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program prevention of pressure ulcers

Mike Carlson, Cheryl Lp Vigen, Salah Rubayi, Erna Imperatore Blanche, Jeanine Blanchard, Michal Atkins, Barbara Bates-Jensen, Susan L Garber, Elizabeth A Pyatak, Jesus Diaz, Lucia I Florindez, Joel W Hay, Trudy Mallinson, Jennifer B Unger, Stanley Paul Azen, Michael Scott, Alison Cogan, Florence Clark
CONTEXT/OBJECTIVE: Medically serious pressure injuries (MSPrIs), a common complication of spinal cord injury (SCI), have devastating consequences on health and well-being and are extremely expensive to treat. We aimed to test the efficacy of a lifestyle-based intervention designed to reduce incidence of MSPrIs in adults with SCI. DESIGN: A randomized controlled trial (RCT), and a separate study wing involving a nonrandomized standard care control group. SETTING: Rancho Los Amigos National Rehabilitation Center, a large facility serving ethnically diverse, low income residents of Los Angeles County...
April 17, 2017: Journal of Spinal Cord Medicine
Wararom Kanchanasamut, Praneet Pensri
Objective: Foot and ankle exercise has been advocated as a preventative approach in reducing the risk of foot ulceration. However, knowledge about the appropriate types and intensity of exercise program for diabetic foot ulcer prevention is still limited. The current study aimed to examine the effects of an eight-week mini-trampoline exercise on improving foot mobility, plantar pressure and sensation of diabetic neuropathic feet. Methods: Twenty-one people with diabetic peripheral neuropathy who had impaired sensation perception were divided into two groups...
2017: Diabetic Foot & Ankle
Yufitriana Amir, Frans E S Tan, Ruud Halfens, Christa Lohrmann, Jos Schols
Although the number of studies on pressure ulcer (PU) occurrence continues to grow, research regarding the quality of PU care and its effect on outcomes is limited. Using an extended Donabedian model, a 1-day, multicenter, cross-sectional evaluation of the quality of PU care was conducted in a convenience sample of Indonesian hospitals among patients ≥18 years of age in the medical, surgical, and intensive care units. Structure (ie, hospital attributes), process (recommended PU preventive measures), and outcome indicators (nosocomial PU prevalence excluding nonblanchable erythema), along with patient characteristics (age, gender, ethnicity, admission days, diseases [per ICD-10], recent surgery, PU categorization [4 categories according to National Pressure Ulcer Advisory Panel-European Pressure Ulcer Advisory Panel guidelines], PU history, care dependency, and Braden score) were examined...
February 2017: Ostomy/wound Management
Jacqueline Magurn, Joanne McGovern, Michelle Jetter, Sarah Beadling, Dorothy Gregoire
230 Background: Developing and maintaining a culture of safety and quality in delivering patient care is critical in the intensive care unit (ICU) especially an oncology ICU. Incorporating the Lean Six Sigma program into daily operations of the ICU achieves, simplifies, and sustains continuous improvement in the delivery of safe quality patient care. This program engages the ICU team through visual management of quality, safety, and budget indicators including medication scanning, falls, sharps exposure, infection prevention including blood stream, catheter, hospital and ventilator acquired pneumonias, venous embolism prevention, and staffing compliance...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jung Yoon Kim, Eunhee Cho
AIM: This study developed a self-efficacy enhancement program and evaluated its effects on the self-care behaviors, self-care knowledge, and self-efficacy regarding pressure ulcer prevention in patients with a spinal cord injury. METHODS: This was a multicenter randomized controlled trial. Six hospitals were invited to recruit patients with a spinal cord injury who were undergoing rehabilitation after receiving acute treatment. These hospitals were randomly allocated into experimental (three hospitals) or control (three hospitals) groups and 47 patients participated (24 in the experimental group and 23 in the control group)...
January 2017: Japan Journal of Nursing Science: JJNS
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
Frank E DiLiberto, Judith F Baumhauer, Deborah A Nawoczenski
Background: Implementation of interprofessional clinical guidelines for the prevention of neuropathic diabetic foot ulceration has demonstrated positive effects regarding ulceration and amputation rates. Current foot care recommendations are primarily based on research regarding the prevention of ulcer recurrence and focused on reducing the magnitude of plantar stress (pressure overload). Yet, foot ulceration remains to be a prevalent and debilitating consequence of Diabetes Mellitus...
November 16, 2016: Brazilian Journal of Physical Therapy
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
Sook Ja Lee, Ok Kyoung Park, Mi Yeon Park
PURPOSE: The purpose of this study was to construct and test a structural equation model for pressure ulcer prevention action by clinical nurses. The Health Belief Model and the Theory of Planned Behavior were used as the basis for the study. METHODS: A structured questionnaire was completed by 251 clinical nurses to analyze the relationships between concepts of perceived benefits, perceived barriers, attitude, subjective norm, perceived control, intention to perform action and behavior...
August 2016: Journal of Korean Academy of Nursing
Lynn M Soban, Linda Kim, Anita H Yuan, Rebecca S Miltner
AIM: To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. BACKGROUND: Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes...
August 4, 2016: Journal of Nursing Management
Cássia Teixeira Dos Santos, Miriam de Abreu Almeida, Amália de Fátima Lucena
OBJECTIVE: to validate the content of the new nursing diagnosis, termed risk for pressure ulcer. METHOD: the content validation with a sample made up of 24 nurses who were specialists in skin care from six different hospitals in the South and Southeast of Brazil. Data collection took place electronically, through an instrument constructed using the SurveyMonkey program, containing a title, definition, and 19 risk factors for the nursing diagnosis. The data were analyzed using Fehring's method and descriptive statistics...
