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Pressure ulcer management

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https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#1
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28419746/factors-for-postoperative-complications-following-pressure-ulcer-operation-stepwise-multiple-logistic-regression-analysis
#2
Hyun Ho Han, Jun Gul Ko, Jong Won Rhie
Patients with pressure ulcers are generally older, have a long hospital stay and often have a variety of comorbidities. The decision to perform surgery for pressure ulcer management can be difficult because of concerns about the risk of postoperative complications. The aim of this study was to analyse the relationship between comorbid conditions and surgical outcomes in order to guide patient selection for pressure ulcer surgery. In 57 patients, data on age, defect size, operating time, hospital stay, body mass index, surgical site, mobility state, cardiac ischaemic history, diabetes, renal failure, ventilator dependency, tracheostomy state, use of haemodilution therapy and cancer were evaluated using stepwise multiple logistic regression analysis to determine the relationships between variables...
April 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28388680/association-between-diabetic-foot-ulcer-and-diabetic-retinopathy
#3
Duck Jin Hwang, Kyoung Min Lee, Moon Seok Park, Sung Hee Choi, Ji In Park, Joon Hee Cho, Kyu Hyung Park, Se Joon Woo
PURPOSE: We aimed to investigate the prevalence of diabetic retinopathy (DR) in patients with diabetic foot ulcer (DFU) and elucidate the association between DR and DFU severities and their shared risk factors. METHODS: A retrospective review was conducted on DFU patients who underwent ophthalmic and vascular examinations within 6 months; 100 type 2 diabetic patients with DFU were included. The medical records of 2496 type 2 diabetic patients without DFU served as control data...
2017: PloS One
https://www.readbyqxmd.com/read/28381584/predicting-the-risk-of-bleeding-during-dual-antiplatelet-therapy-after-acute-coronary-syndromes
#4
Joakim Alfredsson, Benjamin Neely, Megan L Neely, Deepak L Bhatt, Shaun G Goodman, Pierluigi Tricoci, Kenneth W Mahaffey, Jan H Cornel, Harvey D White, Keith Aa Fox, Dorairaj Prabhakaran, Kenneth J Winters, Paul W Armstrong, E Magnus Ohman, Matthew T Roe
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patient's bleeding risk during DAPT treatment in the post-ACS setting. METHODS: To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14...
April 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28365206/prevalence-and-incidence-density-of-unavoidable-pressure-ulcers-in-elderly-patients-admitted-to-medical-units
#5
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/28346243/modeling-flowsheet-data-to-support-secondary-use
#6
Bonnie L Westra, Beverly Christie, Steven G Johnson, Lisiane Pruinelli, Anne LaFlamme, Suzan G Sherman, Jung In Park, Connie W Delaney, Grace Gao, Stuart Speedie
The purpose of this study was to create information models from flowsheet data using a data-driven consensus-based method. Electronic health records contain a large volume of data about patient assessments and interventions captured in flowsheets that measure the same "thing," but the names of these observations often differ, according to who performs documentation or the location of the service (eg, pulse rate in an intensive care, the emergency department, or a surgical unit documented by a nurse or therapist or captured by automated monitoring)...
March 24, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28345975/pressure-ulcer-prevention-is-everyone-s-business-the-pups-project
#7
Juliet Blenman, Di Marks-Maran
Prevention of pressure ulcers is one of the greatest healthcare challenges in terms of reducing patient harm. The literature shows that although numerous reports and policy documents have been published, pressure ulcer prevention remains an ongoing challenge. A number of innovations have been published offering practising nurses and managers ideas for raising awareness of skin care and preventing pressure ulcers. The majority of these have focused on patients in hospital settings with very little in the literature related to care-home and community initiatives...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28345974/the-provision-of-therapy-mattresses-for-pressure-ulcer-prevention
#8
Fania Pagnamenta
Preventing pressure ulcers is complex and involves skin care, the provision of therapy mattresses, repositioning, the management of incontinence and adequate nutritional support. This article describes a model of therapy mattress provision that is based on non-powered products. Evaluating the efficiency of this model is challenging, due to the complexities of care, but Safety Thermometer data and incidents reports offer reassurance that non-powered therapy mattresses can provide adequate pressure ulcer prevention...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28341229/assessment-of-the-extension-of-pressure-ulcers-into-soft-tissue-and-osteomyelitis-diagnosis-using-18-f-fdg-pet-ct
#9
J R Garcia, M Soler, P Bassa, M Minoves, E Riera
The precise assessment of pressure ulcer extension in patients with neurological diseases has crucial therapeutic implications, especially in the early detection of fistula to interior structures and osteomyelitis. Two case reports are presented on patients with a similar ischial ulcer, in whom an (18)F-FDG PET/CT study enabled a precise assessment of infectious complications in underlying tissues. These cases support the implementation of (18)F-FDG PET/CT as a first-line technique in their management.
March 21, 2017: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/28331459/heterotopic-ossification-of-the-calvarium-following-bilateral-craniectomies-in-traumatic-brain-injury
#10
Rafael A Vega, Leslie Hutchins
BACKGROUND: Heterotopic ossification (HO) is defined as ectopic bone formation following traumatic brain injury. Patients typically develop lesions in the hips, knees, and elbows that cause pain, restricted range of motion, nerve impingement, and pressure ulcers. CASE REPORT: We report an unusual presentation of HO in an 18-year-old male who was involved in a motor vehicle accident and subsequently developed malignant intracranial pressure. His HO developed following bilateral craniectomies in which 2 different dural substitutes were used...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28327493/noninvasive-ventilation-open-issues-for-nursing-research
#11
Stefano Bambi, Enrica Mati, Christian De Felippis, Alberto Lucchini
According to the current literature, Noninvasive Ventilation (NIV) is a well-recognized respiratory support technique for patients affected by Acute Respiratory Failure (ARF). As highlighted by recent meta-analysis, a tight adherence to protocols regarding patients' selection criteria, relative or absolute contraindications, plus highly skilled and experienced operators, can positively affect the NIV performance and mortality rates. Positive outcome from NIV respiratory support is dependent from: patient's clinical condition and education needs; confidence of the staff with NIV technology; choice and management of the most suitable interface available prevention of interface complications; nutritional assessment (artificial feeding if required) and conditioning of medical gas...
