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1.
Gerokomos (Madr., Ed. impr.) ; 31(2): 107-112, jun. 2020. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-193892

RESUMO

OBJETIVO: Determinar el apósito con mayor efectividad (hidrocoloide o espuma de poliuretano) en neonatos ingresados en las unidades de cuidados intensivos neonatal y pediátrica del Hospital Clínico Universitario de Valencia, sometidos a ventilación mecánica no invasiva para la prevención de úlceras por presión nasales y/o faciales. MATERIAL Y MÉTODOS: Proyecto de investigación de tipo observacional, prospectivo y analítico cuya muestra estaba formada por 13 neonatos con ventilación mecánica no invasiva, hospitalizados en la unidad de cuidados intensivos neonatales y pediátrica. Los neonatos fueron divididos en dos grupos: en el grupo A (7 pacientes) se empleó el apósito de espuma de poliuretano y en el grupo B se utilizó el hidrocoloide (6 pacientes). La recogida de datos se realizó durante el período comprendido entre abril y mayo de 2018. RESULTADOS: De los neonatos incluidos en el estudio, 5 (38,5%) presentaron úlceras por presión nasales; el resto (62%) no presentó úlceras. Además, se obtuvo que, del total de pacientes con lesión, un 60% llevaba el apósito hidrocoloide y un 40% el de espuma de poliuretano. CONCLUSIONES: Tras el estudio, se determinó que el apósito de espuma de poliuretano presentaba un menor porcentaje de aparición de UPP en comparación con el hidrocoloide. Sin embargo, sería recomendable valorar la posibilidad de emplear alguno de ellos como medida de protección


OBJECTIVE: To determine the most effective dressing (hydrocolloid or polyurethane foam) in neonates admitted by the Neonatal and Pediatric Intensive Care Unit of the Hospital Clínico Universitario de Valencia, subjected to non-invasive mechanical ventilation for the prevention of pressure ulcers nasal and/or facial. MATERIAL AND METHODS: observational, prospective and analytical research project whose sample considered of 13 neonates with non-invasive mechanical ventilation hospitalized in the Neonatal and Pediatric Intensive Care Unit. They were divided into two groups, where group A (7 patients) used the polyurethane foam dressing and group B used the hydrocolloid dressing (6 patients). The data collection was carried out during the period from April to May 2018. RESULTS: Of the neonates included in the study, 5 presented nasal pressure ulcers (38.5%) and the rest did not (62%). In addition, it was obtained that, of the total of patients with injury, 60% wore the hydrocolloid dressing and 40% that of polyurethane foam. CONCLUSIONS: After the study, it was determined that the polyurethane foam dressing had a lower percentage of appearance of pressure ulcers compared to the hydrocolloid. However, it would be advisable to appraise the possibility of using any of them as a protection measure


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lesão por Pressão/enfermagem , Ventilação não Invasiva/métodos , Ventilação não Invasiva/enfermagem , Bandagens/normas , Unidades de Terapia Intensiva Neonatal , Lesão por Pressão/prevenção & controle , Traumatismos Faciais/enfermagem , Nariz/lesões , Estudos Prospectivos
2.
Medicine (Baltimore) ; 99(20): e20254, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443363

RESUMO

BACKGROUND: This study will be designed to appraise the effects of intraoperative pressure ulcer preventive nursing (IPUPN) on inflammatory markers (IMs) in patients with high-risk pressure ulcers (HRPU) based on high quality randomized controlled trials (RCTs). METHODS: In this study, we will perform a rigorous literature search from the following electronic databases: Cochrane Library, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. All electronic databases will be retrieved from their initial time to March 1, 2020 without limitations of language and publication status. We will only consider high quality RCTs that explored the effects of IPUPN on IMs in patients with HRPU. Two investigators will identify relevant trials, extract data, and appraise risk of bias in each eligible trial. Data will be pooled by either a fixed-effects model or a random-effects model according to the results of heterogeneity identification. The primary outcomes include IMs, and incidence of new pressure ulcers. The secondary outcomes are time to ulcer development, quality of life, length of hospital stay, and adverse events. Statistical analysis will be undertaken using RevMan 5.3 software. RESULTS: This study will summarize high quality clinical evidence of RCTs to evaluate the effects of IPUPN on IMs in patients with HRPU. CONCLUSION: The expected findings may provide helpful evidence to determine whether IPUPN is an effective intervention on IMs in patients with HRPU. INPLASY REGISTRATION NUMBER: INPLASY202040029.


