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skin care and prevention of pressure ulcers

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https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#1
Julia Warner, Mary Ann Raible, Gina Hajduk, Jacqueline Collavo
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27884131/improvement-of-pressure-ulcer-prevention-care-in-private-for-profit-residential-care-homes-an-action-research-study
#2
Enid Wy Kwong, Maria Sy Hung, Kevin Woo
BACKGROUND: A need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes...
November 25, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27878785/lesions-requiring-wound-management-in-a-central-tertiary-neonatal-intensive-care-unit
#3
Angéla Meszes, Gyula Tálosi, Krisztina Máder, Hajnalka Orvos, Lajos Kemény, Zsanett Renáta Csoma
BACKGROUND: Most of the skin disorders that occur in neonatal intensive care units are due in part to the immaturity and vulnerability of the neonatal skin. Various iatrogenic diagnostic and therapeutic procedures are also conducive to iatrogenic damage. This study was to review the neonates admitted to our neonatal intensive care unit who needed wound management, and to assess the most common skin injuries and wounds, and their aetiology. METHODS: Data were extracted from medical records of neonates who needed wound management in our Neonatal Intensive Care Unit between January 31, 2012 and January 31, 2013...
November 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27852237/using-cognitive-pre-testing-methods-in-the-development-of-a-new-evidenced-based-pressure-ulcer-risk-assessment-instrument
#4
S Coleman, J Nixon, J Keen, D Muir, L Wilson, E McGinnis, N Stubbs, C Dealey, E A Nelson
BACKGROUND: Variation in development methods of Pressure Ulcer Risk Assessment Instruments has led to inconsistent inclusion of risk factors and concerns about content validity. A new evidenced-based Risk Assessment Instrument, the Pressure Ulcer Risk Primary Or Secondary Evaluation Tool - PURPOSE-T was developed as part of a National Institute for Health Research (NIHR) funded Pressure Ulcer Research Programme (PURPOSE: RP-PG-0407-10056). This paper reports the pre-test phase to assess and improve PURPOSE-T acceptability, usability and confirm content validity...
November 16, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27842564/heel-pressure-ulcer-prevention-and-predictors-during-the-care-delivery-chain-when-and-where-to-take-action-a-descriptive-and-explorative-study
#5
Åsa Muntlin Athlin, Maria Engström, Lena Gunningberg, Carina Bååth
BACKGROUND: Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes...
November 14, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27768578/a-prospective-observational-study-to-assess-the-use-of-thermography-to-predict-progression-of-discolored-intact-skin-to-necrosis-among-patients-in-skilled-nursing-facilities
#6
Jill Cox, Loretta Kaes, Miguel Martinez, Daniel Moles
Skin temperature may help prospectively determine whether an area of skin discoloration will evolve into necrosis. A prospective, observational study was conducted in 7 skilled nursing facilities to determine if skin temperature measured using infrared thermography could predict the progression of discolored intact skin (blanchable erythema, Stage 1 pressure ulcer, or sus- pected deep tissue injury [sDTI]) to necrosis and to evaluate if nurses could effectively integrate thermography into the clinical setting...
October 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27763881/neuropathic-ulcers-among-children-with-neural-tube-defects-a-review-of-literature
#7
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
https://www.readbyqxmd.com/read/27755048/pressure-ulcers-in-the-intensive-care-unit-an-analysis-of-skin-barrier-risk-factors
#8
Minjuan He, Amao Tang, Xuedi Ge, Jie Zheng
OBJECTIVE: The aim of this study was to determine whether skin barrier factors were associated with the common complication of pressure ulcers (PrUs) in intensive care unit (ICU) patients. It is unclear whether skin barrier factors influence the development of PrUs. PATIENT POPULATION: The sample was composed of 102 ICU patients (54 men, 48 women). The patients ranged in age from 23 to 88 years, with a mean age of 55.7 (SD, 19.1) years. METHODS: Demographic variables and the score for the Acute Physiology and Chronic Health Evaluation IV were recorded on admission...
November 2016: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/27742148/pressure-ulcers-in-maturing-skin-a-clinical-perspective
#9
Anna-Barbara Schlüer
While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care...
October 8, 2016: Journal of Tissue Viability
https://www.readbyqxmd.com/read/27717144/an-ex-vivo-porcine-skin-model-to-evaluate-pressure-reducing-devices-of-different-mechanical-properties-used-for-pressure-ulcer-prevention
#10
Ching-Yan C Yeung, David F Holmes, Helen A Thomason, Christian Stephenson, Brian Derby, Matthew J Hardman
Pressure ulcers are complex wounds caused by pressure- and shear-induced trauma to skin and underlying tissues. Pressure-reducing devices, such as dressings, have been shown to successfully reduce pressure ulcer incidence, when used in adjunct to pressure ulcer preventative care. While pressure-reducing devices are available in a range of materials, with differing mechanical properties, understanding of how a material's mechanical properties will influence clinical efficacy remains limited. The aim of this study was to establish a standardised ex vivo model to allow comparison of the cell protection potential of two gel-like pressure-reducing devices with differing mechanical properties (elastic moduli of 77 kPa v 35 kPa)...
September 26, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27712030/effectiveness-of-pressure-ulcer-prevention-strategies-for-adult-patients-in-intensive-care-units-a-systematic-review
#11
Nahla Tayyib, Fiona Coyer
BACKGROUND: Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention...
