Pressure Ulcer Classification Research Articles

The effects of using heel protectors on the prevention of heel pressure injuries and plantar flexion contractures.

Immobilization in the intensive care unit can lead to pressure injuries and plantar flexion contractures. This study was conducted to evaluate the effectiveness of heel protectors applied for the prevention of heel pressure injuries and plantar flexion contractures in intensive care units. This study was conducted as a randomized controlled trial in two adult intensive care units of a teaching and research hospital. The study sample consisted of 84 patients admitted to intensive care units between January 2022 and December 2022. Patients who had been in the intensive care unit for at least 5 days, scored 16 or less on the Braden Pressure Ulcer Risk Assessment Scale and scored 4 or more on the Ramsey Sedation Scale, were included in the study. Heel protector boots were applied to the heels of the patients in the intervention group, while standard positioning with a pillow and ROM exercises were continued in the control group. A sociodemographic data form, the Ramsey Sedation Scale and the Braden Pressure Ulcer Risk Assessment Scale were used to collect data. While pressure injuries were evaluated with the International NPUAP-EPUAP Pressure Ulcer Classification System, goniometric measurements were made to evaluate joint ROM. In the intervention group, heel pressure injuries did not develop during the study, whereas five patients in the control group developed heel pressure injuries. The risk of pressure injury development that was seen in the control group was 1.7 times higher compared with the risk for the intervention group (log 95% CI: 0.91-2.59). There were significant differences between the right foot (99%; F = 99.229; p = .000) and left foot (99%; F = 100.519; p = .000) in range of motion measurement values of the patients in the intervention group according to the measurement times. According to the results of the multiple comparison test (Bonferroni) performed to determine the range of motion measurement periods showing significant differences, it was observed that each measurement for both feet yielded lower results than the previous measurement (seven measurements from day 1 to day 13). The use of heel protector boots was found to be effective in preventing the development of heel pressure injuries and plantar flexion contractures in intensive care unit patients. This study provides evidence that intensive care nurses can use heel protector boots to prevent the development of heel pressure injuries and plantar flexion contractures.

YOLO-Based Deep Learning Model for Pressure Ulcer Detection and Classification.

Pressure ulcers are significant healthcare concerns affecting millions of people worldwide, particularly those with limited mobility. Early detection and classification of pressure ulcers are crucial in preventing their progression and reducing associated morbidity and mortality. In this work, we present a novel approach that uses YOLOv5, an advanced and robust object detection model, to detect and classify pressure ulcers into four stages and non-pressure ulcers. We also utilize data augmentation techniques to expand our dataset and strengthen the resilience of our model. Our approach shows promising results, achieving an overall mean average precision of 76.9% and class-specific mAP50 values ranging from 66% to 99.5%. Compared to previous studies that primarily utilize CNN-based algorithms, our approach provides a more efficient and accurate solution for the detection and classification of pressure ulcers. The successful implementation of our approach has the potential to improve the early detection and treatment of pressure ulcers, resulting in better patient outcomes and reduced healthcare costs.

A Multicenter Assessment of Nurses' Knowledge Regarding Pressure Ulcer Prevention in Intensive Care Units Utilizing the PUKAT 2.0.

Pressure ulcer (PU) care is pivotal in the practice of nurses working in intensive care units (ICUs). Therefore, nurses must possess adequate knowledge about the potential risks leading to the development of PUs, as well as managing complications that worsen patient conditions. To evaluate the level of knowledge of ICU nurses concerning PU prevention in tertiary hospitals in Saudi Arabia. In this cross-sectional study, the researchers recruited 320 ICU nurses from four tertiary hospitals using convenience sampling. Nurses' knowledge regarding PU prevention was assessed using the revised and updated version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) 2.0. Data were collected between May and June 2022. The CROSS checklist was observed for reporting. The mean scores of nurses' level of knowledge regarding PU prevention according to the themes of the revised and updated version of the PUKAT 2.0 were as follows-etiology: 62.81 ± 23.77; classification and observation: 50.86 ± 23.28; risk assessment: 31.19 ± 24.26; nutritious diet: 46.04 ± 25.96; prevention: 22.36 ± 12.41; and specific patient groups: 14.84 ± 22.88. Furthermore, the score for nurses' overall level of knowledge of PU prevention was 39.55 ± 8.84 out of 100, interpreted as low based on the 60% cutoff; the minimum knowledge score was 0. Notably, knowledge of PU etiology, classification, observation, and specific patient groups differed based on the hospital of affiliation. Interestingly, gender was the only demographic characteristic based on which nurses' knowledge regarding specific patient groups differed. This study identified insufficient knowledge among ICU nurses regarding PU prevention, which can lead to complications among patients. Simulation scenarios related to PU prevention and management will be an effective way to help nurses gain appropriate knowledge that can be applied in clinical practice.