Assuntos
Biomarcadores/análise , Inflamação/sangue , Lesão por Pressão/prevenção & controle , Biomarcadores/sangue , Protocolos Clínicos , Humanos , Inflamação/fisiopatologia , Complicações Intraoperatórias/enfermagem , Complicações Intraoperatórias/prevenção & controle , Metanálise como Assunto , Lesão por Pressão/enfermagem
3.
PLoS One ; 15(5): e0233471, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469916

RESUMO

INTRODUCTION: Pressure ulcer is a frequent complication in patients hospitalized in nursing homes and has a serious impact on quality of life and overall health. Moreover, ulcer treatment is highly expensive. Several studies have shown that pressure ulcer prevention is cost-effective. Audit and feedback programmes can help improve professional practices in pressure ulcer prevention and thus reduce their occurrence. The aim of this study was to analyze, with a prospective longitudinal study, the effectiveness of an audit and feedback programme at 1- and 2-year follow-up for reducing pressure ulcer prevalence and enhancing adherence to preventive practices in nursing homes. METHODS: Pressure ulcer point prevalence and preventive practices were measured in 2015, 2016 and 2017 in nursing homes of the Canton of Geneva (Switzerland). Oral and written feedback was provided 2 months after every survey to nursing home reference nurses. RESULTS: A total of 27 nursing homes participated in the programme in 2015 and 2016 (4607 patients) and 15 continued in 2017 (1357 patients). Patients were mostly females, with mean age > 86 years and median length of stay about 2 years. The programme significantly improved two preventive measures: patient repositioning and anti-decubitus bed or mattress. It also reduced acquired pressure ulcers prevalence in nursing homes that participated during all 3 years (from 4.5% in 2015 to 2.9% in 2017, p 0.035), especially in those with more patients with pressure ulcers. CONCLUSION: Audit and feedback is relatively easy to implement at the regional level in nursing homes and can enhance adherence to preventive measures and reduce pressure ulcers prevalence in the homes.


Assuntos
Instituição de Longa Permanência para Idosos , Casas de Saúde , Lesão por Pressão/prevenção & controle , Programas Médicos Regionais , Idoso , Idoso de 80 Anos ou mais , Custos e Análise de Custo , Feminino , Instituição de Longa Permanência para Idosos/economia , Humanos , Estudos Longitudinais , Masculino , Auditoria de Enfermagem/economia , Casas de Saúde/economia , Lesão por Pressão/epidemiologia , Lesão por Pressão/enfermagem , Prevalência , Estudos Prospectivos , Programas Médicos Regionais/economia , Programas Médicos Regionais/estatística & dados numéricos , Programas Médicos Regionais/tendências , Suíça/epidemiologia
4.
Gerokomos (Madr., Ed. impr.) ; 31(1): 41-50, mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192212

RESUMO

INTRODUCCIÓN: Las úlceras por presión (UPP) constituyen un importante problema de salud en todos los sistemas de salud. Es por ello por lo que el Comité de Expertos Enfermeros en Cuidados de UPP y Heridas de la Federación Argentina de Enfermería (CEECUPPYH-FAE) decidió iniciar una estrategia nacional específica acerca del problema de las UPP, "La Maratón Nacional: El primer paso". En el presente artículo presentamos los datos correspondientes al primer estudio nacional de prevalencia de UPP en la República Argentina como punto de partida de nuestra maratón nacional. METODOLOGÍA: Para ello se planteó un estudio nacional con los siguientes OBJETIVOS: obtener indicadores epidemiológicos sobre UPP en instituciones de salud de la República Argentina; identificar el riesgo de padecer UPP; determinar las características demográficas y clínicas de los pacientes prevalentes; determinar las características de las lesiones identificadas, e identificar medidas utilizadas en prevención de UPP. Para ello se realizó un estudio descriptivo transversal mediante encuesta online realizada a profesionales de enfermería entre el 1 de junio y el 30 julio de 2018. Se utilizaron las directrices de clasificación de EPUAP-NPUAP y los indicadores del GNEAUPP. RESULTADOS: Participaron 200 profesionales de enfermería que relevaron 3755 encuestas en 22 de las 24 provincias del país. La prevalencia bruta de UPP fue del 22,55% en pacientes adultos, un 48,3% de los pacientes habían desarrollado UPP nosocomiales; el 57% de la muestra tenía edad para jubilarse (+ 60 años) y el 70% pertenecía a servicios generales. Las localizaciones de las lesiones más frecuentes fueron sacro, talones y trocánteres, respectivamente. La prevalencia de UPP en pacientes pediátricos fue del 8,35%; un 69,44% de los pacientes pediátricos presentaban UPP nosocomiales. El 76% de los pacientes pediátricos estaban internados en cuidados generales y el 66% presentaba riesgo bajo de padecer UPP. Las localizaciones más frecuentes fueron cabeza, sacro y talones. La prevalencia bruta de UPP en neoonatos fue del 4,15%, todos ellos presentaban UPP nosocomiales. El 66% de los neonatos presentaba riesgo de padecer UPP y las localizaciones más frecuentes fueron cabeza y sacro. CONCLUSIONES: "La Maratón Nacional: El primer paso" es el primer estudio de investigación a nivel nacional sobre UPP en el que participaron profesionales de enfermería de todo el país y ha permitido obtener cifras de prevalencia a nivel nacional, así como de tendencias de prevención, lo que sin lugar a dudas es una información de gran utilidad para establecer estrategias nacionales para la mejora del problema de las UPP y monitorizar dicho problema en la Argentina