March 14, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28319416/specifics-in-the-review-of-health-documentation
#12
K Kacalova, B Havelkova, D Farkasova
OBJECTIVES: The objective of the work was to identify if health documentation management is depending of actually current legislation. Also to review range and consistency records. The work described forms and content of documentation, relating to treat wounds and decubitus. METHODS: A content analysis of 139 health documentation of insurer of General Health Insurance Company, which were treated by 28 home care agencies (hereinafter "HCA") and in the HCA was done directly audit in 2012 and 2014...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28314562/intermittent-vibration-protects-aged-muscle-from-mechanical-and-oxidative-damage-under-prolonged-compression
#13
Sing Wan Wong, Brian Chun Ho Cheung, Bruce Tak Keung Pang, Ateline Kwong, Anna Chung, Kenneth Ka Ho Lee, Arthur Fut Tak Mak
Deep tissue pressure ulcers, a serious clinical challenge originating in the muscle layer, are hardly detectable at the beginning. The challenge apparently occurs in aged subjects more frequently. As the ulcer propagates to the skin surface, it becomes very difficult to manage and can lead to fatal complications. Preventive measures are thus highly desirable. Although the complex pathological mechanisms have not been fully understood, prolonged and excessive physical challenges and oxidative stress are believed to be involved in the ulcer development...
April 11, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28301799/does-participating-in-a-clinical-trial-affect-subsequent-nursing-management-post-trial-care-for-participants-recruited-to-the-intact-pressure-ulcer-prevention-trial-a-follow-up-study
#14
Joan Webster, Tracey Bucknall, Marianne Wallis, Elizabeth McInnes, Shelley Roberts, Wendy Chaboyer
BACKGROUND: Participation in a clinical trial is believed to benefit patients but little is known about the post-trial effects on routine hospital-based care. OBJECTIVES: To describe (1) hospital-based, pressure ulcer care-processes after patients were discharged from a pressure ulcer prevention, cluster randomised controlled trial; and (2) to investigate if the trial intervention had any impact on subsequent hospital-based care. METHODS: We conducted a retrospective analysis of 133 trial participants who developed a pressure ulcer during the clinical trial...
February 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28272013/when-traditional-offloading-is-not-an-option-could-an-external-fixator-be-a-solution-a-case-report
#15
Abdulaziz A Kimawi, Robert J Snyder, Mario A Cala, Cherison Cuffy
Offloading is a cornerstone in managing diabetic plantar foot ulcers; however, it often represents one of the most challenging aspects of treatment for clinician and patient alike. The authors present a case of a 61-year-old African American man with type 2 diabetes and a limb-threatening plantar foot ulcer that required aggressive wound and surgical management. Due to the heavy drainage and patient adherence issues, traditional offloading techniques such as total contact cast, DH Pressure Relief Walker (Össur, Foothill Ranch, CA), and wedge shoes, among others, were not viable options...
February 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28267681/pressure-ulcer-risk-and-prevention-practices-in-pediatric-patients-a-secondary-analysis-of-data-from-the-national-database-of-nursing-quality-indicators%C3%A2
#16
Ivy Razmus, Sandra Bergquist-Beringer
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status...
January 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28267120/pressure-mapping-in-elderly-care-a-tool-to-increase-pressure-injury-knowledge-and-awareness-among-staff
#17
Lisa Hultin, Estrid Olsson, Cheryl Carli, Lena Gunningberg
PURPOSE: The purpose of this study was to evaluate the use of a pressure mapping system with real-time feedback of pressure points in elderly care, with specific focus on pressure injury (PI) knowledge/attitudes (staff), interface pressure, and PI prevention activities (residents). DESIGN: Descriptive, 1-group pretest/posttest study. SUBJECTS AND SETTING: A convenience sample of 40 assistant nurses and aides participated in the study; staff members were recruited at daytime, and 1 nighttime meeting was held at the facility...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
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
#18
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/28252905/-wound-care-management-impact-on-outcomes-of-nursing-care
#19
Jacopo Fiorini, Giulia Venturini, Guido Scotti, Roberto Cresta, Roberto Latina, Alessandro Sili
AIM: To evaluate wound care management in Rome's Hospital. METHOD: Observational study, divided into phases, through the analysis of 301 nursing records of patients either admitted to the hospital with ulcer pressure at the admission or grown later. Among the nursing records, 151 have been analyzed directly in the wards and 150 are referred to the triennium 2010-2012 and have been traced in a computerized version. RESULTS: The nursing records concerning the ulcer pressure is completed in 4% average...
October 2016: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28252339/could-lateral-tilt-mattresses-be-the-answer-to-pressure-ulcer-prevention-and-management
#20
Sylvie Hampton
Pressure ulcers have been part of illness for thousands of years and are not reducing in number. Traditionally, since the Crimean War, patients have been ritually repositioned every 2 hours, regardless of the individual need. Pressure ulcers occur mainly on bony prominences, and so it makes sense to reposition into the 30 degree tilt, off of bony prominences. Nevertheless, this still takes time in order to reposition on a regular basis. It is time to look at automatic repositioning, reducing nursing time, increasing patient comfort and releasing carers to provide more social support to the patients...
March 2017: British Journal of Community Nursing
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