Профілактика і лікування пролежнів у відділенні інтенсивної терапії (огляд літератури)

У статті з позиції Міжнародної національної нарадо-рекомендаційної ради з пролежнів, Європейської рекомендаційної ради з пролежнів, Всесвітнього альянсу з проблем пролежнів наведено питання термінології, статистики, факторів ризику розвитку, міжнародної класифікації, основних напрямків профілактики, диференціальної діагностики, інспекції шкірних покривів і документування; наведено шкали для прогнозування ризику розвитку пролежнів (PUSH Toll, 2008); викладені вузлові питання інтенсивної терапії залежно від результатів категорії пролежнів; надано правило SPECIAL; рекомендації робочої групи ICSI. Наведено практичні рекомендації Американської колегії фізіотерапевтів. Особливу увагу приділено принципам нутритивної терапії за наявності пролежнів.

Economic evaluations of interventions for the prevention and treatment of pressure ulcers: an umbrella review protocol.

The objective of this review is to synthesize the findings of economic evaluations of preventing or treating pressure ulcers. Pressure ulcers are one of the most common preventable complications characterized by local tissue injury. Pressure ulcers increase mortality rates, impair quality of life, increase the length of hospital stay, and alter overall health outcomes. Published studies have found higher costs associated with treating pressure ulcers than preventing them, with treatment cost varying based on the pressure ulcer category (the greater the category, the higher the cost). We will systematically review the evidence on preventing or treating pressure ulcers from an economic perspective. We will include systematic reviews that investigate both the cost and outcomes associated with the prevention or treatment of pressure ulcers. Systematic reviews dealing with economic evaluation of wound care or management will be excluded if they have not provided separate information for pressure ulcers. Epistemonikos, MEDLINE, NHS Economic Evaluation Database, and the Canadian Agency for Drugs and Technologies in Health (CADTH) website will be searched for relevant systematic reviews from inception and without any language restrictions. Titles and abstracts will be screened at the initial stage, followed by full-text screening. Quality assessment will be done using the standard JBI critical appraisal instrument for systematic reviews and research syntheses. Article screening, data extraction, and quality assessment will be performed by two reviewers independently. All economic health outcomes will be considered under the primary outcomes of the study. Open Science Framework (https://osf.io/9y2a7/).

International comparison of pressure ulcer measures in long-term care facilities: Assessing the methodological robustness of 4 approaches to point prevalence measurement

IntroductionPressure ulcer indicators are among the most frequently used performance measures in long-term care settings. However, measurement systems vary and there is limited knowledge about the international comparability of different measurement systems. The aim of this analysis was to identify possible avenues for international comparisons of data on pressure ulcer prevalence among residents of long-term care facilities. Material and methodsA descriptive analysis of the four point prevalence measurement systems programs used in 28 countries on three continents was performed. The criteria for the description and analysis were based on the scientific literature on criteria for indicator selection, on issues in international comparisons of data and on specific challenges of pressure ulcer measurements. ResultsThe four measurement systems use a prevalence measure based on very similar numerator and denominator definitions. All four measurement systems also collect data on patient mobility. They differ in the pressure ulcer classifications used and the requirements for a head-to-toe resident examination. The regional or country representativeness of long-term care facilities also varies among the four measurement systems. ConclusionsMethodological differences among the point prevalence measurement systems are an important barrier to reliable comparisons of pressure ulcer prevalence data. The alignment of the methodologies may be improved by implementing changes to the study protocols, such as aligning the classification of pressure ulcers and requirements for a head-to-toe resident skin assessment. The effort required for each change varies. All these elements need to be considered by any initiative to facilitate international comparison and learning.

