Risk Profile Characteristics Associated With Outcomes of Hospital-Acquired Pressure Ulcers: A Retrospective Review

Alderden, Jenny; Whitney, JoAnne D.; Taylor, Shirley M.; Zaratkiewicz, Sunniva

doi:10.4037/ccn2011806

Cited by 79 publications

(75 citation statements)

References 29 publications

(53 reference statements)

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“…In clinical practice, risk assessment scales that include age as one of the factors involved in PU development should be used, such as the Cubin-Jackson scale (1) . Regarding the ICU period, in a prospective study with 140 patients conducted in Turkey, the time spent by the patients in ICU was found to be a risk factor for the development of PU (p<0.001), always associated with mobility and level of consciousness of patients (31) , which is similar to the findings of this study. In this study, the patients were confined to bed and had reduced mobility due to the great number of artifacts inserted in the skin, use of sedatives and the patient's fear of feeling pain and discomfort when moving.…”

Section: Discussionsupporting

confidence: 81%

“…Loss of muscle mass, reduced inflammatory response, reduced albumin levels and subcutaneous tissue associated with reduced dermal-epidermal junction cause a higher risk of skin integrity rupture, as the skin does not have the proper ability to redistribute the mechanical load applied, presenting an important item for risk classification (28)(29)(30)(31) . The Braden scale, although commonly used and studied, at national and international levels, does not include age (1) .…”

Section: Discussionmentioning

confidence: 99%

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Incidência de úlceras por pressão em pacientes de Unidade de Terapia Intensiva Cardiopneumológica

Campanili

Santos

Strazzieri-Pulido

et al. 2015

Rev. esc. enferm. USP

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RESUMO Objetivo Identificar e analisar os coeficientes de incidência de úlceras por pressão (UP) e os fatores de risco para o seu desenvolvimento em pacientes críticos com doenças cardiopneumológicas. Método Estudo de coorte, prospectivo realizado na Unidade de Terapia Intensiva (UTI) Cardiopneumológica de um hospital de grande porte na cidade de São Paulo, durante os meses de novembro de 2013 a fevereiro de 2014. Participaram do estudo 370 pacientes maiores de 18 anos, que não apresentavam UP na admissão e que estavam na UTI há menos de 24 horas. Os dados foram analisados por meio de análises univariadas e multivariada (Classification And Regression Tree - CART). Resultados Os coeficientes de incidência de UP foram: 11,0% para o total, distribuindo-se em 8,0% entre os homens e 3,0% para as mulheres (p=0,018); 10,0% na raça branca e 6,5% em pessoas com idade igual e superior a 60 anos. Os principais fatores de risco encontrados foram tempo de permanência na UTI igual ou superior a 9,5 dias, idade igual ou superior a 42,5 anos e raça branca. Conclusão O estudo contribui para os conhecimentos relacionados à epidemiologia das UP em pacientes críticos com doenças cardiopneumológicas, favorecendo o planejamento de cuidados preventivos específicos para essa clientela.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Incidência de úlceras por pressão em pacientes de Unidade de Terapia Intensiva Cardiopneumológica

Campanili

Santos

Strazzieri-Pulido

et al. 2015

Rev. esc. enferm. USP

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“…Because of economic pressure, the problem of unclosed pressure ulcers at discharge is increasingly reported. 8,25 In our population as an example of the Swiss health-care system, the proportion of patients with open HAPU (32.7%) was lower at the time of discharge than in other populations (50%, 54.1%). 8,25 Economic and politic factors, ethical considerations, vision of the institution and caregivers in the Swiss health-care system influence this rate, allowing patients an ongoing in-house treatment until closure.…”

Section: Time Until Occurrencementioning

confidence: 97%

“…8,25 In our population as an example of the Swiss health-care system, the proportion of patients with open HAPU (32.7%) was lower at the time of discharge than in other populations (50%, 54.1%). 8,25 Economic and politic factors, ethical considerations, vision of the institution and caregivers in the Swiss health-care system influence this rate, allowing patients an ongoing in-house treatment until closure. 7,22 Although occurrence of PU is often discussed as an indicator of worse outcome and discharge destination, 4,7 closure of HAPU did not change the discharge destination in our population.…”

