Braden Scale Research Articles

Real-time Positioning Among Nursing Home Residents Living With Dementia: A Case Study

This study describes the real-time body positions of 2 nursing home (NH) residents, residing in the United States and living with dementia, to inform development of PrI prevention strategies tailored to individual risk profiles. As part of a larger study, eligible residents were fitted with a triaxial accelerometer sensor placed on the anterior chest to monitor body positions 24-hours daily through a 4-week monitoring period. The current study used an observational, prospective design during routine repositioning events for 2 residents. A convenience sample of 2 residents from a single NH wing who were considered moderately at risk for PrI development (Braden Scale score 13-14) with a Brief Interview for Mental Status score in the severely impaired range were selected based on nursing staff recommendation. Sensor data showed that both residents, although "chairfast" according to the Braden Scale, spent <5% in an upright position and the great majority of time reclining at an angle <50%. One (1) resident demonstrated a persistent side preference. Wearable sensors are not a long-term solution for protecting those with dementia from PrI formation but do provide a crude picture of overall body positions throughout the 24-hour day that may inform individualized PrI prevention strategies. Studies including large samples of NH residents living with dementia are warranted.

Predictive Modeling of Pressure Injury Risk in Patients Admitted to an Intensive Care Unit.

Pressure injuries are an important problem in hospital care. Detecting the population at risk for pressure injuries is the first step in any preventive strategy. Available tools such as the Norton and Braden scales do not take into account all of the relevant risk factors. Data mining and machine learning techniques have the potential to overcome this limitation. To build a model to detect pressure injury risk in intensive care unit patients and to put the model into production in a real environment. The sample comprised adult patients admitted to an intensive care unit (N = 6694) at University Hospital of Torrevieja and University Hospital of Vinalopó. A retrospective design was used to train (n = 2508) and test (n = 1769) the model and then a prospective design was used to test the model in a real environment (n = 2417). Data mining was used to extract variables from electronic medical records and a predictive model was built with machine learning techniques. The sensitivity, specificity, area under the curve, and accuracy of the model were evaluated. The final model used logistic regression and incorporated 23 variables. The model had sensitivity of 0.90, specificity of 0.74, and area under the curve of 0.89 during the initial test, and thus it outperformed the Norton scale. The model performed well 1 year later in a real environment. The model effectively predicts risk of pressure injury. This allows nurses to focus on patients at high risk for pressure injury without increasing workload.

Topical Almond Oil for Prevention of Pressure Injuries: A Single-Blinded Comparison Study.

The aim of our study was to determine the effect of topical almond oil for prevention of pressure injuries. Single-blind randomized clinical trial. Patients admitted to an intensive care unit in Besat Hospital, Hamadan, Iran, were invited to participate in the trial. Data were collected over an 8-month period. A convenience sample of 108 patients, using a permuted block randomization method was assigned to 3 equal groups that received the intervention almond oil, placebo (liquid paraffin), or control (standard of care). Data included demographic information, Braden Scale score, and National Pressure Ulcer Advisory Panel-European Pressure Ulcer Advisory Panel (NPUAP-EPUAP) pressure injury staging system classification score. The intervention and placebo groups received daily application of 6.5 cc of topical almond oil or paraffin to the sacrum, heels, and shoulders for 7 consecutive days. The skin was evaluated for pressure injuries by an expert nurse who was blinded to groups. Chi-square test, analysis of variance, and regression analyses were used to evaluate relationships within and between groups for study variables, incidence of pressure injuries, and duration of time of onset of pressure injuries. P values less than .05 were deemed statistically significant. The incidence of pressure injury in the almond oil group (n = 2; 5.6%) was lower than that in the placebo (n = 5; 13.9%, P = .189) or control groups (n = 9; 25.1%, P = .024). The incidence of pressure injuries in the control group was 6.8 and 2.12 (P = .227) times higher than that in the almond and placebo groups, respectively. The onset day of a pressure injury occurred 5.4 days after initiation of the protocol in the almond oil group compared to 4.22 days in the control group (P = .023) and 5 days in the placebo group (P = .196). The topical application of almond oil was associated with a lower incidence of pressure injuries and that developed later during the study compared to participants who received paraffin or standard of care only. Further study is recommended to advance this work in populations at risk for pressure injury.