INTRODUCTION: Pressure ulcers (PU) are a major health problem in all Health Systems. That is why the Committee of Experts in UPP and Wound Nurses of the Argentine Nursing Federation (CEECUPPYH-FAE) decided to initiate a specific national strategy on the UPP problem, "The National Marathon: The First Step". In the present article we present the data corresponding to the first national study of PUs prevalence in the Argentine Republic as the starting point of our national marathon. METHODOLOGY: For this purpose, a national study was proposed with the following OBJECTIVES: to obtain Epidemiological Indicators on PUs in Health Institutions of the Argentine Republic, to identify the risk of suffering PU, to determine the demographic and clinical characteristics of the patients of the prevalent patients, to determine the characteristics of identified lesions and to identify measures used in PU's prevention. A cross-sectional descriptive study was conducted through an online survey of Nursing Professionals between June 1 and July 30, 2018, using EPUAP-NPUAP classification guidelines and GNEAUPP indicators. RESULTS: There were 200 nurses who surveyed 3755 surveys in 22 of the country's 24 provinces. The Gross Prevalence of PUs was 22.55% in adult patients, of which 48.3% of prevalent patients had developed nosocomial PUs.57% of the sample is old enough to retire (+ 60 years), 70% belongs to general services. The most frequent lesion locations were sacrum, heels and trochanteres respectively. The prevalence of PUs in paediatric patients was 8.35%; 69.4% of paediatric prevalent patients presented nosocomial PUs.76% of the prevalent pediatric patients were hospitalized in general care and 66% had a low risk of UPP. The most frequent locations were head, sacrum and heels. The gross prevalence of PUs in neoonates was 4.15%, all of them presenting nosocomial PUs. Sixty-six percent of neonates were at risk of PU and the most frequent locations were head and sacrum. CONCLUSIONS: "The National Marathon: The first step" is the First National Argentinian Research Study on PUs where nurses from all over the country participated and has allowed to obtain national prevalence figures, as well as prevention trends, which without a doubt is a very useful information to establish national strategies for the improvement of the PUs problem and to monitor this problem in Argentina


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Lesão por Pressão/epidemiologia , Estratégias Nacionais , Lesão por Pressão/enfermagem , Argentina/epidemiologia , Estudos Epidemiológicos , Indicadores Demográficos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Inquéritos e Questionários , Estudos Transversais
5.
J Clin Nurs ; 29(7-8): 1398-1421, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31889342

RESUMO

BACKGROUND: Despite decades of research, pressure injuries continue to be a source of significant pain and delayed recovery for patients and substantial quality and cost issues for hospitals. Consideration of the current thinking around pressure injury risk must be evaluated to improve risk assessments and subsequent nursing interventions aimed at reducing hospital-acquired pressure injuries. DESIGN: This is a discursive paper using Walker and Avant's (2005) theory synthesis framework to examine the relevance of existing pressure injury models as they align with the current literature. METHODS: PubMed and CINAHL indexes were searched, first for conceptual models and then for pressure injury research conducted on hospitalised patients for the years 2006-2016. A synthesis of the searches culminated into a new pressure injury risk model. CONCLUSIONS: Gaps in previous models include lack of attention to the environment, contributing episode-of-care factors and the dynamic nature of injury risk for patients. Through theory synthesis, the need for a new model representing the full risk for pressure injury was identified. The Pressure Injury Predictive Model is a representation of the complex and dynamic nature of pressure injury risk that builds on previous models and addresses new patient, contextual and episode-of-care process influences. The Pressure Injury Predictive Model (PIPM) provides a more accurate picture of the complexity of contextual and process factors associated with pressure injury development. RELEVANCE TO CLINICAL PRACTICE: Using the PIPM to determine risk can result in improved risk identification. This information can be used to implement targeted, evidence-based pressure injury prevention interventions specific to the patient risk profile, thus limiting unwarranted and unnecessary care.


Assuntos
Teoria de Enfermagem , Lesão por Pressão/prevenção & controle , Medição de Risco/métodos , Enfermagem Baseada em Evidências , Hospitalização , Humanos , Lesão por Pressão/enfermagem
6.
Nursing ; 50(2): 41-44, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31904618

RESUMO

This article discusses an evidence- and consensus-based support-surface algorithm designed to help clinicians choose the most appropriate support surface for preventing or treating pressure injuries based on patient, nurse, and institutional considerations.


Assuntos
Algoritmos , Leitos , Tomada de Decisão Clínica/métodos , Enfermeiras Clínicas/psicologia , Lesão por Pressão/enfermagem , Consenso , Prática Clínica Baseada em Evidências , Humanos , Fatores de Risco
7.
Rev. Rol enferm ; 43(1,supl): 493-499, ene. 2020. tab
Artigo em Português | IBECS | ID: ibc-193425