Pressure ulcers: an overview.

This article gives a general overview of pressure ulcers, with a focus on secondary care. Pressure ulcers are damage to the skin or underlying tissue as a result of pressure, friction or shearing forces. They place a significant physical, psychological and financial burden on patients and healthcare systems which will be explored. This review also covers risk assessment, classification and management of pressure ulcers in the inpatient setting.

Series 5, chronic wounds. Part 4d. Classification of pressure ulcers

British Journal of Healthcare AssistantsVol. 14, No. 7 ClinicalSeries 5, chronic wounds. Part 4d. Classification of pressure ulcersMenna Lloyd JonesMenna Lloyd JonesConsultant Editor, BJHCASearch for more papers by this authorMenna Lloyd JonesPublished Online:19 Aug 2020https://doi.org/10.12968/bjha.2020.14.7.321AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleReferencesAgrawal K, Chauhan N. Pressure ulcers: back to basics. Indian J Plast Surg. 2012 May;45(2):244–254. doi: https://doi.org/10.4103/0970-0358.101287 Crossref, Google ScholarBarts Health NHS Trust. Sign up to safety—pressure ulcers. 2017. https://www.youtube.com/watch?v=10xxDsJ5nqA&t=19s (accessed 29 June 2020) Google ScholarEuropean Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure injuries: quick reference guide. 2019. https://www.epuap.org/wp-content/uploads/2016/10/quick-reference-guide-digital-npuap-epuap-pppia-jan2016.pdf (accessed 29 June 2020) Google ScholarNHS Improvement. Pressure ulcers: revised definition and measurement. Summary and recommendations. 2018. https://improvement.nhs.uk/documents/2932/NSTPP_summary__recommendations_2.pd (accessed 29 June 2020) Google ScholarShea JD. Pressure sores: classification and management. Clin Orthop Relat Res. 1975;112:89–100 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 July 2020Volume 14Issue 7ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 19 August 2020 Published in print 2 July 2020 Information© MA Healthcare LimitedPDF download

The coccygeal pressure ulcer-does coccygectomy prevent recurrence?

This is a retrospective, non-randomized cohort study, with data collected during the regular annual visits between 2001 and 2019. The aim of this study was to evaluate the efficacy of coccygectomy for coccygeal pressure ulcers in individuals with paraplegia due to spinal cord injury or other neurological causes and to evaluate its role in the prophylaxis of ulcer recurrence. This study included inpatients and outpatients with a coccygeal pressure ulcer who were treated surgically at our Institution REHAB Basel and were followed with regular annual check-ups. Individuals with category 3 or 4 acute or chronic coccygeal pressure ulcer (classification according European Pressure Ulcer Advisory Panel (EPUAP)) received coccygectomy in addition to rotation flap surgery. The operative care was provided exclusively by the head of the plastic surgery department at REHAB Basel. Standardized follow-up treatment was carried out according to the "Basel Decubitus Concept" and thus allowed continuous and usually lifelong, regular follow-up care. Forty-nine individuals underwent coccygectomy from 2001 to 2019 due to coccygeal category 3 or 4 pressure ulcers. The observation period was between 1.5 and 18.3 years. In 86% of the individuals, no relapse occurred during the first year. Over the next 5 years 78% remained relapse free. In coccygeal pressure ulcer category 3 or 4, coccygectomy, in addition to sufficient rotation flap surgery, is a suitable method for recurrence prevention of pressure ulcer in this anatomic area.