Wound Healing in the Long-Term Acute Care Setting Using an Air Fluidized Therapy/Continuous Low-Pressure Therapeutic Bed: A Multiple Case Series.

We evaluated a new bed that updates the functionality of the current air fluidized therapy (AFT)/continuous low-pressure (CLP) pressure redistributing beds. This bed was evaluated in conjunction with standard wound care interventions in a long-term acute care hospital (LTACH). The AFT feature is designed to provide pressure distribution via a fluid-like medium that forces air though millions of tiny silicone beads that float the patient's body to achieve maximum immersion and envelopment. The CLP feature of the bed provides pressure distribution for the upper body. Standard wound care was provided that included debridement, topical treatments, and biophysical therapies such as negative pressure wound therapy, as indicated. Our multiple case series comprised 10 medically compromised patients with 25 wounds. Their mean age was 63 years, 50% were male, and the mean cumulative Braden Scale score was 12.4 out of 23, indicating a high risk for pressure injury (PI). Seven of 10 patients were incontinent of urine, 6 had fecal incontinence, and 2 had ostomies. Types of wounds treated included 2 large tissue defects from surgical excisions for the treatment of gangrene and 23 PIs. On admission, wounds had an average surface area of 139.1 cm. The mean percentage of reduction in wound surface area was 59.3% over an average of 31.3 days of therapy. No new wounds formed during their course of care despite being at elevated risk. Findings from this multiple case series suggest that the AFT/CLP bed facilitates healing of advanced wounds in medically complex patients when included as part of a wound care program. Despite mild to high risk, no new PIs developed, and severe PIs and large tissue defects significantly improved or completely resolved. One hundred percent of surveyed staff members recommend use of the AFT/CLP bed.

Evaluation of a Modified Version of the Norton Scale for Use as a Pressure Injury Risk Assessment Instrument in Critical Care: A Quality Improvement Project.

No risk assessment scale exists in the United States specifically designed for use among patients with critical illness. The aim of this project was to modify the Norton Scale for Pressure Sore Risk to improve its predictive power when used in the critical care setting. The setting for this quality improvement project was a 1157-bed academic medical center in the Southeast United States. Data were collected from 114 clinicians; 111 were critical care nurses and 3 were certified wound care nurses. Participants assessed the pressure injury risks of a video-simulated critical care patient using the optimized Norton Scale (oNS); this instrument was modified from the Norton Scale. Data were collected on reliability, validity, usability, and preference. All 114 participants accurately predicted a patient's severe high risk for pressure injury using the oNS. Predictive validity and reliability of the oNS were excellent based on a correlation coefficient of more than 0.6 and a Cronbach α = 0.944, respectively. The intraclass correlation coefficient (ICC) was 0.933 (95% confidence interval, 0.911-0.950). From 71.2% to 84.9% of the participants agreed that the oNS represented the desired characteristics for optimal usability in the critical-care setting. Preference for the oNS was associated with perceptions that it was easier, quicker, and more critical-care-specific than the Braden Scale for Pressure Sore Risk currently used in critical care units in the project facility. The oNS offered critical care nurses in our facility a quick, easy-to-use, critical care- specific risk assessment tool that focused on the unique vulnerabilities of patients with critical illness.

Identifying Risk Factors for Pressure Injury in Adult Critical Care Patients.

