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skin care and prevention of pressure ulcers

Kevin Woo
Maintaining skin integrity is espoused by several international authorities as a benchmark for patient safety and quality of care. National guidelines advocate the use of prophylactic multi-layer foam dressings over bony prominences for the prevention of pressure ulcers or injuries. The purpose of this study was to evaluate the implementation of best practice guidelines including the use of multi-layer foam dressings for the prevention of pressure injuries. The analysis involved data from a total number of 62 unique patients...
March 12, 2018: Surgical Technology International
Anna Polak, Cezary Kucio, Luther C Kloth, Malgorzata Paczula, Ewa Hordynska, Tomasz Ickowicz, Edward Blaszczak, Ewa Kucio, Krystian Oleszczyk, Krzysztof Ficek, Andrzej Franek
The use of electrical stimulation (ES) should be considered for treating nonhealing pressure ulcers (PUs), but optimal ES wound treatment protocols have yet to be established. A randomized, controlled, double-blind clinical study was conducted to evaluate the effects of cathodal and anodal high-voltage monophasic pulsed current (HVMPC) on periwound skin blood flow (PSBF) and size reduction of Stage 2 to Stage 4 PUs of at least 4 weeks' duration. Persons >18 years of age, hospitalized with neurological injuries, at high risk for PU development (Norton scale <14 points; Waterlow scale >15 points), and with at least 1 Stage 2 to Stage 4 PU were eligible to participate in the study...
February 2018: Ostomy/wound Management
Michael Clark, Trudie Young, Maureen Fallon
Successful prevention of pressure ulcers is the end product of a complex series of care processes including, but not limited to, the assessment of vulnerability to pressure damage; skin assessment and care; nutritional support; repositioning; and the use of beds, mattresses, and cushions to manage mechanical loads on the skin and soft tissues. The purpose of this review was to examine where and how Statistical Process Control (SPC) measures have been used to assess the success of quality improvement initiatives intended to improve pressure ulcer prevention...
February 15, 2018: International Wound Journal
Fariba Sadeghi Fazel, Nazi Derakhshanrad, Mir Saeed Yekaninejad, Fardis Vosoughi, Asal Derakhshanrad, Hooshang Saberi
Pressure Ulcers (PUs) remain among the most common complications after traumatic spinal cord Injuries (SCIs). The main goal of risk factor assessment with different tools has been to provisionally estimate the chance of developing pressure ulcers in patients with Spinal Cord Injury (SCI). Braden tool has been of good predictive value and most commonly employed in hospital communities for risk assessment of pressure sore development. The objective of this study was to determine the Braden risk factors as well as the prevalence of pressure injuries in SCI patients...
January 2018: Acta Medica Iranica
Francisco J Molina, Paula T Rivera, Alejandro Cardona, Diana C Restrepo, Oralia Monroy, Daniel Rodas, Juan G Barrientos
AIM: To investigate the incidence of disadvantageous events by using the Global Trigger Tool in an intensive care unit (ICU). METHODS: A retrospective descriptive study was performed in a 12-bed university ICU in the city of Medellin, Colombia. Clinical charts of hospitalized patients were reviewed, between January 1 and December 31, 2016, with the following inclusion criteria: subjects aged over 18 years, with at least 24 h of hospitalization and who had a complete medical history that could be accessed...
February 4, 2018: World Journal of Critical Care Medicine
Marita Koivunen, Anna Hjerppe, Eija Luotola, Tommi Kauko, Paula Asikainen
OBJECTIVE: To quantify pressure ulcer (PU) prevalence and to describe and identify the PU risk factors in acute hospital wards. METHOD: A descriptive quantitative study was performed in 13 wards in a central hospital in Finland. The study included PU risk evaluation using the Braden risk assessment method, and full skin and medical assessment of consenting adult patients. Patients in paediatric, maternity and psychiatric wards, and in the intensive care unit were excluded...
