU) continues to remain a personal and economic health concern. Hospitalacquired PUs are reported to cost an average of $129,000 per hospitalization.…”

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Addressing Hospital-Acquired Pressure Ulcers

Frumenti

Kurtz²

2014

JONA: The Journal of Nursing Administration

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An innovative leadership training program for patient care managers (PCMs) aimed at improving the management of operational failures was conducted at a large metropolitan hospital center. The program focused on developing and enhancing the transformational leadership skills of PCMs by improving their ability to manage operational failures in general and, in this case, hospital-acquired pressure ulcers. The PCMs received 8 weeks of intense training using the Toyota Production System process improvement approach, along with executive coaching. Compared with the control group, the gains made by the intervention group were statistically significant.

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Prevention and Early Detection of Pressure Ulcers in Hospitalized Patients

Cited by 25 publications

References 45 publications

The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

Factors Associated With Occipital Pressure Ulcers in Hospitalized Infants and Children

Addressing Hospital-Acquired Pressure Ulcers

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