Section: Time Until Occurrencementioning

confidence: 97%

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Hospital-acquired pressure ulcers in spinal cord injured patients: time to occur, time until closure and risk factors

et al. 2016

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Study design: Prospective observational cohort study. Objectives: To describe time to occur and time until closure of hospital-acquired pressure ulcers (HAPUs) in patients with spinal cord injury (SCI). Setting: Specialised SCI acute care and rehabilitation clinic in Switzerland. Methods: Daily registration of the presence and severity of HAPUs in a consecutive sample of SCI patients during their entire in-patient stay. Results: Out of 185 observed SCI patients, 55 patients (29.7%) developed at least one HAPU. Within the first 30 days after admission, 50% of all HAPUs occurred. Less severe HAPUs occurred earlier than severe HAPUs. The occurrence of HAPUs was significantly associated with reason of admission (Po0.01), and was highest in first rehabilitation (51.4%) and orthopaedic surgery patients (41.4%). The incidences of first HAPU in these groups were 1.04 and 2.31 per patient-year, respectively. Patients in first rehabilitation or readmitted because of pressure ulcer (PU) showed an initial lower risk for HAPUs in the Kaplan-Meier curve compared with patients readmitted for other reasons. Cox regression analysis revealed an association between longer time since SCI and time until occurrence (P = 0.01). Closure of the HAPUs during hospitalisation was observed in 37 patients (67.3%) after 38.9 days on average. No significant associations were found between patient characteristics and time until closure. Conclusion: The dynamics of HAPUs varied according to admission reason and time since lesion. However, ongoing awareness to prevent HAPUs is needed in all patients with SCI.

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Dressings and topical agents for preventing pressure ulcers

Moore

Webster

2013

Cochrane Database of Systematic Reviews

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Background Pressure ulcers, which are localised injury to the skin, or underlying tissue or both, occur when people are unable to reposition themselves to relieve pressure on bony prominences. Pressure ulcers are often difficult to heal, painful and impact negatively on the individual's quality of life. The cost implications of pressure ulcer treatment are considerable, compounding the challenges in providing cost effective, efficient health services. Efforts to prevent the development of pressure ulcers have focused on nutritional support, pressure redistributing devices, turning regimes and the application of various topical agents and dressings designed to maintain healthy skin, relieve pressure and prevent shearing forces. Although products aimed at preventing pressure ulcers are widely used, it remains unclear which, if any, of these approaches are effective in preventing the development of pressure ulcers. Objectives To evaluate the effects of dressings and topical agents on the prevention of pressure ulcers, in people of any age without existing pressure ulcers, but considered to be at risk of developing a pressure ulcer, in any healthcare setting. Search methods In February 2013 we searched the following electronic databases to identify reports of relevant randomised clinical trials (RCTs): the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Database of Abstracts of Reviews of Effects (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. Selection criteria We included RCTs evaluating the use of dressings, topical agents, or topical agents with dressings, compared with a different dressing, topical agent, or combined topical agent and dressing, or no intervention or standard care, with the aim of preventing the development of a pressure ulcer. Data collection and analysis We assessed trials for their appropriateness for inclusion and for their risk of bias. This was done by two review authors working independently, using predetermined inclusion and quality criteria.

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Risk Profile Characteristics Associated With Outcomes of Hospital-Acquired Pressure Ulcers: A Retrospective Review

Cited by 79 publications

References 29 publications

Incidência de úlceras por pressão em pacientes de Unidade de Terapia Intensiva Cardiopneumológica

Incidência de úlceras por pressão em pacientes de Unidade de Terapia Intensiva Cardiopneumológica

Hospital-acquired pressure ulcers in spinal cord injured patients: time to occur, time until closure and risk factors

Dressings and topical agents for preventing pressure ulcers

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