February 1, 2018: Journal of Wound Care
Ji Seon Shine, Soo Jin Kim, Ji Hyun Lee, Mi Yu
PURPOSE: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. METHODS: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea...
December 2017: Journal of Korean Academy of Nursing
Martin van Leen, Ruud Halfens, Jos Schols
OBJECTIVE: Prevention of pressure ulcers (PrUs) is based on relieving pressure, diminishing shear stress, and controlling the skin's microclimate. Based on the recommendations in the most recent guideline for prevention of PrUs, a pressure-relieving, shear stress-diminishing, and microclimate-controlling skin interface multilayer support system (Bedcare; Sense Textile, 's-Hertogenbosch, the Netherlands) has been developed for use on top of a viscoelastic foam mattress (Formafoam, Kabelfabriek Eupen, Belgium)...
January 2018: Advances in Skin & Wound Care
Kerstin Hug, Caroline Stumm, Isabelle Debecker, Carolina Saskia Fellinghauer, Claudio Peter, Magret Hund-Georgiadis
BACKGROUND: Pressure ulcers (PUs) are a common and severe health condition in persons with spinal cord injury (SCI). Skin-care strategies for PU prevention are usually provided during the first rehabilitation session. However, individuals with SCI often do not perform these strategies continuously, especially after discharge. The influence of psychological factors such as general self-efficacy (GSE) on the performance of PU prevention behavior has not yet been sufficiently explored. OBJECTIVE: To investigate whether persons with greater levels of GSE are more likely to perform skin-care strategies for PU prevention regularly...
December 7, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Rona Katzengold, Amit Gefen
Patients who are stationary endure prolonged soft tissue distortions and deformations at contact areas between their body and the support surface, which may lead to the onset of pressure ulcers (PUs) over time. A novel technology for patient positioning employs innovation in materials science, specifically viscoelastic materials with shape memory properties that compose the Z-Flo™ head positioner (Mölnlycke Health Care, Gothenburg, Sweden). Head positioners are generally known to reduce the occurrence of PUs in scalp tissues and the ears, but quantitative assessments of their biomechanical efficacy are missing in the literature...
November 27, 2017: International Wound Journal
David Voegeli
David Voegeli, Associate Professor of Nursing, Skin Health Research Group, Faculty of Health Sciences, University of Southampton, discusses the care of patients with incontinence-associated dermatitis and how to distinguish this condition from pressure ulcers.
November 9, 2017: British Journal of Nursing: BJN
Jackie Stephen-Haynes, Rosie Callaghan
BACKGROUND: alternating pressure air mattresses (APAMs) support the prevention and management of pressure ulcers. A health and care NHS trust was seeking an APAM that would improve clinical outcomes in relation to pressure ulcers while considering financial cost. An APAM existed that could meet the trust's needs but there was a lack of evidence over its use in a community/home setting. This study examined the effect of using the Dual Professional (IQ Medical) APAM for patients at a high risk of pressure ulceration...
November 8, 2017: British Journal of Nursing: BJN
Peter Blume, Stephanie Wu
OBJECTIVE: Since the last diabetic foot ulcer (DFU) treatment algorithm was published in 2002, new options for diagnostic testing and treatments have been developed. This study seeks to update the DFU treatment algorithm to include new options available in diagnostic testing and treatment. MATERIALS AND METHODS: A computerized literature search of peer-reviewed articles published between January 2003 and January 2016 was conducted using MEDLINE (PubMed), EMBASE, and the Cochrane Library...
October 20, 2017: Wounds: a Compendium of Clinical Research and Practice
Martin Wf van Leen, Joseph Mga Schols, Steven Er Hovius, Ruud Jg Halfens
Pressure ulcers (PUs) are an important and distressing problem in Dutch nursing homes. A secondary analysis of longitudinal data from the Dutch National Prevalence Measurement of Care Problems (LPZ) - an annual, multicenter, point-prevalence survey - was conducted for the years 2005-2014 to determine the use of specific recommended PU preventive measures from the European Pressure Ulcer Advisory Panel 1998, the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel 2009, and the 2002 and 2011 Dutch PU guidelines...
