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2.
Adv Skin Wound Care ; 33(3): 137-145, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32058439

RESUMO

GENERAL PURPOSE: To present the results of the 2019 study of healthcare professionals' consensus and opinions regarding terminology for terminal ulcers, Skin Changes At Life's End, skin failure, and unavoidable pressure injuries to improve clinical care and to foster research into current criteria for unavoidable skin changes at the end of life. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, NPs, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, the participant should be better able to:1. Explain the survey methodology and identify the consensus statements.2. Synthesize the open-ended questions and respondent comments and their implications for clinical care and research. ABSTRACT: This article reports the results of a global wound care community survey on Kennedy terminal ulcers, Skin Changes At Life's End, Trombley-Brennan terminal tissue injuries, skin failure, and unavoidable pressure injury terminology. The survey consisted of 10 respondent-ranked statements to determine their level of agreement. There were 505 respondents documented. Each statement required 80% of respondents to agree (either "strongly agree" or "somewhat agree") for the statement to reach consensus. Nine of the 10 statements reached consensus. Comments from two additional open-ended questions were grouped by theme. Conclusions and suggested recommendations for next steps are discussed. This summary is designed to improve clinical care and foster research into current criteria for unavoidable skin changes at the end of life.

4.
Adv Skin Wound Care ; 32(10): 437, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31567449
5.
Adv Skin Wound Care ; 32(11): 485, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31625962
6.
Adv Skin Wound Care ; 32(11): 512-519, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31498171

RESUMO

OBJECTIVE: To replicate previous research that found four independent and significant predictors of heel pressure injuries (HPIs) in hospitalized patients using a larger and more diverse patient population. METHODS: Researchers conducted a retrospective, case-control study with a main and a validation analysis (N = 1,937). The main analysis had 1,697 patients: 323 patients who had HPIs and 1,374 who did not. The validation analysis had 240 patients: 80 patients who developed HPIs and 160 who did not. Researchers used a series of diagnosis codes to define variables associated with an HPI. Data were extracted from the New York Statewide Planning and Research Cooperative System for January 2014 to June 2015. Study authors conducted a series of forward stepwise logistic regression analyses for both samples to select the variables that were significantly and independently associated with the development of an HPI in a multivariable setting. Researchers generated a receiver operating characteristic curve using the final model to assess the regression model's ability to predict HPI development. RESULTS: Seven variables were significant and independent predictors associated with HPIs: diabetes mellitus, vascular disease, perfusion issues, impaired nutrition, age, mechanical ventilation, and surgery. The receiver operating characteristic curve demonstrated predictive accuracy of the model. CONCLUSIONS: Beyond a risk assessment scale, providers should consider other factors, such as comorbidities, which can predispose patients to HPI development.

7.
14.
Adv Skin Wound Care ; 32(3): 109-121, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30801349

RESUMO

GENERAL PURPOSE: To synthesize the literature regarding skin injuries that are found in patients at the end of life and to clarify the terms used to describe these conditions. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be better able to:1. Define the terms used to describe pressure injuries and skin changes at the end of life.2. Discuss the concept of skin failure as applied to end-of-life skin injuries and implications for practice. ABSTRACT: This article synthesizes the literature regarding the concepts of "terminal" skin injuries that are found in patients at the end of life, including Kennedy terminal ulcers, Skin Changes At Life's End, Trombley-Brennan terminal tissue injuries, and skin failure. Also included is a discussion of avoidable and unavoidable pressure injuries as defined and differentiated by the Centers for Medicare & Medicaid Services and the National Pressure Ulcer Advisory Panel. To help clarify the controversy among these terms, a unifying concept of "skin failure" that may occur with an acute illness, chronic illness, or as part of the dying process is proposed. This proposed concept of skin failure is etiologically different than a pressure injury, although pressure injury and skin failure can occur concomitantly. These proposed concepts require further research and validated diagnostic criteria. Consensus around appropriate terminology is essential to reduce confusion among stakeholders and ensure appropriate patient care.


Assuntos
Assistência de Longa Duração/normas , Lesão por Pressão/diagnóstico , Lesão por Pressão/enfermagem , Assistência Terminal/organização & administração , Humanos , Papel do Profissional de Enfermagem , Planejamento de Assistência ao Paciente/organização & administração , Lesões dos Tecidos Moles/diagnóstico , Lesões dos Tecidos Moles/enfermagem , Úlcera , Cicatrização
15.
Adv Skin Wound Care ; 32(3): 131-138, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30801351

RESUMO

Pressure injuries/ulcers are a global health issue, and there is a need for clinicians from many countries and continents to express their opinions on the terminology change (pressure ulcer to injury) and revised staging definitions. A convenience, opinion survey sample of clinicians from the Western Asia Gulf Region enrolled in a yearlong wound care course participated by expressing their opinion about these changes. Results reveal support for the pressure injury terminology and the revised staging definitions.


Assuntos
Lesão por Pressão/classificação , Lesão por Pressão/patologia , Terminologia como Assunto , Comitês Consultivos , Lesões por Esmagamento/classificação , Lesões por Esmagamento/patologia , Humanos , Lesão por Pressão/terapia , Índice de Gravidade de Doença , Higiene da Pele/enfermagem , Cicatrização
16.
Nursing ; 49(3): 9-11, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30801398
17.
Nursing ; 49(2): 8-10, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30676548
19.
Nursing ; 49(1): 9-11, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30586041
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