Critically ill patients have a variety of unique risk factors for pressure injury. Identification of these risk factors is essential to prevent pressure injury in this population. To identify factors predicting the development of pressure injury in critical care patients using a large data set from the PhysioNet MIMIC-III (Medical Information Mart for Intensive Care) clinical database. Data for 1460 patients were extracted from the database. Variables that were significant in bivariate analyses were used in a final logistic regression model. A final set of significant variables from the logistic regression was used to develop a decision tree model. In regression analysis, cardiovascular disease, peripheral vascular disease, pneumonia or influenza, cardiovascular surgery, hemodialysis, norepinephrine administration, hypotension, septic shock, moderate to severe malnutrition, sex, age, and Braden Scale score on admission to the intensive care unit were all predictive of pressure injury. Decision tree analysis revealed that patients who received norepinephrine, were older than 65 years, had a length of stay of 10 days or less, and had a Braden Scale score of 15 or less had a 63.6% risk of pressure injury. Determining pressure injury risk in critically ill patients is complex and challenging. One common pathophysiological factor is impaired tissue oxygenation and perfusion, which may be nonmodifiable. Improved risk quantification is needed and may be realized in the near future by leveraging the clinical information available in the electronic medical record through the power of predictive analytics.

Incidence and Influencing Factors of Medical Adhesive-Related Skin Injury in Critically Ill Patients.

To determine the incidence and influencing factors of medical adhesive-related skin injury (MARSI) among ICU patients. Study authors enrolled patients admitted to two ICUs at a class 3, grade A hospital in Beijing between January and June 2018 in this prospective cohort study. A data collection sheet was designed, and the data were collected by querying the electronic medical record and via direct assessment. Univariate and multivariate logistic regression analyses were performed to identify factors that independently influenced MARSI incidence. The STROBE checklist was used. In total, 39 of 356 patients (27 men and 12 women with an average age of 61.51 ± 17.49 years) developed MARSI, an incidence of 10.96%. The median time from admission to MARSI occurrence was 26 days. Multivariate logistic regression analysis revealed that the ICU length of stay, Braden Scale score, and mechanical ventilation all independently influenced incidence. The Braden Scale score (odds ratio [OR], 0.758; 95% confidence interval [CI], 0.636-0.904; P < .05) was a protective factor against MARSI, with higher scores indicating lower risk. The ICU length of stay (OR, 1.098; 95% CI, 1.061-1.136; P < .05) and mechanical ventilation (OR, 3.373; 95% CI, 0.889-12.795; P < .05) were independent risk factors for MARSI. The incidence of MARSI in ICU patients was relatively high. Awareness of MARSI should be increased among medical staff, and proper skin care should be provided to prevent and treat MARSI effectively.

The Six-Clicks Mobility Measure: A Useful Tool for Predicting Discharge Disposition

ObjectiveTo assess the predictive capabilities of 2 measures of functional mobility, the 6-clicks score and the Braden scale mobility score. We also identified the additional predictive value of adding electronic health record data (demographics, laboratory data, and vital signs) to each model. DesignCohort study. SettingA large integrated health system. ParticipantsPatients ≥18 years of age (N=17,022) admitted to the inpatient medical service of one of 8 hospitals. InterventionsNone. Main Outcome MeasuresPredictive measures were patient demographics, laboratory values, vital signs, and functional mobility as measured by the 6-clicks score within the first 48 hours of hospital admission. Our outcome was discharge destination (home vs other). ResultsOur final sample included 19,963 records. Patients were discharged alive from 19,698 admissions. The majority were women (n=11,729, 59%) with a mean age of 73 (standard deviation, 15.3) years. Patients’ initial 6-clicks score had moderate discrimination for discharge destination (c-statistic of 0.78) and outperformed the Braden score (c-statistic of 0.68). Electronic health record data alone had poor discrimination (c-statistic of 0.66) and added little to the model of 6-clicks alone (adjusted c-statistic increased from 0.78 to 0.80). ConclusionFunctional mobility measured via 6-clicks within 48 hours of admission can help identify patients who are likely to go home, facilitating early discharge planning.

Development of recurrent pressure ulcers, risk factors in older patients: a prospective observational study.