RESUMO

Introduction: The term senescence translates the natural process of aging, which includes a sum of physiological, anatomical and functional changes. These changes can lead to morbidities and, when associated with chronic diseases, provide a situation of fragility and dependence, which may leave the elderly vulnerable to the appearance of wounds, which usually present a chronic evolution. Objective: to determine the prevalence and characteristics of pressure ulcers among institutionalized elderly people, the association between risk scores and clinical conditions of the elderly, and the measure of intensity of association of these variables with the development of the lesion. Method: This is a cross-sectional, population-based study with a quantitative approach, based on the analysis of part of the database. All the elderly included in the database (N = 324), enrolled in long-term institutions, were included in the study. Results: The prevalence of pressure ulcer was 8% in institutionalized elderly. It can be verified that of the five variables related to clinical conditions, they had a significant association (p≤0.05). The estimates of the coefficients of the binary logistic regression model showed that positive values, such as urinary incontinence, osteoarticular, neurological diseases and negative values for the change in vision, may increase and / or decrease the chance of developing the lesion. Conclusion: Pressure ulcers are preventable wounds that require constant observa-tion by the professionals responsible for the planning and implementation of care


No disponible


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Lesão por Pressão/enfermagem , Saúde do Idoso Institucionalizado , Cuidados de Enfermagem/métodos , Planejamento de Assistência ao Paciente/organização & administração , Fragilidade/enfermagem , Lesão por Pressão/epidemiologia , Fatores de Risco , Fatores Epidemiológicos , Prevalência , População Institucionalizada , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Estudos Transversais , Pessoas Acamadas/estatística & dados numéricos , Idoso Fragilizado/estatística & dados numéricos
8.
J Nurs Care Qual ; 35(1): 51-57, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30817407

RESUMO

BACKGROUND: Considerable evidence exists on how to prevent hospital-acquired pressure injuries (HAPIs). However, processes employed to implement evidence play a significant role in influencing outcomes. PROBLEM: One Australian health district experienced a substantial increase in HAPIs over a 5-year period (by almost 60%) that required a systemwide practice change. APPROACH: This article reports on the people, processes, and learnings from using the Promoting Action on Research Implementation in Health Services (PARiHS) framework taking into account the evidence, context, and facilitation to address HAPIs. OUTCOMES: Applying this approach resulted in a significant decrease in pressure injuries and positive practice change, leading to improved patient outcomes in a shorter time frame than previous strategies. CONCLUSION: Processes guided by the PARiHS enhanced the effectiveness of translating evidence into practice and positively assisted clinicians to promote optimal patient care. This approach is transferrable to other health care settings.


Assuntos
Doença Iatrogênica/prevenção & controle , Lesão por Pressão/enfermagem , Austrália , Assistência à Saúde/métodos , Assistência à Saúde/normas , Prática Clínica Baseada em Evidências , Fidelidade a Diretrizes , Humanos , Lesão por Pressão/prevenção & controle , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , Pesquisa Médica Translacional/métodos
9.
Rev Rene (Online) ; 21: 42053, 2020. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1087338

RESUMO

Objetivo: descrever os elementos constitutivos do cuidado de enfermagem presentes nas escalas de avaliação do risco de lesão por pressão usadas em unidades de terapia intensiva. Métodos: trata-se de uma revisão integrativa da literatura a partir do LILACS, MEDLINE, SCIELO e BDENF. Os descritores utilizados para a busca foram Pressure Ulcer; Decubitus Ulcer; Prevention and Control; Prevention; Intensive Care Units. A amostra final foi constituída por 13 artigos científicos. Resultados: a escala mais utilizada entre os estudos analisados foi Braden. Os elementos constitutivos evidenciados foram avaliação estruturada do risco, avaliação da pele e tecidos, cuidados preventivos com a pele, nutrição, reposicionamento no leito, superfícies de apoio e cuidados com dispositivos médicos. Conclusão: a prevenção de lesões relacionadas às incontinências, avaliação nutricional, intervenções nutricionais com o objetivo de prevenir lesões e os cuidados relacionados a dispositivos médicos são elementos constitutivos do cuidado de enfermagem pouco explorados ou ausentes nas escalas avaliadas


Objective: to describe the constituent elements of nursing care present in the pressure injury risk assessment scales used in intensive care units. Methods: this is an integrative literature review based on LILACS, MEDLINE, SCIELO and BDENF. The descriptors used for the search were Pressure Ulcer; Decubitus Ulcer; Prevention and control; Preven-tion; Intensive Care Units. The final sample consisted of 13 scientific articles. Results: the Braden scale was the most used scale among the analyzed studies. The constituent ele-ments highlighted were structured risk assessment, skin and tissue assessment, preventive skin care, nutrition, re-positioning in bed, support surfaces, and care with medical device. Conclusion: the prevention of incontinence-related injuries, nutritional assessment, nutritional interventions aimed at preventing injuries and care with medical devices are constituent elements of nursing care still poorly explo-red or absent in the evaluated scales


Assuntos
Humanos , Lesão por Pressão/prevenção & controle , Unidades de Terapia Intensiva , Avaliação Nutricional , Medição de Risco/métodos , Lesão por Pressão/enfermagem , Equipamentos e Provisões Hospitalares
10.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 1172-1178, jan.-dez. 2020. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1118066