Prevalencia hospitalaria de lesiones relacionadas con la dependencia en la provincia de Burgos. Estudio multicéntrico

espanolRESUMEN Objetivo: Determinar la prevalencia hospitalaria de lesiones relacionadas con la dependencia (LRD) en la provincia de Burgos. Determinar las caracteristicas de las LRD. Identificar las valoraciones del riesgo de padecer lesion por presion (LPP) y el uso de dispositivos de prevencion de LPP. Cuantificar los registros de enfermeria de LRD. Metodologia: Estudio observacional, descriptivo, transversal y multicentrico, realizado mediante observacion directa y revision de la historia clinica de adultos ingresados en unidades de hospitalizacion. Realizado en tres hospitales de Burgos en 2018. Resultados: La poblacion sumo 511 pacientes; presentaron LRD: 188. Se detectaron 328 LRD: 176 (53,65%) LPP, 48 (14,63%) lesiones por humedad, 81 (24,69%) lesiones por friccion, 11 (3,35%) lesiones combinadas y 12 (3,65%) lesiones multicausales. Las LPP de categoria 1 fueron las mas numerosas, sumando un 35,36%. El 78,96% de las LRD se consideraron adquiridas en el hospital. La prevalencia de LRD es del 36,79%. Las prevalencias por tipos de LRD son: LPP 20,93%, lesiones por humedad 9%, friccion 12,72%, combinadas 1,76% y multicausales 1,56%. El 35,61% de los pacientes presentaba algun tipo de dispositivo preventivo; el 60,07% presentaba valoracion del riesgo de padecer LPP; el 30,31% presentaba registro de la lesion, y el 18,37% contaba con plan de cuidados especifico. Conclusiones: La prevalencia de LRD, obtenida por inspeccion directa, cuadruplica los resultados nacionales, pero parece reflejar con mayor exactitud la realidad que los datos obtenidos mediante los registros de enfermeria. Es aconsejable universalizar la valoracion del riesgo de padecer LPP a todos los pacientes, la mejora de los registros de enfermeria y reforzar los esfuerzos preventivos. EnglishABSTRACT Aim: To determine the hospital prevalence of dependencerelated lesions (DRL) in the province of Burgos. Determine the characteristics of the DRL. Identify the risk assessments of pressure ulcer (PU) and the use of PU prevention devices. Quantify the DRL nursing records. Methodology: Observational, descriptive, cross-sectional and multicenter study, performed through direct observation and review of the health record of adults admitted to hospitalization units. Results: The population totaled 511 patients, of wich 188 presented DRL. 328 DRL were detected: 176 (53.65%) PU, 48 (14.63%) moisture lesions, 81 (24,69%) friction lesions, 11 (3.35%) combined lesions, and 12 (3.65%) multifactorial lesions. The most numerous was PU category 1 totaling 35.36%. 78.96% of the DRL were determined to be hospital acquired. The prevalence of DRL is 36.79%. The prevalences for DRL types are: PU 20.93%, moisture lesions 9%, friction 12.72%, combined 1.76% and multifactorial 1.56%. 35.61% of patients had some type of preventive device, 60.07% had a risk assessment for PU, 30.31% had a record of the lesion and 18.37% had a specific care plan. Conclusions: The prevalence of DRL, obtained by direct inspection, quadruples national results, but it seems to be more accurate than the data obtained through nursing records. It is advisable to universalize the assessment of the risk of suffering PU to all patients, to improve nursing records and to reinforce preventive efforts.

Sex-specific differences in prevention and treatment of institutional-acquired pressure ulcers in hospitals and nursing homes

IntroductionGender and/or sex have a major impact on staying healthy, becoming ill, or care dependent. Differences between men and women have been described for socioeconomic positions, health behaviors, courses and severities of diseases and mortality rates. Consequently, sex and/or gender need to be adequately taken into account while developing and implementing evidence-based healthcare. Evidence regarding differences between men and women in pressure ulcer care is limited. Our research aim was to measure possible differences between male and female hospital patients and nursing home residents in prevention and treatment of institutional-acquired pressure ulcers. MethodsA secondary data analysis was conducted including data sets collected in nursing homes and hospitals in Germany annually from 2001 to 2016. Relevant variables were compared according to biological sex (men/woman). ResultsThe study included 38,655 nursing home residents (mean age 85.4 years women, 77.3 years men) and 58,760 hospital patients (mean age 66.7 years women, 63.4 years men). More women were underweight and at pressure ulcer risk in both settings. The proportion of institutional-acquired pressure ulcers was higher for men in hospitals. Slightly more men had a PU category 2 to 4 (OR 0.87, 95% CI 0.76 to 0.99) in nursing homes or developed an institutional-acquired pressure ulcers category 2 to 4 in both settings (OR 0.85, 95% CI 0.76 to 0.95). Special mattresses were more often used by women at PU risk. More men with an institutional-acquired pressure ulcer in hospitals received counseling of relatives (OR 0.53, 95% CI 0.39 to 0.72). ConclusionAlthough slightly more men had institutional-acquired pressure ulcers than women, overall differences regarding pressure ulcer occurrence were minor. Gender and/or sex can rather not be considered as an independent risk factor for pressure ulcer development and differences regarding pressure ulcer prevention interventions seem to be minor.