Prevention of recurrent pressure ulcers (PU) is one of the most important challenges in wound care, furthermore, the risk factors for recurrent PUs are still not fully understood. This study aimed to explore the risk factors for recurrent PU development within two weeks, including biophysical skin properties, pro-inflammatory cytokine (tumour necrosis factor [TNF]-α) levels and bacterial species, in older patients. This prospective study was conducted in a long-term care facility with patients whose PU had healed within two months. Biophysical skin properties were evaluated by stratum corneum hydration, pH, sebum content and transepidermal water loss. TNF-α level was measured using skin blotting. Skin bacteria were collected using tape stripping and determined by species-specific gene amplification. These parameters, along with Braden scale and interface pressure, were evaluated every two weeks for a total period of eight weeks. A penalised generalised estimating equation analysis was used to determine the risk factors for recurrent PUs. In total, 20 patients were included in this study, with 57 observations. Of these, recurrent PU was seen in eight observations. Elevation of pH (p=0.049; odds ratio [OR] per 1 unit=3.91, 95% confidence interval [CI]:1.01-15.15), presence of Acinetobacter spp. (p=0.039; OR versus culture-negative=6.28, 95%CI:1.10-35.86) and higher interface pressure (p=0.008; OR per 1 mmHg=1.06, 95%CI:1.01-1.10) on the healed PU were significantly related to the development of recurrent PU. Higher pH, existence of Acinetobacter spp. and higher interface pressure on the site of the healed PU were associated with the development of recurrent PUs in older patients undergoing conservative treatments.

Risk for undernutrition and development of pressure injury in hospitalised patients in Brazil: Multicentre prospective cohort study.

Although pressure injury (PI) is preventable, the number of patients developing this type of injury is still high. In this prospective cohort study, we aimed to assess whether high risk for undernutrition was a risk factor for PI in 1937 patients aged ≥18 at six hospitals in Sao Paulo, Brazil. Patients' risk for undernutrition was assessed using three unique screening tools. Risk for PI was assessed using the Braden Scale. Data were analysed using Poisson regression with robust variance (95% CI, P ≤ .05). While 57.1% of patients were at risk for undernutrition in the Nutritional Risk Screening (NRS 2002), only 36.8% and 2.6% were at risk in the Braden Scale Nutrition Subscale (BSNS) and Subjective Global Assessment of Nutritional Status (SGANS), respectively. The cumulative incidence rate was 5.9%. Of those who developed PI, 91.2%, 56.2%, and 18.4% were at risk for undernutrition in the NRS 2002, BSNS, and SGANS scales, respectively. We found a significantly higher risk for PI in patients who were at risk for undernutrition compared with those who were not at risk, supporting previous evidence about the role of undernutrition as a key risk factor for PI in hospitalised patients.

Comparison of the Effect of 30° and 90° Sloping Position on Pressure Ulcer Incident on Stroke Patients

Pressure ulcer is a serious problem on stroke patients. The incidence of pressure ulcer has a negative impact on the physical, psychological, social, spiritual and economic burden of the family. One of the efforts to prevent the pressure ulcer is by providing a sleeping position with a 30 ° or 90 ° sloping position. Some hospitals still apply standard operational procedures with a 90 ° sloping position. Therefore, it is important to retest the prevention of pressure ulcer on stroke patients by using both sloping positions. This study aimed to compare the effect of 30 ° and 90 ° sloping position on the incidence of presssure ulcer on stroke patients at Hasan Sadikin Hospital Bandung. This quasi-experimental study involved 34 patients taken using purposive sampling technique which was then divided into groups of 30° and 90° sloping positions (17 respondents each) with the matching was based on the Braden scale. Each group was repositioned every 2 hours and the incidence of pressure ulcer was evaluated every day for 72 hours. The results showed the incidence of pressure ulcer in the 30 ° sloping position group (5.88%) and 90° sloping position (41.18%). Statistical results using exact fisher showed a value of p = 0.039 (&lt;0.05) which means that the incidence of pressure ulcer in the 30° sloping group was significantly less than the result of 90° sloping group. Based on the odds ratio of 11.200, it means that stroke patients who were given a 90° sloping position are at risk 11 times higher risk of pressure ulcer than in stroke patients who were given a 30° sloping position. The conclusion in this study is the incidence of fewer pressure ulcer in a 30 ° sloping position. The results and treatment protocol in this study can be used as one of the considerations in efforts to prevent pressure ulcer, especially in stroke patients.&#x0D; Keywords: pressure ulcer, sloping position, stroke

