Prevention of Pressure Ulcer in Intensive Care Units

Abstract

Prevention of Pressure Ulcer in Intensive Care Units Fatemeh Ahmadian 1 , Davood Hekmatpou 1 , * , Maryam Eghbali 2 and Shadi Farsaei 3 1 Nursing and Midwifery Faculty, Arak University of Medical Sciences, Arak, IR Iran 2 Isfahan Cardiovascular Research Center, Department of Intensive Care Nursing, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, IR Iran 3 Pharmacology Faculty, Isfahan University of Medical Sciences, Isfahan, IR Iran Abstract Background: One of the most common problems in intensive care units (ICUs) is pressure ulcer or bed sore and its prevention is a priority in nursing cares. Objectives: The current study aimed to evaluate the effect of henna (Lawsonia inermis) on prevention of pressure ulcers in patients in ICU. Patients and Methods: The current randomized clinical trial was conducted on 80 patients with the inclusion criteria hospitalized in the ICU of Al-Zahra hospital, Isfahan, Iran in 2015. Patients were randomly allocated into two groups of control (40 patients) and intervention (40 patients) by drawing method. For the intervention group, along with the standard prevention cares for pressure ulcers, once a 15 cm thick layer of henna was applied on patients’ sacrum. Data was gathered using demographic data questionnaire, Braden scale to predict pressure ulcer risk and the table to control daily record of skin temperature before the intervention for a week. Data were analyzed using SPSS ver. 21 and Chi-square, Greenhouse Geisser, Pearson correlation coefficient and independent t-test were used in the study. Results: The mean age of patients in the intervention and control groups was 51.35 ± 17 and 52.94 ± 19.61years, respectively. The means of standard deviation score of the Braden scale for all the participants on the first, fourth and seventh day of the study were 12.27 ± 2.85, 14.23 ± 3.21 and 15.73 ± 3.82, respectively, which had significant differences with each other (P < 0.0001); suggesting that the risk of pressure ulcers occurrence was higher on the first day than the seventh day. There was a reverse relationship between reduction of the Braden scale score and increase in local warmth of sacrum (r = 0.558) in both groups. The mean and standard deviation of local warmth of sacrum during the seven days of study were 37.84 ± 0.52 and 38.06 ± 0.67 in the intervention and control groups, but their difference was insignificant (P < 0.14). The mean and standard deviation of local warmth of forehead during the seven days of study were 37.09 ± 0.41 and 37.03 ± 0.44 in the intervention and control groups but their difference was insignificant (P < 0.5). There was a statistically significant difference between the mean local warmth of sacrum and forehead in the intervention group during the seven days of study (P = 0.0001). At the end of the study, one patient in the intervention group (2.7% male) and six patients in the control group (14.29% male, 2.85% female) had developed pressure ulcers; this difference was significant (P = 0.001). Conclusions: Considering the effect of henna in reducing the local warmth, redness, and inflammation of sacrum in patients in intensive care units, application of henna to prevent pressure ulcers for patients at risk of developing pressure ulcers is recommended. Keywords: Intensive Care Unit; Henna; Pressure Ulcer; The Braden Scale; Iran; Lawsonia inermis