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

Effect of transparent film on the duration of pressure ulcer formation for noninvasive ventilation patients: A randomized controlled trial.

Due to the prolonged use of face mask in noninvasive ventilation, pressure ulcer is a common complication. Pressure ulcer can occur within a few hours at the site where the mask contacts in 2-70% of cases. The aim of this study is to conduct a randomized controlled trial to investigate the effects of transparent film use on the duration of pressure ulcer formation in the nasal region in patients undergoing noninvasive ventilation. This study was a randomized controlled trial. 46 patients who met the sample selection criteria and agreed to participate in the study were included in the study at a university hospital in İzmir, Turkey. Of them, 25 were assigned to the intervention group and 21 to the control group. Data were collected using the Socio-demographic and Disease-related Characteristics Questionnaire, The Noninvasive Ventilation Parameters Monitoring Form, and The Pressure Ulcer Classification Form at 4-hour intervals. The duration of pressure ulcer formation in intervention group was longer than that in control group, and the difference between them was statistically significant (P < 0.05). In this study, the use of nasal protective film (transparent film) prolonged the duration of pressure ulcer formation on the nasal bridge in patients who underwent noninvasive mechanical ventilation.

Pressure ulcer Cat. II-IV incidence on the CuroCell S.A.M. PRO powered reactive air support surface in a high-risk population: A multicentre cohort study in 12 Belgian nursing homes.

The primary objective was to study pressure ulcer (PU) category II-IV (including suspected deep tissue injury and unstageable PUs) cumulative incidence and PU incidence density, in a 30day observation period, associated with the use of the CuroCell S.A.M. PRO powered reactive air support surface in nursing home residents at risk for PU development. Secondary objectives were to study (a) PU category I cumulative incidence and PU incidence density and (b) user (caregivers and residents) experiences and perceptions of comfort associated with the use of the support surface under study. A multicentre cohort study was set up in 37 care units of 12 Belgian nursing homes. The sample consisted of 191 residents at risk of PU development (Braden score ≤ 17). The cumulative PU incidence was 4.7% (n = 9). The PU incidence density was 1.7/1000 observation days (9 PU/5370 days). The experience and perceptions of comfort analysis revealed that the CuroCell S.A.M. PRO powered reactive air support surface was comfortable for daily use. The mode of action and the quietness of the pump function had a positive impact on sleep quality. Patient comfort and sleep quality are essential criteria in the selection of a support surface.

Nursing personnel’s knowledge regarding pressure sore management in a public hospital’s medical and surgical wards