RESUMO

Objetivo: Identificar na literatura científica as variáveis associadas à prevenção da LPP para subsidiar o cuidado de enfermagem. Método: Trata-se de uma revisão integrativa da literatura. Resultados: Foram analisados 18 artigos analisados, destes, 13 eram exclusivamente elaborados por enfermeiros. A análise possibilitou a identificação de 39 variáveis associadas as três dimensões emanadas do termo "conhecimento". Foi possível observar uma predominância de valorização da literatura daquelas associadas a dimensão técnico-científica com um quantitativo de 35 variáveis. Nesta dimensão pode-se notar que as medidas de prevenção estão associadas à utilização de procedimentos para alívio de pressão. Conclusão: A revisão integrativa permitiu verificar que os cuidados voltados a medidas de prevenção se constituem como um tema que demanda preocupação por parte da equipe multiprofissional, principalmente, pelos enfermeiros que tem investido de forma expressiva no melhor entendimento do problema e na busca de soluções através de pesquisas metodologicamente mais refinadas


Objective: To identify in the scientific literature the variables associated with LPP prevention to subsidize nursing care. Method: This is an integrative review of the literature. Results: We analyzed 18 analyzed articles, of which 13 were exclusively elaborated by nurses. The analysis enabled the identification of 39 variables associated with the three dimensions emanating from the term "knowledge". It was possible to observe a predominance of valorization of the literature of those associated to the technical-scientific dimension with a quantitative of 35 variables. In this dimension it can be noted that the preventive measures are associated with the use of procedures for pressure relief. Conclusion: The integrative review made it possible to verify that care for prevention measures is a theme that demands concern on the part of the multiprofessional team, mainly by the nurses who have invested expressively in the best understanding of the problem and in the search for solutions through methodologically more refined searches


Objetivo: Identificar en la literatura científica las variables asociadas a la prevención de la LPP para subsidiar el cuidado de enfermería. Método: Se trata de una revisión integrativa de la literatura. Resultados: Se analizaron 18 artículos analizados, de éstos, 13 eran exclusivamente elaborados por enfermeros. El análisis posibilitó la identificación de 39 variables asociadas a las tres dimensiones emanadas del término "conocimiento". Fue posible observar una predominancia de valorización de la literatura de aquellas asociadas a la dimensión técnico-científica con un cuantitativo de 35 variables. En esta dimensión se puede observar que las medidas de prevención están asociadas a la utilización de procedimientos para alivio de presión. Conclusión: La revisión integrativa permitió verificar que los cuidados dirigidos a medidas de prevención se constituyen como un tema que demanda preocupación por parte del equipo multiprofesional, principalmente, por los enfermeros que han invertido de forma expresiva en el mejor entendimiento del problema y en la búsqueda de soluciones a través de investigaciones metodológicamente más refinadas


Assuntos
Humanos , Masculino , Feminino , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Utilização de Procedimentos e Técnicas/tendências , Equipe de Assistência ao Paciente , Educação em Saúde , Enfermeiras e Enfermeiros , Cuidados de Enfermagem
11.
Rev. enferm. UFPE on line ; 14: [1-7], 2020.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1096024

RESUMO

Objetivo: conhecer como os enfermeiros atuam na avaliação e tratamento de lesões por pressão no contexto da Estratégia Saúde da Família. Método: trata-se de um estudo qualitativo, descritivo e exploratório em unidades urbanas da Estratégia Saúde da Família. Coletaram-se os dados por meio de entrevistas, com um instrumento semiestruturado aplicado a dez enfermeiros, sendo posteriormente analisados pela técnica de Análise de Conteúdo na modalidade Análise Categorial. Resultados: elencaram-se as seguintes categorias: Participação em formação específica sobre lesão por pressão; Aplicação de método de avaliação de lesões por pressão; Indicação, utilização e disponibilidade de coberturas para a prevenção e tratamento de lesões por pressão e Orientações a pacientes e familiares sobre os cuidados com lesões por pressão. Conclusão: conclui-se que o enfermeiro necessita possuir o conhecimento teóricoprático para que, juntamente à equipe multiprofissional e à família, se promova o cuidado na prevenção e tratamento necessário a estes pacientes.(AU)


Objective: to know how nurses work in the evaluation and treatment of pressure ulcers in the context of the Family Health Strategy. Method: this is a qualitative, descriptive and exploratory study in urban units of the Family Health Strategy. The data was collected through interviews, with a semi-structured instrument applied to ten nurses, being subsequently analyzed by the Content Analysis technique in the Category Analysis modality. Results: the following categories were listed: Participation in specific training on pressure ulcers; Application of pressure ulcer assessment method; Indication, use and availability of coverings for the prevention and treatment of pressure ulcers and Guidance to patients and family members on care for pressure ulcers. Conclusion: it is concluded that the nurse needs to have the theoretical-practical knowledge so that, together with the multiprofessional team and the family, the care in the prevention and treatment necessary for these patients is promoted.(AU)


