Pressure Ulcer Risk In Patients Research Articles

Incidence of Pressure Ulcers In The Patients On Mechanical Ventilation: A Prospective Study

Aim: The aim of this study was to determine the incidence of pressure ulcers among the patients on mechanical ventilation.Methods: The type of the study was cross-sectional and prospective. It was carried out in 5 intensive care units of a state hospital located in Western Black Sea region of Turkey. The sample of the study included 260 patients who began to get mechanical ventilatory support. Pressure ulcer risk in patients was assessed by Braden Risk Assessment Scale at 10th hour, 1st week and 2nd week timepoints following the initiation of mechanical ventilatory support. Results: Mean age of the patients was 54±10 years; 52.7% were males; and 55.4% had a Body Mass Index within normal range. It was determined that 46.5% of the patients were hospitalized due to the diagnosis of a cerebrovascular event; the state of consciousness was confused in 52.3% and mean Braden Risk Assessment Scale was 11.0±2.64. It was observed that the incidence of pressure ulcers was 10.8% at 10th hour, 58.5% at first week and 71.15% at second week following the beginning of mechanical ventilation treatment. At the end of second week, stage1 pressure ulcer was developed on the sacrum in 30% and on coccyx area in 22.7% of the patients. Conclusion:It was found that the incidence of pressure ulcer development risk was significantly high among the patients who underwent mechanical ventilation treatment. Considering the effect of mechanical ventilator and other factors, taking primary protective precautions for preventing pressure ulcers was suggested to be very important.

An automatic repositioning system to prevent pressure ulcers: a case series.

The Danish automated Vendlet V5s repositioning system is intended to reduce pressure ulcer risk in patients and work-related musculoskeletal disorders (MSDs) in caregivers. In two Belgian nursing homes, 13 residents with mobility levels C, D and E experienced the repositioning system, operated by 35 caregivers, for 4 weeks. Data about skin condition, nursing time needed for repositioning and MSD symptoms were collected. The use of the repositioning system was not associated with the development of nor a reduction in skin problems; the study included residents who were vulnerable to or already had pressure ulcers. In addition, four pressure ulcers healed during the experiment. The research focused only on the automated repositioning system. Repositioning frequency and postures were determined by the standard nursing home protocol. Frequency depended on the support surface in use, and a limited number of patient criteria (mobility in bed, presence of bony prominences/pressure points and presence of non-blanchable erythema). In future studies, the Vendlet V5s system should be tested with a more individualised patient repositioning protocol, including more criteria such as fever and moisture. The automated system reduces nursing time so could potentially improve staff efficiency. Compared with manual repositioning, caregivers perceived fewer work-related MSD symptoms during repositioning when using the Vendlet V5s system. Controlled studies with larger samples are needed to verify these conclusions.

Optimal Time Interval for Position Change for ICU Patients using Foam Mattress Against Pressure Ulcer Risk

This study was done to identify the time interval to pressure ulcer and to determine the optimal time interval for position change depending on pressure ulcer risk in patients using foam mattress in intensive care units. The Braden scale score, occurrence of pressure ulcers and position change intervals were assessed with 56 patients admitted to an intensive care unit from April to November, 2011. The time to pressure ulcer occurrence by Braden scale risk group was analyzed with Kaplan-Meier survival analysis and log rank test. Then, the optimal time interval for position change was calculated with ROC curve. The median time to pressure ulcer occurrence was 5 hours at mild or moderate risk, 3.5 hours at high risk and 3 hours at very high risk on the Braden scale. The optimal time interval for position change was 3 hours at mild and moderate risk, 2 hours at high and very high risk of Braden scale. When foam mattresses are used a slight extension of the time interval for position change can be considered for the patients with mild or moderate pressure ulcer risk but not for patients with high or very high pressure ulcer risk by Braden scale.

Using the braden and glasgow scales to predict pressure ulcer risk in patients hospitalized at intensive care units

Pressure ulcers remain a major health issue for critical patients. The purpose of this descriptive and exploratory study was to analyze the risk factors for the development of pressure ulcers in patients hospitalized at an intensive care unit of a university hospital. Patients were assessed through the Braden scale to determine the risk for the development of pressure ulcers and to identify individual risks, and the Glasgow scale was used to assess their consciousness. It was found that the risks associated with pressure ulcer development were: low scores on the Braden Scale on the first hospitalization day and low scores on the Glasgow scale. The results showed that these tools can help nurses to identify patients at risk, with a view to nursing care planning.

Risk factors for pressure ulcers among elderly hip fracture patients.

The purpose of this study was to estimate the incidence of hospital-acquired pressure ulcers among elderly patients hospitalized for hip fracture surgery and to identify extrinsic factors that are associated with increased risk. We conducted a secondary analysis of data abstracted from medical records at 20 hospitals in Pennsylvania, Texas, New Jersey, and Virginia. Participants were patients aged 60 years and older admitted with hip fracture to the study hospitals between 1983 and 1993. The incidence of hospital-acquired pressure ulcers was 8.8% (95% confidence interval 8.2%-9.4%). After adjusting for confounding variables, longer wait before surgery, intensive care unit stay, longer surgical procedure, and general anesthesia were significantly associated with higher pressure ulcer risk. Extrinsic factors may be important markers for high pressure ulcer risk in hospitalized hip fracture patients. Although it is not possible to eliminate factors such as requiring an intensive care unit stay or having a long surgical procedure, it may be possible to develop interventions that minimize pressure ulcer risk in patients who experience these factors.