Introduction: Despite the recent advances in ulcer treatment and management, and the immense advancements in technology, pressure ulcers are still a major challenge for nurses and doctors who are responsible for their management. Aim: The aim of the present study was to investigate the knowledge, practices and attitudes of nursing staff in a large public hospital regarding prevention and management of pressure ulcers. Methods: This study is a research cross-sectional study which involved all nursing staff (nurses and nursing assistants) working in medical and surgical wards of the General Hospital of Nikaia “St Panteleimon”. The questionnaire used for data collection has been developed by Gouda et al. (2014). The reliability of the questionnaire was high (Cronbach a=0.714) and the response rate was 76.7%. Statistical analysis was performed with the SPSS for Windows (21.00) statistical software. Results: The sample of the study consisted of 92 nurses aged 40.5(± 7.9) years. A total of 41 (44.6%) participants were nurse assistants, 33 (35.9%) had graduate from applied science universities, 14 (15.2%) had postgraduate degree and 4 (4.3%) had a university degree. The participants’ working experience was 15.1(± 9.1) years, while 45 (48.9%) nurses were working in surgical departments and 47 (51.1%) in medical ones. Of the total sample, twelve (13.3%) nurses have claimed that training seminars on prevention and management of pressure ulcers have been organized in the hospital that they are working. In a total of 27 questions, the correct answers given by the respondents were 18.59(±2.8) or 68.6% (±10.4%) with a minimum of 12 (44.4%) and a maximum of 25 (92.6%) correct answers. Participants with a higher level of education and those who had attended educational seminars [18.7(±2.8) versus 17(±2.6)] answered significantly more questions than those with a lower level of education (p &lt;0.05). Conclusions: The nursing staff working in the medical and surgical wards had moderate levels of knowledge and high level of knowledge for the definition and classification of pressure ulcers. It is proposed that clinical protocols be drawn up concerning the staging, prevention and management of pressure ulcers, as well as a more organized continuing training of nursing staff.

Nursing records, prevention measures and incidence of pressure ulcers in an Intensive Care Unit

ObjectivesThe aim of this paper is to determine the incidence and most incident pressure ulcers (PU) category. Establish the main clinical characteristics of these PU. Determine whether there is adequate documentation of PU and of the measures used to prevent them. MethodObservational descriptive and retrospective study during 2014 at Intensive Care Unit (ICU)-University Hospital of Araba. Study sample, all patients suffering from PU at the time of the study by accidental sampling.Computerised records regarding risk assessment, clinical assessment and pressure sore treatment, provided by the ‘Metavision’ computer programme and descriptive statistics using SPSS version 22.0. Approval from the Ethics Committee for Clinical Research of the University Hospital of Araba was obtained. ResultsThe incidence of patients suffering from PU during 2014 was 6.78%. The most common locations for PU were the sacral region and the heels: the most incident pressure ulcers category was grade II, followed by grade I. Out of the 98 PU treated in our patients, 43 occurred outside the ICU and 55 in the unit itself. The lack of records, in all the variables described about PU, was 19.10%. ConclusionsThe incidence of pressure ulcers was lower than in the current literature. The most frequent category, location and clinical characteristics are comparable to previous studies. There is a high rate of failing to record the characteristics of the PU declared. Good PU prevention measures and recording were carried out.

Aplicação do pressure ulcer knowledge test em enfermeiros de um hospital de atenção secundária – estudo transversal

Objetivo: identificar o nível de conhecimento de enfermeiros sobre a avaliação, prevenção e classificação de lesões por pressão em um hospital do Rio de Janeiro. Métodos: Trata-se de um estudo do quantitativo com delineamento descritivo-exploratório. Os dados foram coletados sem a realização de qualquer tipo de orientação ou treinamento prévio dos profissionais sobre lesão por pressão (LPP). Para seu desenvolvimento, foi utilizado o Pressure Ulcer Pieper Knowledge Test (PUKT), que é composto de 41 questões sobre avaliação, classificação e prevenção de lesões por pressão. Destas, 8 questões referem-se a avaliação e classificação da LPP e 33 questões sobre prevenção. Resultados: Participaram 102 enfermeiros, sendo 71 do sexo feminino e 31 do sexo masculino. A predominância de idade dos participantes foi de 30 a 39 anos. Quanto ao tempo de formado a maioria possui entre 2 a 5 anos de conclusão de curso e formação em Latu senso. Em relação aos resultados globais do teste, 70% (68.63%) dos enfermeiros acertaram menos de 70 % das questões, indicando um déficit de conhecimento na área. Conclusão: Diante dos resultados, identifica-se um déficit no conhecimento sobre a avaliação, classificação e prevenção de LPP, indicando a necessidade da educação permanente para atualização dos profissionais de enfermagem. Palavras Chave: Enfermagem; conhecimento; lesão por pressão; classificação.