Objetivo: saber cómo trabajan los enfermeros en la evaluación y el tratamiento de las lesiones por presión en el contexto de la Estrategia de Salud Familiar. Método: se trata de un estudio cualitativo, descriptivo y exploratorio en unidades urbanas de la Estrategia de Salud Familiar. Los datos fueron recolectados a través de entrevistas, con un instrumento semiestructurado aplicado a diez enfermeros, analizándolos posteriormente por la técnica de Análisis de Contenido en la modalidad de Análisis de Categoría. Resultados: se enumeraron las siguientes categorías: participación en capacitación específica sobre lesiones por presión; Aplicación del método de evaluación de lesiones por presión; Indicación, uso y disponibilidad de recubrimientos para la prevención y el tratamiento de lesiones por presión y orientación a pacientes y familiares sobre la atención de lesiones por presión. Conclusión: se concluye que el enfermero necesita tener el conocimiento teórico-práctico para que, junto con el equipo multiprofesional y la familia, se promueva la atención en la prevención y el tratamiento necesarios para estos pacientes.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estratégia Saúde da Família , Lesão por Pressão , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Lesão por Pressão/terapia , Segurança do Paciente , Enfermeiras e Enfermeiros , Educação em Saúde , Epidemiologia Descritiva , Pesquisa Qualitativa
12.
Br J Community Nurs ; 25(1): 22-26, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31874079

RESUMO

Good skin integrity is vital to good health because the skin acts as a barrier to microbes and toxins, as well as physical stressors such as sunlight and radiation. It is well known that the skin loses integrity with the ageing process, and this makes older adults susceptible to pressure injury. Additionally, older skin takes longer to heal where there are injuries or breaks. This article looks at what skin integrity is by briefly outlining the physiology of the skin. It discusses how skin integrity can be impaired, what can be done to maintain skin integrity and skin health, and why skin integrity is important for pressure ulcer prevention. Some of the factors that can make skin care difficult are discussed, in addition to the role of community nurses in helping patients engage in skin care. The article outlines how community nurses can identify when there is skin integrity risk or damage and support patients and carers or relatives, in maintaining skin integrity.


Assuntos
Enfermagem em Saúde Comunitária , Enfermagem Geriátrica , Lesão por Pressão/enfermagem , Higiene da Pele/enfermagem , Idoso , Envelhecimento/fisiologia , Humanos , Lesão por Pressão/prevenção & controle , Fatores de Risco , Autocuidado , Pele/anatomia & histologia , Fenômenos Fisiológicos da Pele
13.
Br J Community Nurs ; 24(Sup12): S26-S33, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31804884

RESUMO

Pressure injury is a healthcare problem frequently encountered in nursing homes. This study evaluated the effects of the care delivered under the guidance of a protocol for pressure injury prevention at a nursing home. It was implemented in four phases. In the pre-protocol period, the pressure injury incidence and nurses' care practices were evaluated. In the second phase, nurses were trained to use the protocol. In the third phase, the nurses provided care under the guidance of the protocol (post-protocol period). In the fourth phase, the incidence of pressure injury and nurses' care practices were compared between the pre- and post-protocol periods. The average age of the older residents was 78.40±7.12 years, and all were at high or very high risk of pressure injury according to the Braden scale scores. Some 30% were bed bound; 90% had faecal and urinary incontinence; and 70% had malnutrition. The results showed that the pressure injury incidence reduced from 17.39% in the pre-protocol period to 10.87% in the post-protocol period, while the nurses' care practices improved in the post-protocol period. Thus, use of pressure injury-prevention protocols can reduce the incidence of these injuries in vulnerable care home residents.


Assuntos
Protocolos Clínicos , Instituição de Longa Permanência para Idosos , Casas de Saúde , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Idoso , Feminino , Humanos , Incidência , Masculino , Lesão por Pressão/epidemiologia , Higiene da Pele/enfermagem , Turquia/epidemiologia
14.
Br J Community Nurs ; 24(Sup12): S38-S42, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31804885

RESUMO

Pressure ulcer/injury remains a significant health problem in the community, requiring comprehensive care. Nurses are involved in the management and prevention of pressure injury. However, to date, studies focusing on applying nursing theory to pressure ulcer care have been limited. In the present study, the three dimensions of Lydia Hall's 1964 theory-core, care and cure-are extensively discussed and linked with the practice of pressure injury management. It is hoped that this review will help community nurses understand the application of this nursing theory to the prevention and management of pressure injury.


Assuntos
Enfermagem em Saúde Comunitária , Teoria de Enfermagem , Lesão por Pressão/enfermagem , Humanos , Lesão por Pressão/etiologia , Lesão por Pressão/prevenção & controle
15.
J Wound Care ; 28(12): 795-806, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31825774

RESUMO

OBJECTIVE: To critically appraise and synthesise existing research literature pertaining to nurses' attitudes towards pressure ulcer (PU) prevention. METHOD: Using systematic review methodology, published quantitative studies focusing on nurses' attitudes towards PU prevention measured by psychometric tests were included. The search was conducted in May 2019 using PubMed, CINAHL, Scopus, Cochrane and EMBASE databases, and returned 442 records, of which 21 met the inclusion criteria. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the checklist. RESULTS: Of the included studies, 20 employed a cross-sectional design and one author employed a validation study. In measuring nurses' attitudes toward PU prevention two distinct instruments were used: the 'Moore and Price Attitude Scale' and the 'Attitude towards Pressure Ulcer Prevention Instrument'. The mean attitude score within the studies was 73% (standard deviation=9.2%). The lowest attitude score was 51%, while the highest score was 89%. The results obtained from the studies indicated that 86% (n=18) yielded positive attitude results. CONCLUSION: The findings suggest that, overall, nurses are positively disposed towards PU prevention. However, it is important to highlight that the nurses have difficulties translating this positive attitude into actual PU prevention strategies.


