Reexamining the Literature on Terminal Ulcers, SCALE, Skin Failure, and Unavoidable Pressure Injuries

Abstract

present at some of the sections that were moved that refer the reader to the Tag to which they belong has been removed, since the language is now at the appropriate Tag. R Appendix PP: Regulatory language revisions made at F150, F156 -483.10(b)(7)(iv), F386, 483.70(a) -untagged, 483.70(a)(4) -untagged. R Appendix PP: Corrections made due to text errors at F333 (Tag was missing), F363 (Tag was missing), F428 (regulatory text missing).III. FUNDING: Medicare contractors shall implement these instructions within their current operating budgets. IV. ATTACHMENTS: Business Requirements x Manual InstructionConfidential Requirements One-Time Notification Recurring Update Notification *Unless otherwise specified, the effective date is the date of service.F153 §483.10(b)(2) --The resident or his or her legal representative has the right--(i) Upon an oral or written request, to access all records pertaining to himself or herself including current clinical records within 24 hours (excluding weekends and holidays); and(ii) After receipt of his or her records for inspection, to purchase at a cost not to exceed the community standard photocopies of the records or any portions of them upon request and 2 working days advance notice to the facility. Interpretive Guidelines §483.10(b)(2)An oral request is sufficient to produce the current record for review. Procedures §483.10(b)(3)Look, particularly during observations and record reviews, for on-going efforts on the part of facility staff to keep residents informed. Look for evidence that information is communicated in a manner that is understandable to residents and communicated at times it could be most useful to residents, such as when they are expressing concerns, or raising questions, as well as on an on-going basis. §483.10(d)(2) -The resident has the right to be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the resident's well-being; Interpretive Guidelines §483.10(d)(2) "Informed in advance" means that the resident receives information necessary to make a health care decision, including information about his/her medical condition and changes in medical condition, about the benefits and reasonable risks of the treatment, and about reasonable available alternatives. ______________________________________________________________________ F155 §483.10(b)(4) --The resident has the right to refuse treatment, to refuse to participate in experimental research, and to formulate an advance directive as specified in paragraph (8) of this section; and Interpretive Guidelines §483.10(b)(4) "Treatment" is defined as care provided for purposes of maintaining/restoring health, improving functional level, or relieving symptoms. The failure to provide notice of room changes could result in an avoidable decline in physical, mental, or psychosocial well-being. ______________________________________________________________________ §483.10(c) Protection of Resident Funds _____________________________________________________________ ...

Avanços dos estudos Lesão Terminal de Kennedy no cuidado de enfermagem na terminalidade: Revisão integrativa

“…Os dados foram categorizados a partir do delineamento do conteúdo dos artigos selecionados e com referência ao objeto de estudo, os quais foram agrupados (11) Inglês Fornecer uma hipótese unificadora para alterações de valores no final da vida e de outros estados que comprometam a integridade da pele.…”

Capacidade discriminativa da escala de Braden na predição de Lesão por Pressão em Unidade de Terapia Intensiva

“…Por fim, a literatura aponta que ainda são desconhecidos os fatores indiretos de risco que influenciam a suscetibilidade de um paciente a lesões superficiais ou graves por pressão (Kayser et al, 2018). O documento SCALE (Skin Changes At Life's End) traz ponderações sobre tal suscetibilidade individual ao desenvolvimento de LPP e aponta que as mudanças fisiológicas do processo de morrer e de estados críticos podem causar mudanças inevitáveis Research, Society and Development, v. 9, n. 11, e4929119836, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i11.9836 na pele e tecidos moles, independente do grau de cuidados adotados na sua prevenção (Sibbald et al, 2010;Ayello et al, 2019). À medida que novos estudos sobre a etiologia de LPPs são realizados, novos conceitos passam a ser debatidos.…”

“…À medida que novos estudos sobre a etiologia de LPPs são realizados, novos conceitos passam a ser debatidos. Um exemplo disso é o conceito de 'insuficiência cutânea' definido por Langemo e Brown (2006) e refinado por Delmore et al (2015) como "o estado de hipoperfusão que ocasiona isquemia e morte da pele e do tecido subjacente e que ocorre concomitantemente com disfunção grave ou falha de outros sistemas orgânicos" classificando o evento como agudo, crônico e de fase final de vida (Ayello et al 2019;Langemo & Brown, 2006;Delmore et al 2015). Pondera-se ainda que no paciente gravemente enfermo, o fenômeno de insuficiência cutânea aguda pode estar ocorrendo e esses eventos podem ser incorretamente identificados como LPPs, com o atual nível de evidência (Delmore et al 2015;Ayello et al, 2019) reforçando que mais estudos ainda são necessários até a plena compreensão dos eventos que culminam em lesões do maior órgão humano que é a pele.…”

Development and validation of the Pressure Injury Prevention Barriers questionnaire in hospital nurses in Spain

“…Open access $26.8 billion, according to a recent report of US national data. 12 There is an international consensus on the consideration of PIs as an avoidable adverse event in healthcare (excluding the Kennedy terminal ulcers or other skin changes at life's end, that were considered as unavoidable injuries) 13 ; the National Quality Forum has included PIs in a list of reportable serious events categorised as an event that should never occur. 14 A number of factors have been associated with the development of PIs, some as aetiologic factors (friction, shear, pressure, moisture) 15 and others as risk factors (age, diabetes, malnutrition, poor circulation, blood disorders).…”