September 2017: Ostomy/wound Management
Suzanne E Courtwright, Kari A Mastro, Christa Preuster, Navid Dardashti, Sandra McGill, Myrlene Madelon, Donna Johnson
PURPOSE: This review focuses on identifying (1) evidence of the effectiveness of care bundle methodology to reduce hospital-acquired pressure ulcers (HAPUs) in pediatric and neonatal patients receiving extracorporeal membrane oxygenation (ECMO) therapy and (2) barriers to implementing HAPU care bundles in this at-risk population. DESIGN AND METHODS: An integrative review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
September 8, 2017: Journal for Specialists in Pediatric Nursing: JSPN
S Meaume, M Marty, D Colin
OBJECTIVE: In patients with reduced mobility, specialised pressure-relieving supports (mattresses, beds and cushions) are widely used to reduce or relieve the interface pressure between the skin and support surfaces to prevent incidence of pressure ulcers (PUs). The primary objective of these two observational studies was to assess the incidence of PUs in patients at high risk of PUs, seated in a wheelchair using a single- or multi-compartment air cushion. The level of patient satisfaction with the comfort and the views of the care team that used the air cushions were considered as secondary objectives...
September 2, 2017: Journal of Wound Care
Kyung Hee Park, Joohee Park
PURPOSE: The purpose of this study was to compare a viscoelastic foam overlay (VEFO) to a standard hospital mattress for pressure injury (PI) prevention. We also compared interface pressures (IPs) of the VEFO to our facility's standard hospital mattress. DESIGN: Prospective, randomized controlled trial. SUBJECTS AND SETTING: Data analysis was based on 110 participants (55 in each group) who were 19 years or older, had a Braden Scale for Pressure Sore Risk score of 16 or less, and were cared for on a neurology, oncology, or pulmonology inpatient care unit...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
Silvia Garcia-Mayor, Juan Carlos Morilla-Herrera, Inmaculada Lupiáñez-Pérez, Shakira Kaknani Uttumchandani, Álvaro Leon Campos, Marta Aranda-Gallardo, Ana Belén Moya-Suárez, José Miguel Morales-Asencio
AIM: To analyse the changes in peripheral oxygenation and microvascular flow in tissues subjected to different pressure regimes in healthy subjects and in hospitalised patients. BACKGROUND: The presence of pressure ulcers in hospitalised patients is a common complication that has a negative impact on health and often prolongs hospital stay and increases health care costs. DESIGN: Experimental non-controlled, non-randomised study in two phases: preclinical and clinical...
August 9, 2017: Journal of Advanced Nursing
Donna Martin, Lisa Albensi, Stephanie Van Haute, Maria Froese, Mary Montgomery, Mavis Lam, Kendra Gierys, Rob Lajeunesse, Lorna Guse, Nataliya Basova
BACKGROUND: In 2013, an observational survey was conducted among 242 in-patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence-based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled "Healthy Skin Wins" with an online tutorial about PU prevention. AIMS: To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP...
December 2017: Worldviews on Evidence-based Nursing
Jennifer A Whitty, Elizabeth McInnes, Tracey Bucknall, Joan Webster, Brigid M Gillespie, Merrilyn Banks, Lukman Thalib, Marianne Wallis, Jose Cumsille, Shelley Roberts, Wendy Chaboyer
BACKGROUND: Pressure ulcers are serious, avoidable, costly and common adverse outcomes of healthcare. OBJECTIVES: To evaluate the cost-effectiveness of a patient-centred pressure ulcer prevention care bundle compared to standard care. DESIGN: Cost-effectiveness and cost-benefit analyses of pressure ulcer prevention performed from the health system perspective using data collected alongside a cluster-randomised trial. SETTINGS: Eight tertiary hospitals in Australia...
June 27, 2017: International Journal of Nursing Studies
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