Análise da presença de lesão por pressão em pacientes hospitalizados e as principais comorbidades associadas

O presente estudo objetivou analisar a presença de Lesão por Pressão (LP) em pacientes hospitalizados, observando as principais comorbidades associadas. Trata-se de uma análise documental retrospectiva com perfil observacional analítico, de caráter quantitativo e transversal. A pesquisa foi realizada em um hospital de alta complexidade da rede pública, situado no estado da Paraíba e se deu por análise criteriosa de 884 prontuários médicos dos pacientes internados nos meses de janeiro a dezembro de 2019, sendo incluídos no estudo aqueles que possuíssem pelo menos uma LP durante sua estadia hospitalar. Foram avaliadas informações como perfil sociodemográfico, idade, sexo, histórico clínico do paciente e enfermidades associadas, além de observada a pontuação na escala de Braden para identificar o risco de desenvolvimento da lesão. A amostra foi composta por 85 pacientes, que apresentaram em sua maioria (83,5%) mais de 65 anos de idade, sendo 47 (55,29%) do sexo feminino e 38 (44,71%) do sexo masculino. Foi observada uma incidência de 11,5% de presença de LP nos pacientes, caracterizando-se como um número ao qual deve-se atentar, visto que se trata de uma complicação classificada como evitável na maioria dos casos, e sabendo-se ainda da existência de subnotificação por ser considerado um problema de negligência médica. A Diabetes Mellitus (DM) e a Hipertensão Arterial Sistêmica (HAS) foram apontadas como as principais comorbidades associadas, sendo que dos pacientes que desenvolveram LP, 10 (11,8%) possuíam DM, 21 (24,7%) possuíam HAS e 33 (38,8%) possuíam as duas doenças, acarretando implicações na cicatrização e agravamento da lesão. Assim sendo, torna-se relevante ressaltar a importância da monitorização sistemática do paciente, a fim de se verificar as comorbidades existentes e os riscos de ocorrência da lesão, para assim maximizar os cuidados de prevenção, proporcionando uma melhor estadia hospitalar ao paciente e evitando altos custos com o tratamento.

Pressure ulcers related to medical device in intensive care in Indonesia: A prospective study

The aim of this study was to describe the MDrPU on patients with prolonged bed rest in the ICU. A prospective cohort design was used in this study. We used non probabilility consecutive sampling. A total of 32 samples were included in this study. The Braden scale and NPUAP staging were used to predict the risk of pressure ulcers, and ulcers staging in 5 days. Statistical analysis were conducted using Chi-Square, Fisher Exact, and ROC Curve. The result showed the prevalence of medical devices was 21.9%. Most pressure ulcers related to medical devices was stage 2 (57.1%) with the most common area for the wounds was on fingers (37.5%). Braden scale prediction score also showed specificity (56%) and sensitivity (92%). Numerous risk factors for pressure ulcer development were identified and Braden scale could to predict the risk of pressure ulcers related to medical devices.

Incidence and prevalence of pressure ulcers in cancer patients admitted to hospice: A multicentre prospective cohort study.