Assuntos
Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros/psicologia , Lesão por Pressão/prevenção & controle , Humanos , Lesão por Pressão/enfermagem , Lesão por Pressão/psicologia
16.
J Wound Care ; 28(12): 835-841, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31825777

RESUMO

OBJECTIVE: To identify the skin temperature in different body areas of hospitalised individuals in the surgical unit, without risk of developing a pressure ulcer (PU). METHODS: A descriptive, correlational and cross-sectional study, carried out May-October 2017, in a surgical unit of a university hospital in southern Brazil. Temperature was measured at the bony prominences including scapula, elbow, trochanters and heels, on both sides of the body, as well as occipital and sacral regions. RESULTS: A total of 230 patients took part in the study. All regions of the body measured presented differences in temperatures. The sacral region presented the highest mean temperature (34.2±0.1°C). Patients (aged 18-59 years) had higher skin temperatures in the sacral region than older patients (aged 60-88 years). There was a symmetry in temperatures on both sides of the body. There was a low degree of correlation between age, room temperature, room humidity and skin temperature in some body regions. CONCLUSION: The study established mean values for skin temperature in specific body regions in patients without risk of developing a PU, hospitalised in a surgical unit. It also demonstrates how skin temperature can be used as a clinical parameter in practice to support the prevention of PUs.


Assuntos
Avaliação em Enfermagem , Lesão por Pressão/prevenção & controle , Temperatura Cutânea , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/enfermagem , Adulto Jovem
17.
PLoS One ; 14(12): e0226359, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31869363

RESUMO

AIM: To explore the barriers and facilitators perceived by home caregivers regarding their involvement in the home care of people with pressure injuries. BACKGROUND: Although home caregivers are key in the process of caring for people with pressure injuries, little is known about their perceptions regarding their involvement in the same. METHODS: A qualitative study based on grounded theory involving a theoretical sample of 15 home caregivers of people with pressure injuries within the health district of Puertollano, Spain. RESULTS: This study identified three barriers (feminization of care, necessary life adaptations as a home caregiver, and the organization of health services) and three facilitators (the perceived family duty for caring, willingness to provide care, and satisfaction with the care received on behalf of primary care services) associated with caregiver involvement in the home care of pressure injuries. CONCLUSIONS: The care of a person with pressure injuries is perceived as a duty and requires important adaptations affecting the home caregiver's personal, social and work life. The emotional closeness and trust that develops between a patient and the primary care staff equals an involvement which, in turn, also has positive results for both the home caregiver and the patient.


Assuntos
Atitude Frente a Saúde , Cuidadores/psicologia , Barreiras de Comunicação , Lesão por Pressão/enfermagem , Atenção Primária à Saúde/normas , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cuidadores/estatística & dados numéricos , Feminino , Teoria Fundamentada , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Assistência Domiciliar , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Percepção/fisiologia , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Fatores Socioeconômicos , Espanha/epidemiologia
18.
Gerokomos (Madr., Ed. impr.) ; 30(4): 210-216, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-188210

RESUMO

Las úlceras por presión (UPP) son un problema de salud que deteriora la calidad de vida del paciente y su entorno. Los profesionales debemos estar preparados para afrontar este fenómeno, debemos mantener un nivel de conocimientos óptimos y actualizados. Objetivo: Evaluar la efectividad de una intervención formativa, sobre úlceras por presión, en enfermeras de cuidados intensivos del Hospital del Mar y analizar la concordancia entre la información que consta en el registro de úlceras y la información aportada por la enfermera referente del paciente. Metodología: Estudio cuantitativo, analítico, transversal. Los instrumentos para la recogida de datos fueron: un cuestionario autoadministrado pre- y postintervención formativa sobre conocimientos y un cuestionario realizado por la investigadora a las enfermeras referentes de los pacientes con úlceras por presión sobre registros en la trayectoria clínica. Resultados: Colaboraron 30 enfermeras y se obtuvo el 100% de la participación en el estudio. En el nivel de conocimientos preformación se obtuvo una nota media global de 0,547 (desviación estándar [DE] = 0,122) sobre 1 y en la posformación, esta media global fue de 0,728 (DE = 0,140). En el segundo objetivo, en los registros de las UPP se observó que en los días preformación hubo un 27% de pacientes con úlceras, de las cuales el 25% no fueron registradas, y después de la formación el porcentaje de pacientes con úlceras fue de un 9% y el 100% registradas. Conclusiones: La acción formativa mejora el nivel de conocimientos de las enfermeras sobre úlceras por presión. Los porcentajes de úlceras registradas mejoran significativamente después de la formación