June 14, 2016: Revista Latino-americana de Enfermagem
Lynn M Soban, Erin P Finley, Rebecca S Miltner
PURPOSE: To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. DESIGN: Multisite comparative case study. SUBJECTS AND SETTING: Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26)...
May 2016: Journal of Wound, Ostomy, and Continence Nursing
Ida Marie Bredesen, Karen Bjøro, Lena Gunningberg, Dag Hofoss
BACKGROUND: Pressure ulcers (PUs) are a problem in health care. Staff competency is paramount to PU prevention. Education is essential to increase skills in pressure ulcer classification and risk assessment. Currently, no pressure ulcer learning programs are available in Norwegian. OBJECTIVES: Develop and test an e-learning program for assessment of pressure ulcer risk and pressure ulcer classification. METHODS: HASH(0x3588a08) DESIGN, PARTICIPANTS AND SETTING: Forty-four nurses working in acute care hospital wards or nursing homes participated and were assigned randomly into two groups: an e-learning program group (intervention) and a traditional classroom lecture group (control)...
May 2016: Nurse Education Today
Ogochukwu Azuh, Harriet Gammon, Charlotte Burmeister, Donald Frega, David Nerenz, Bruno DiGiovine, Aamir Siddiqui
BACKGROUND: Pressure ulcer formation continues to be problematic in acute care settings, especially intensive care units (ICUs). Our institution developed a program for early mobility in the ICU using specially trained nursing aides. The goal was to impact hospital-acquired pressure ulcers incidence as well as factors associated with ICU deconditioning by using specially trained personnel to perform the acute early mobility interventions. METHODS: A 5-point mobility scale was developed and used to establish a patients' highest level of activity achievable during evaluation...
August 2016: American Journal of Medicine
Rose Ekama Ilesanmi, Odunayo Morohunfoluwa Oluwatosin
Educational intervention programs are an important element to improve nurses' knowledge of pressure ulcer (PU) prevention. Various teaching methods have been used with diverse results but none have been analyzed in Nigeria. A quasi- experimental study using a pretest/post test design was conducted among 193 registered nurses with >6 months experience who worked in purposefully selected wards (neuroscience, orthopedics, renal, and cardiac) in 3 teaching hospitals to examine the level of knowledge retention after interactive instruction...
April 2016: Ostomy/wound Management
Kumal Rajpaul, Claire Acton
Pressure ulcers are a frequent, but often preventable, occurrence among patients in acute care facilities, and the heel is one of the anatomical locations most commonly affected. Multiple clinical guidelines recommend the use of robust assessments to identify at-risk patients and the application of heel protection devices to reduce the likelihood of developing heel pressure ulcers. A quality improvement initiative involving robust skin-assessment practices, staff education, and the use of heel protection devices was analysed retrospectively to evaluate the efficacy of current practice interventions...
March 2016: British Journal of Nursing: BJN
Brenda S Bos, Tina M Wangen, Carl E Elbing, Debra J Rowekamp, Heather A Kruggel, Patricia M Conlon, Leann M Scroggins, Shauna P Schad, Julie A Neumann, Melissa M Barth, Pamela L Grubbs, Beth A Sievers
This article describes the processes used to implement a pressure ulcer management program in a Midwest academic medical center, which led to a decrease in reportable pressure ulcers. A learning needs assessment was completed, and a workgroup was formed to address the learning needs. Methods, materials, and processes included lectures, technology-enhanced learning, and interactive stations with mannequins and pressure ulcer moulages. The processes and outcome measures used to measure effectiveness of the program are discussed...
March 2016: Journal for Nurses in Professional Development
Katie Swafford, Rachel Culpepper, Christina Dunn
BACKGROUND: Hospital-acquired pressure ulcers (HAPUs) are a costly and largely preventable complication occurring in a variety of acute care settings. Because they are considered preventable, stage III and IV HAPUs are not reimbursed by Medicare. OBJECTIVES: To assess the effectiveness of a formal, year-long HAPU prevention program in an adult intensive care unit, with a goal of achieving at least a 50% reduction in 2013, compared with 2011. METHODS: Planning for the prevention program began in 2012, and the program was rolled out in the first quarter of 2013...
March 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Tohid Jafari-Koshki, Sayed Mohsen Hosseini, Shahram Arsang-Jang, Masoud Amini, Elham Faghihimani
BACKGROUND: Diabetes mellitus is a metabolic disorder and its subsequent complications such as retinopathy, nephropathy, ulcers, disability, and amputation increase the burden of the disease. Patient knowledge-improving programs are employed to prevent disease progression and to improve the quality of life of the patients. In this way, we need to characterize the groups of patients in urgent need for more and rich-in-content programs. In the present study, we used piecewise regression to evaluate the trends of diabetic nephropathy prevalence in patients registered in the Sedigheh-Tahereh Research Center and to identify patients who were in need of more attention...
October 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
(no author information available yet)
In the October In Our Unit article by Cooper et al, “Against All Odds: Preventing Pressure Ulcers in High-Risk Cardiac Surgery Patients” (Crit Care Nurse. 2015;35[5]:76–82), there was an error in the reference citation on page 82. At the top of that page, reference 18 cited on the second line should be reference 23, which also should be added to the References list: 23. AHRQ website. Prevention and treatment program integrates actionable reports into practice, significantly reducing pressure ulcers in nursing home residents...
February 2016: Critical Care Nurse
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