Pressure ulcers lead to discomfort for patients and may have an important impact on a patient's quality of life. Measure the incidence and prevalence of pressure ulcers in a Hospice environment; evaluate the risk factors associated with pressure ulcers; and calculate the incidence of Kennedy Terminal Pressure Ulcers. This multicentre prospective cohort study enrolled 440 cancer patients in advanced phase, consecutively admitted to five hospices of the AUSL della Romagna (Italy), during a period of 1 year. Five hundred more patients were excluded from the study because of inability to sign the consent form or refusal to participate. All patients were adults above 18 years of age. The National Pressure Advisory Panel Classification System was used to evaluate the pressure ulcers. Potential risk predictors were evaluated through the Braden Scale, the Numerical Scale, and the Pain Assessment in Advanced Dementia Scale. Starting in September 2016, 214 (48.6%) females and 226 (51.4%) males were analysed. The incidence of pressure ulcers in the total population was 17.3%. The risk factors that influence the development of pressure ulcers were age, proximity to death, and duration of stay in Hospice. The incidence of Kennedy Terminal Pressure Ulcers was 2.7%. This study demonstrates that 17.3% of all patients admitted to a hospice setting developed a pressure ulcer. The longer the patients stay in hospice and the clinical condition deteriorates, the higher the risk of developing a pressure ulcer.

Prevalence of pressure ulcers in hospitalized adult patients in Bursa, Turkey: A multicentre, point prevalence study.

Pressure ulcers (PUs), which are preventable complications, increase the cost of health care and the risk of prolonged hospital stay, as well as morbidity and mortality. In this study, we aimed to describe the prevalence, clinical features, and risk factors for PUs among hospitalized patients. This study was cross-sectional and conducted over a single day in all the care units. Data were recorded on a patient observation form that included demographic data, diagnosis of admission to the hospital or intensive care unit (ICU), comorbidity and chronic diseases, location, stage of PU, and Braden Scale score. Acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma score (GCS), PaO2 /FiO2 ratio, and albumin level were recorded for ICU patients. A total of 1548 adult patients participated in the study. Of these patients, 177 (11.43%) had PU. The patients with PU had more advanced age, lower body mass index (BMI), and longer duration of hospital and ICU stay (for all P = .001). Evaluation of PU in the first 24 hours after hospital admission and the last PU evaluation time also showed a significant effect (both P = .001). Braden Scale score less than or equal to 13 in the first evaluation after hospital admission increased the risk of PU. Albumin was 2.78 ± 0.57 gm/dL in ICU patients, and albumin level was significantly lower in patients with PU (P = .001). PUs were located mainly in the sacrum (47.59%) and were classified as stage II (42.76%) for all patients. The prevalence of PU is related to the age and severity of patient clinical status, as predicted by the Braden Scale score and APACHE II score, and length of hospital and ICU stay. Low albumin level is also related to development of PUs in ICU patients.

Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Critical Care: A Meta-Analysis.

Pressure ulcers (PUs) are encountered in all types of care settings. The incidence of PUs in the intensive care unit (ICU) is higher for a variety of reasons. The Braden Scale is a widely used tool to assess the risk of PU, but its predictive power is controversial in ICU settings. In this systematic review and meta-analysis, we aimed to evaluate the predictive accuracy of the Braden Scale for measurement of risk of PU in adult ICU patients. A comprehensive literature search in English databases (PubMed, Cochrane Library, OVID, and Web of Science), Chinese databases (SinoMed, CNKI, and Wanfang), and gray literature was performed. Studies assessing the predictive value of the Braden Scale for risk of PU in adult ICU patients were searched. Quality of the studies was scored with Quality Assessment of Diagnostic Accuracy Studies-2. Country, study design, setting, blinding, and characteristics of included studies were extracted. Eleven full-text articles containing 10 044 patients, comprising 1058 patients with PUs were included. The pooled sensitivity and specificity of the Braden Scale for predicting PU risk in ICU adults were 0.89 (95% CI, 0.87-0.91; I2 = 94.9%, P = .0000) and 0.28 (95% CI, 0.27-0.29; I2 = 99.2%, P = .0000), respectively. The pooled DOR was 6.29 (95% CI: 4.09-9.68). The overall weighted AUC was 0.7812 ± 0.0331 (95% CI: 0.7163-0.8461) and the Q* value was 0.7196 ± 0.0283 (95% CI: 0.6641-0.7751). Significant heterogeneity was noted among the included studies. Meta-regression analysis showed that there was no heterogeneity in blinding (P = .074), study design (P = .679), or cut-off value (P = .821). This meta-analysis demonstrated that the Braden Scale had a moderate predictive validity with good sensitivity and low specificity in adult critically ill patients. Further development and modification of this tool or generation of a new tool with higher predictive power is warranted for use in ICU populations. The first step in prevention of PU is risk assessment. In this meta-analysis, we aimed to evaluate the predictive power of the Braden Scale for assessing risk of PU in ICU adult patients, which could potentially guide clinical practice.

