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Hospital acquired pressure ulcer

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https://www.readbyqxmd.com/read/28365206/prevalence-and-incidence-density-of-unavoidable-pressure-ulcers-in-elderly-patients-admitted-to-medical-units
#1
Alvisa Palese, Barbara Trevisani, Annamaria Guarnier, Paolo Barelli, Paola Zambiasi, Elisabetta Allegrini, Letizia Bazoli, Paola Casson, Meri Marin, Marisa Padovan, Michele Picogna, Patrizia Taddia, Daniele Salmaso, Paolo Chiari, Oliva Marognolli, Canzan Federica, Luisa Saiani, Elisa Ambrosi
To describe the prevalence and incidence density of hospital-acquired unavoidable pressure sores among patients aged ≥65 years admitted to acute medical units. A secondary analysis of longitudinal study data collected in 2012 and 2013 from 12 acute medical units located in 12 Italian hospitals was performed. Unavoidable pressure ulcers were defined as those that occurred in haemodynamically unstable patients, suffering from cachexia and/or terminally ill and were acquired after hospital admission. Data at patient and at pressure ulcer levels were collected on a daily basis at the bedside by trained researchers...
March 23, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28323686/applying-the-pdsa-framework-to-examine-the-use-of-the-clinical-nurse-leader-to-evaluate-pressure-ulcer-reporting
#2
Shea Polancich, Sarah Coiner, Rebekah Barber, Terri Poe, Linda Roussel, Kelley Williams, Heather Cumbest, Kristen Noles, Ashlea Herrero, Shannon Graham, Rebecca Miltner
The clinical nurse leader (CNL) role has been cited as an effective strategy for improving care at the microsystem level. The purpose of this article is to describe the use of the CNL role in an academic medical center for evaluating pressure ulcer reporting. The Plan-Do-Study-Act cycle was used as the methodological framework for the study. The CNL assessment of pressure ulcers resulted in a 21% to 50% decrease in the number of hospital-acquired pressure ulcers reported in a 3-month time period. The CNL role has potential for improving the validity and reliability of pressure ulcer reporting...
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28269339/a-novel-system-to-tackle-hospital-acquired-pressure-ulcers
#3
B S Renganathan, S P Preejith, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam
Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#4
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28266917/virtual-breakthrough-series-part-1-preventing-catheter-associated-urinary-tract-infection-and-hospital-acquired-pressure-ulcers-in-the-veterans-health-administration
#5
Lisa Zubkoff, Julia Neily, Beth J King, Mary Ellen Dellefield, Sarah Krein, Yinong Young-Xu, Shoshana Boar, Peter D Mills
BACKGROUND: In 2014 the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) implemented a Virtual Breakthrough Series (VBTS) collaborative to help VHA facilities prevent hospital-acquired conditions: catheter-associated urinary tract infection (CAUTI) and hospital-acquired pressure ulcers (HAPUs). METHODS: During the prework phase, participating facilities assembled a multidisciplinary team, assessed their current system for CAUTI or HAPU prevention, and examined baseline data to set improvement aims...
November 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28227581/a-novel-system-to-tackle-hospital-acquired-pressure-ulcers
#6
B S Renganathan, S P Preejith, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam, B S Renganathan, S P Preejith, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam, S P Preejith, B S Renganathan, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam
Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28195000/prevention-of-tracheostomy-related-hospital-acquired-pressure-ulcers
#7
Thomas R O'Toole, Natalie Jacobs, Brian Hondorp, Laura Crawford, Lisa R Boudreau, Jill Jeffe, Brian Stein, Phillip LoSavio
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head...
April 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28152722/integrating-lean-six-sigma-in-the-daily-operations-of-an-icu-to-achieve-safe-quality-patient-care
#8
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
https://www.readbyqxmd.com/read/28128459/a-hybrid-methodology-for-modeling-risk-of-adverse-events-in-complex-health-care-settings
#9
Reza Kazemi, Ali Mosleh, Meghan Dierks
In spite of increased attention to quality and efforts to provide safe medical care, adverse events (AEs) are still frequent in clinical practice. Reports from various sources indicate that a substantial number of hospitalized patients suffer treatment-caused injuries while in the hospital. While risk cannot be entirely eliminated from health-care activities, an important goal is to develop effective and durable mitigation strategies to render the system "safer." In order to do this, though, we must develop models that comprehensively and realistically characterize the risk...
January 27, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28039852/pathway-from-delirium-to-death-potential-in-hospital-mediators-of-excess-mortality
#10
Kumar Dharmarajan, Sunil Swami, Ray Y Gou, Richard N Jones, Sharon K Inouye
OBJECTIVES: (1) To determine the relationship of incident delirium during hospitalization with 90-day mortality; (2) to identify potential in-hospital mediators through which delirium increases 90-day mortality. DESIGN: Analysis of data from Project Recovery, a controlled clinical trial of a delirium prevention intervention from 1995 to 1998 with follow-up through 2000. SETTING: Large academic hospital. PARTICIPANTS: Patients ≥70 years old without delirium at hospital admission who were at intermediate-to-high risk of developing delirium and received usual care only...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27928911/soft-silicone-foam-dressing-is-more-effective-than-polyurethane-film-dressing-for-preventing-intraoperatively-acquired-pressure-ulcers-in-spinal-surgery-patients-the-border-operating-room-spinal-surgery-boss-trial-in-japan
#11
Mine Yoshimura, Norihiko Ohura, Junko Tanaka, Shoichi Ichimura, Yusuke Kasuya, Oruto Hotta, Yu Kagaya, Takuya Sekiyama, Mitsuko Tannba, Nao Suzuki
Preventing intraoperatively acquired pressure ulcers (IAPUs) in patients undergoing spinal surgery in the prone position using a Relton-Hall frame is challenging. We investigated the efficacy of soft silicone foam dressings in preventing IAPUs. A prospective dual-center sham study was conducted among patients undergoing elective spinal surgery in a general hospital and a university hospital in Japan. The incidence of IAPUs that developed when soft silicone foam dressings and polyurethane film dressings were used was compared on two sides in the same patient...