Registros enfermeros, medidas de prevención e incidencia de úlceras por presión en una Unidad de Cuidados Intensivos

ObjectivesThe aim of this paper is to determine the incidence and most incident pressure ulcers (PU) category. Establish the main clinical characteristics of these PU. Determine whether there is adequate documentation of PU and of the measures used to prevent them. MethodObservational descriptive and retrospective study during 2014 at Intensive Care Unit (ICU)-University Hospital of Araba. Study sample, all patients suffering from PU at the time of the study by accidental sampling.Computerised records regarding risk assessment, clinical assessment and pressure sore treatment, provided by the ‘Metavision’ computer programme and descriptive statistics using SPSS version 22.0. Approval from the Ethics Committee for Clinical Research of the University Hospital of Araba was obtained. ResultsThe incidence of patients suffering from PU during 2014 was 6.78%. The most common locations for PU were the sacral region and the heels: the most incident pressure ulcers category was grade II, followed by grade I. Out of the 98 PU treated in our patients, 43 occurred outside the ICU and 55 in the unit itself. The lack of records, in all the variables described about PU, was 19.10%. ConclusionsThe incidence of pressure ulcers was lower than in the current literature. The most frequent category, location and clinical characteristics are comparable to previous studies. There is a high rate of failing to record the characteristics of the PU declared. Good PU prevention measures and recording were carried out.

Recognition and correct classification of pressure ulcers: aposition paper

Pressure ulcers comprise serious skin and tissue damage. The correct diagnosis and classification into different categories is often difficult in daily practice. What procedure can be recommended to correctly diagnose and classify pressure ulcers in practice? The society Initiative Chronische Wunden (ICW) e. V. established agroup of experts who developed practical recommendations for the diagnosis and classification of pressure ulcers based on the current literature and their own expertise. Pressure ulcers should only be diagnosed if skin and/or tissue damage is most likely due to prolonged pressure or pressure associated with shear forces. Acomplete anamnesis must be performed to detect periods of previous prolonged immobility. Pressure ulcers are usually located at typical predilection sites. For categoryI and "suspected deep tissue damage" the tissue damage occurs under (initially) intact skin. However, the diagnosis is uncertain and the classification should be made later. The categoryII pressure ulcer is usually an exclusion diagnosis. The categoriesIII andIV are pressure ulcers in the proper sense. As long as the distinction between categoryIII andIV is not possible, the lower category should be coded. Currently, arelevant classification should be used uniformly for the respective setting. In accordance with the clinical picture, amost suitable diagnosis is to be made. It does not matter which classification system is used. The future WHO ICD-11 version will allow better classification of pressure ulcers.

Incontinence-associated dermatitis in older people: prevention and management

British Journal of Community NursingVol. 23, No. 5 Care of the Older PersonIncontinence-associated dermatitis in older people: prevention and managementAnn YatesAnn YatesSearch for more papers by this authorAnn YatesPublished Online:30 Apr 2018https://doi.org/10.12968/bjcn.2018.23.5.218AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References All Wales Tissue Viability Nurse Forum and All Wales Continence Forum. All Wales best practice statement on the prevention and management of moisture lesions. 2014. https://tinyurl.com/h5z7equ (accessed 18 April 2018) Google ScholarBale S, Tebble N, Jones V, Price P. The benefits of implementing a new skin care protocol in nursing homes. J Tissue Viability. 2004; 14(2):44–50 https://doi.org/https://doi.org/10.1016/S0965-206X(04)42001-4 Crossref, Medline, Google ScholarBardsley A. 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Br J Nurs 27 (3) 2-3 https://doi.org/https://doi.org/10.12968/bjon.2018.27.2.76 Google Scholar FiguresReferencesRelatedDetailsCited byAssessment and documentation of incontinence-associated dermatitis after implementation of a standardised instrument: a comparative studyMary Montague, Matthew Karafa, Nancy M. Albert11 September 2019 | Journal of Wound Care, Vol. 28, No. Sup9 2 May 2018Volume 23Issue 5ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 30 April 2018 Published in print 2 May 2018 Information© MA Healthcare LimitedPDF download