Braden Scale in pressure ulcer risk assessment.

To analyze the applicability of the Braden Scale to individuals admitted to an Intensive Care Unit (ICU) with the nursing diagnosis Impaired Physical Mobility, in its prediction potential to develop pressure ulcer (PU). A cross-sectional, quantitative study that evaluated all patients hospitalized in an ICU between November 2016 and February 2017, with the Braden Scale. The prevalence of PU was 35.8% (24/67), in male individuals 58.3% (14/24), diagnosed with ischemic CVA 51.9% (12/27), and with hemorrhagic CVA 7.4% (2/27). Among patients classified at severe risk of developing pressure ulcer, 83.3% (20/53) developed it, and 76.7% (33/53) did not develop it. The performance of the Braden Scale showed a balance between sensitivity and specificity, confirming it as a better predictive risk assessment instrument in this group of patients.

The Interrater Agreement for the Assessment of Pressure Ulcer Risk Using the Braden Scale and the Classification of Pressure Ulcers by Nurses in A Medium-Sized Hospital

The Interrater Agreement for the Assessment of Pressure Ulcer Risk Using the Braden Scale and the Classification of Pressure Ulcers by Nurses in A Medium-Sized Hospital

Methodology of Care Humanitude Implementation at an Integrated Continuing Care Unit: Benefits for the Individuals Receiving Care

The increasing number of elderly people with behavioral changes, agitation, aggressiveness, and refusal to receive care imposes new challenges to caregivers, who need to take ownership of innovative care methodologies to better take care of this group of people. Objective: To evaluate the benefits of the Humanitude Care Methodology (HCM) in order to improve the health condition of people admitted in a Portuguese Integrated Continuing Care Unit (UCCI). Methods: An action research study was conducted between September and December 2016. The sample consisted of 33 people who were admitted in this UCCI for at least 90 days. Monthly data collection, during four periods, using the Braden Scale, Morse Scale, Barthel Index and Mini Mental State Examination. The data was processed using the Statistical Package for Social Science, version 17.0. Results: The following decreases were observed: in individuals with cognitive deficit (93.94 percent to 81.82 percent); in individuals considered totally dependent (60.61 percent to 30.30 percent); at risk developing pressure ulcers (PU) (84.85 percent to 51.52 percent); in individuals who had PU (24.24 percent to 15.15 percent); in people with high risk of fall (45.45 percent to 39.39 percent); in the number of individuals with two antipsychotic prescriptions (27.27 percent to 9.09 percent). Conclusions: These results allowed to understand the positive benefits, of implementing the HCM, on the people receiving care, specifically at cognitive level, dependency level in activities of daily living, and the avoidance of physical and mental deterioration.

Risk of pressure injury among users of emergency care units.

To identify the risk of pressure injury in patients of emergency care units. Descriptive, cross-sectional, and quantitative by applying the Braden scale to 377 patients from eight units in Paraná, between April and September 2016. Descriptive statistics and Spearman's correlation were used, with a significance of 0.1% for analysis. There was a prevalence of risk-free patients (64.5%; n=243) and of older adults (54.6%; n=206); those at high risk for pressure injury were in the emergency department. Most of the variables were preserved, with emphasis on sensory perception (65.3%; n=246). The Spearman's correlation coefficient was at least 0.93 and indicated a strong linear relation between the results obtained in the variables and in the scale; it was verified that the risk for pressure injury increases with age. Most of the patients were not at risk; however, the older adults and those treated in the emergency department were at high risk of developing pressure injuries.