December 2016: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/27696694/the-care-of-transmetatarsal-amputation-in-diabetic-foot-gangrene
#12
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27693836/the-effect-of-a-patient-centred-care-bundle-intervention-on-pressure-ulcer-incidence-intact-a-cluster-randomised-trial
#13
Wendy Chaboyer, Tracey Bucknall, Joan Webster, Elizabeth McInnes, Brigid M Gillespie, Merrilyn Banks, Jennifer A Whitty, Lukman Thalib, Shelley Roberts, Mandy Tallott, Nicky Cullum, Marianne Wallis
BACKGROUND: Hospital-acquired pressure ulcers are a serious patient safety concern, associated with poor patient outcomes and high healthcare costs. They are also viewed as an indicator of nursing care quality. OBJECTIVE: To evaluate the effectiveness of a pressure ulcer prevention care bundle in preventing hospital-acquired pressure ulcers among at risk patients. DESIGN: Pragmatic cluster randomised trial. SETTING: Eight tertiary referral hospitals with >200 beds each in three Australian states...
September 23, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27682442/protect-trial-a-multicentre-prospective-pragmatic-rct-and-health-economic-analysis-of-the-effect-of-tailored-repositioning-to-prevent-pressure-ulcers-study-protocol
#14
Dorien De Meyer, Nele Van Damme, Karen Van den Bussche, Ann Van Hecke, Sofie Verhaeghe, Dimitri Beeckman
AIM: The aims of this trial were as follows: (1) to compare the (cost-) effectiveness of a turning and repositioning system and an algorithm for a tailored repositioning vs. usual care to improve reposition frequency in patients at risk; and (2) to compare the (cost-) effectiveness of standardized incontinence care vs. usual care. BACKGROUND: Pressure ulcers are a serious and common problem for hospitalized patients. In many countries, pressure ulcers are recognized as a national health issue and governments designate pressure ulcers as one of the most important sentinel events for health care...
September 28, 2016: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/27676113/skin-rounds-a-quality-improvement-approach-to-enhance-skin-care-in-the-neonatal-intensive-care-unit
#15
Marliese Dion Nist, Elizabeth A Rodgers, Brenda M Ruth, C Briana Bertoni, Thomas Bartman, Leah A Keller, James W Dail, Renee Gardikes-Gingery, Edward G Shepherd
BACKGROUND: Skin injuries are common among neonatal intensive care unit (NICU) patients and may lead to significant complications. Standardized methods of preventing, detecting, and treating skin injuries are needed. PURPOSE: The aim of this project was to standardize the assessment, documentation, and tracking of skin injuries among hospitalized neonatal patients and to determine the incidence of pressure ulcers in this patient population. METHODS: (1) Creation of an interdisciplinary skin team to identify skin injuries through weekly skin rounds...
October 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27668479/exploring-the-effect-of-educating-certified-nursing-assistants-on-pressure-ulcer-knowledge-and-incidence-in-a-nursing-home-setting
#16
Cathy L Wogamon
The certified nursing assistant (CNA) is the caregiver who frequently identifies the first signs and symptoms of pressure ulcers (PUs) in the long-term care setting. A quality improvement effort was implemented to explore the effect of a 1-hour CNA education program about early identification, treatment, and prevention of PUs on PU knowledge, PU incidence, and PU prevention interventions, including skin checks. All 33 CNAs employed in a care facility for residents 55+ years old were invited to participate. CNA demographic and PU education variables were obtained...
September 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27600153/self-management-interventions-to-improve-skin-care-for-pressure-ulcer-prevention-in-people-with-spinal-cord-injuries-a-systematic-review-protocol
#17
Justine Baron, Jillian Swaine, J Presseau, Arlene Aspinall, Susan Jaglal, Barry White, Dalton Wolfe, Jeremy Grimshaw
BACKGROUND: Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI...
2016: Systematic Reviews
https://www.readbyqxmd.com/read/27544020/systematic-mapping-review-about-costs-and-economic-evaluations-of-skin-conditions-and-diseases-in-the-aged
#18
Andrea Lichterfeld-Kottner, Elisabeth Hahnel, Ulrike Blume-Peytavi, Jan Kottner
BACKGROUND: Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. OBJECTIVES: The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years)...
July 25, 2016: Journal of Tissue Viability
https://www.readbyqxmd.com/read/27532798/effectiveness-of-offloading-methods-in-preventing-primary-diabetic-foot-ulcers-in-adults-with-diabetes-a-systematic-review
#19
Lisa Heuch, Judith Streak Gomersall
BACKGROUND: The incidence of foot ulceration related to diabetes is increasing. Many foot care professionals recommend offloading measures as part of management strategies for modulating excess pressure to prevent development of diabetic foot ulcers (DFUs). These measures may include padding, insoles/orthotic devices and footwear. There is a lack of evidence-based guidance on the effectiveness of the different offloading options for preventing primary ulceration in those with diabetes...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27532137/effectiveness-of-pressure-ulcer-prevention-strategies-for-adult-patients-in-intensive-care-units-a-systematic-review-protocol
#20
Nahla Tayyib, Fiona Coyer
The objective of this review is to identify the effectiveness of pressure ulcer (PU) prevention strategies on the incidence of hospital-acquired PUs in the intensive care unit (ICU).More specifically, the objectives are to identify the effectiveness of utilizing PU prevention strategies such as risk assessment, skin assessment, skin care, nutrition, position and repositioning, education and training, medical devices care or other strategies designed to manage the risk factors for PU development and reduce the incidence of PUs in ICUs...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
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