December 7, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#12
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/27861136/a-prospective-descriptive-quality-improvement-study-to-investigate-the-impact-of-a-turn-and-position-device-on-the-incidence-of-hospital-acquired-sacral-pressure-ulcers-and-nursing-staff-time-needed-for-repositioning-patients
#13
Kimberly D Hall, Rebecca C Clark
Patients in critical care areas are at risk for developing hospital-acquired pressure ulcers (HAPUs) due to their physical conditions and limited ability to reposition themselves. A prospective, 2-phase quality improvement study was conducted from September to November 2011 and from February to April 2012 in 1 medical and 1 surgical ICU to investigate the impact of a turn-and-assist device on the incidence of HAPUs and the time and personnel required to reposition patients reported as person/minutes (staff x minutes)...
November 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27802960/five-layered-soft-silicone-foam-dressing-to-prevent-pressure-ulcers-in-the-intensive-care-unit
#14
Peggy Kalowes, Valerie Messina, Melanie Li
BACKGROUND: In critically ill patients, prevention of pressure ulcers is a challenge because of the high risk for multiple comorbid conditions, immobility, hemodynamic instability, and increased use of medical devices. OBJECTIVES: To compare the difference in incidence rates of hospital-acquired pressure ulcers (HAPUs) in critically ill patients between those treated with usual preventive care and a 5-layered soft silicone foam dressing versus a control group receiving usual care...
2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27757068/nurse-staffing-and-patient-outcomes-a-longitudinal-study-on-trend-and-seasonality
#15
Jianghua He, Vincent S Staggs, Sandra Bergquist-Beringer, Nancy Dunton
BACKGROUND: Time trends and seasonal patterns have been observed in nurse staffing and nursing-sensitive patient outcomes in recent years. It is unknown whether these changes were associated. METHODS: Quarterly unit-level nursing data in 2004-2012 were extracted from the National Database of Nursing Quality Indicators® (NDNQI®). Units were divided into groups based on patterns of missing data. All variables were aggregated across units within these groups and analyses were conducted at the group level...
2016: BMC Nursing
https://www.readbyqxmd.com/read/27712030/effectiveness-of-pressure-ulcer-prevention-strategies-for-adult-patients-in-intensive-care-units-a-systematic-review
#16
REVIEW
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/27708825/characteristics-of-patients-who-are-admitted-with-or-acquire-pressure-ulcers-in-a-district-general-hospital-a-3%C3%A2-year-retrospective-analysis
#17
Peter R Worsley, Glenn Smith, Lisette Schoonhoven, Dan L Bader
AIM: The study aimed to characterize demographic and clinical practice factors associated with community (CAPU) and hospital acquired pressure ulcers (HAPU). DESIGN: A comparative retrospective evaluation of pressure ulcer data, collected from a district general hospital. METHODS: Demographic and pressure ulcer related data were collected from patients at risk of developing a pressure ulcer, collated by a single observer using a standardized tool...
July 2016: Nursing Open
https://www.readbyqxmd.com/read/27707831/comparing-physical-assessment-with-administrative-data-for-detecting-pressure-ulcers-in-a-large-canadian-academic-health-sciences-centre
#18
Chantal Backman, Saskia E Vanderloo, Toba B Miller, Lisa Freeman, Alan J Forster
OBJECTIVE: This study aimed to compare classification of pressure ulcers from administrative data with a gold standard assessment, specifically; pressure ulcers confirmed by an independent physical assessment performed by trained nurse surveyors. SETTING: A retrospective analysis of pooled cross-sectional samples of inpatients assessed across 3 consecutive prevalence surveys in a large academic health sciences centre between 2012 and 2013. PARTICIPANTS: There were 2001 patients for whom physical and chart assessments were completed, and for whom a discharge abstract was also available at the time of analysis...
October 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27693836/the-effect-of-a-patient-centred-care-bundle-intervention-on-pressure-ulcer-incidence-intact-a-cluster-randomised-trial
#19
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...
December 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27607602/a-pressure-ulcer-and-fall-rate-quality-composite-index-for-acute-care-units-a-measure-development-study
#20
Diane K Boyle, Ananda Jayawardhana, Mary E Burman, Nancy E Dunton, Vincent S Staggs, Sandra Bergquist-Beringer, Byron J Gajewski
BACKGROUND: Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. OBJECTIVE: The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index. DESIGN: Two-phase measure development study...
November 2016: International Journal of Nursing Studies
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