Pressure ulcers supposed a health problem that deteriorates patient's life and their environment. Professionals must be well prepared, updating their knowledge in order to face and solve them. Objectives: The main purpose of this quantitative and crosssectional study is to evaluate the effectiveness of a training session in Intensive Care nurses of "Hospital del Mar" about pressure ulcers. The secondary purpose is to analyze the agreement between the information included in the ulcer's registry and the information provided by the nurse in patient's charge. Methods and materials: Data was acquired through pre- and post-training tests to nurses, in charge of patients with pressure ulcers, about clinical history record. Results: 30 nurses agreed to become part of the study and the obtained participation was 100%. The average mark in the pre-training test was 0.547 /1 (DE = 0.122) while in the post-training test was 0.728 (DE = 0.140). Additionally, the recording of pressure ulcers improved. During pre-training time 27% of patients showed pressure ulcers but 25% of them weren't recorded. However, 9% of patients showed pressure ulcers by post-training days and all of them were recorded. Conclusions: The training session allowed nurses to improve their knowledge about pressure ulcers. Also the registration of pressure ulcers raise after training session


Assuntos
Humanos , Masculino , Feminino , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Lesão por Pressão/enfermagem , Unidades de Terapia Intensiva , Resultado do Tratamento , Qualidade de Vida , Estudos Transversais , Análise de Dados , Inquéritos e Questionários
19.
Gerokomos (Madr., Ed. impr.) ; 30(4): 217-225, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-188211

RESUMO

Objetivos: a) identificar los instrumentos para medir las actitudes de profesionales de enfermería hacia la prevención de las lesiones por presión (LPP); b) identificar los instrumentos para medir las barreras para la prevención de LPP dirigidos a profesionales de enfermería; c) analizar las propiedades psicométricas de estos instrumentos. Metodología: Revisión de la bibliografía sobre estudios de desarrollo, validación y uso de instrumentos sobre actitudes y barreras para la prevención de las LPP, en profesionales de enfermería. Se ha realizado la búsqueda sobre 12 bases de datos bibliográficas, hasta diciembre de 2018. Se incluyeron estudios cuantitativos que utilizasen instrumentos, cuestionarios o test, que determinasen las actitudes y las barreras de los profesionales o estudiantes de enfermería. Se llevó a cabo una síntesis descriptiva. Resultados: Se han encontrado 33 artículos sobre instrumentos de actitudes hacia la prevención, que describen un total de 5 cuestionarios. Solo dos han sido usados en varios estudios: Escala de actitudes hacia la prevención de las UPP de Moore y Price (rango de fiabilidad 0,63-0,88) y Attitude toward Pressure ulcer Prevention (rango de fiabilidad: 0,66-0,91). Respecto a barreras para la prevención de las LPP se han encontrado 18 estudios que describen instrumentos de medición, de los cuales solo 5 presentan datos de propiedades psicométricas. La falta de tiempo es la barrera citada más frecuentemente. Conclusión: Existen dos cuestionarios validados para medir las actitudes de enfermeras hacia la prevención de las LPP, aunque no tienen versión en español. Hay una diversidad de cuestionarios para establecer las barreras para la prevención, pero ninguno cuenta con una sólida evaluación psicométrica


Aim: a) To identify the instruments to measure the attitudes of nurses towards the pressure injuries (PI) prevention; b) To identify the instruments to measure the barriers or obstacles to PI prevention aimed at nurses; c) To analyze the psychometric properties of these instruments. Methodology: Review of the literature on the development, validation and use of instruments on attitudes and barriers to PI prevention, aimed at nursing professionals. The search was carried out on 12 bibliographic databases until December 2018. Quantitative studies using instruments, questionnaires or tests were included to determine the attitudes and barriers of nursing professionals or students. A descriptive synthesis was carried out. Results: We found 33 articles on instruments of attitudes towards prevention, which describe a total of 5 questionnaires. Only two have been used in various studies: Moore and Price Staff Attitude Scale (reliability range: 0.63 - 0.88) and Attitude toward Pressure ulcer Prevention (reliability range: 0.66 - 0.91). With regard to barriers to the prevention of LPP, 18 studies have been found that describe measurement instruments; only 5 of those shown data on psychometric properties. Lack of time is the most frequently cited barrier. Conclusions: There are two validated questionnaires to measure nurses' attitudes towards PI prevention, although none of those have a Spanish version. There are a variety of questionnaires to establish barriers to prevention, but none have a solid psychometric assessment


Assuntos
Humanos , Lesão por Pressão/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Lesão por Pressão/enfermagem , Psicometria , Inquéritos e Questionários , Enfermeiras e Enfermeiros/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos
20.
Br J Nurs ; 28(20): S4-S8, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31714836

RESUMO

The assessment of patients' risk for developing pressure ulcers is a routine and fundamental nursing process undertaken to prevent avoidable harm to patients in all care settings. Many risk assessment tools are currently used in clinical practice, however no individual tool is recommended by advisory bodies such as the National Institute for Health and Care Excellence or the European Pressure Ulcer Advisory Panel. The evidence base on the value of structured risk assessment tools in reducing the incidence or severity of pressure ulcers is poor. This purpose of this article is to provide a clinimetric analysis of the recently developed Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE-T) and identify areas for future research to improve the utility of structured risk assessment in identifying patients at risk of developing pressure ulcers.


Assuntos
Lesão por Pressão/enfermagem , Humanos , Medição de Risco/métodos
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