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1.
Zhonghua Shao Shang Za Zhi ; 35(9): 690-691, 2019 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-31594188

RESUMO

A 67-year-old female patient with incontinent dermatitis complicated with sacrococcygeal pressure ulcer was admitted to our unit in November 2017. The wound was treated with a new dressing based on the concept of wet healing, management of exudation, prevention of infection to promote wound healing. Meanwhile, the fecal incontinence was properly treated with colostomy bag combined with disposable negative pressure drainage device to avoid fecal contamination and aggravation of pressure ulcer. Incontinent dermatitis was treated with wound protective powder and wound protective film. After 14 days of treatment, the wound of pressure ulcer was reduced and the incontinent dermatitis was cured.


Assuntos
Dermatite/enfermagem , Incontinência Fecal/enfermagem , Lesão por Pressão/enfermagem , Idoso , Bandagens , Dermatite/complicações , Feminino , Humanos , Lesão por Pressão/complicações
2.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 992-997, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005821

RESUMO

Objetivo: Identificar o conhecimento dos enfermeiros assistenciais quanto à prevenção e aos cuidados com lesões por pressão (LPP) em unidades de clínica médica e cirúrgica de um hospital universitário de Brasília. Métodos: Trata-se de estudo descritivo, transversal com análise quantitativa. Os dados foram coletados por meio da aplicação de um instrumento com informações acerca da formação e conhecimento do enfermeiro acerca da LPP. Resultados: A amostra foi de 38 enfermeiros, na qual 78.9%, acertaram entre 70 a 89% do instrumento, e somente dois enfermeiros (5,2%) obtiveram nota igual ou maior a 90% de acerto. Os itens de menor acerto estão relacionados ao uso de dispositivos, como luva d'água (23,6%), almofadas (23,6%), e em relação a posicionamento e reposicionamento, além da massagem em proeminências ósseas. Conclusão: Conclui-se que há um déficit do conhecimento da equipe de enfermagem deste hospital, o que pode comprometer diretamente na assistência principalmente do paciente em risco para LPP


Objective: To identify the knowledge of nursing assistants regarding the prevention and care of pressure lesions (LPP) in medical and surgical clinic units of a university hospital in Brasília. Methods: This is a descriptive, cross-sectional study with quantitative analysis. Data were collected through the application of an instrument with information about nurses' training and knowledge about LPP. Results: The sample consisted of 38 nurses, where 78.9% scored between 70 and 89% of the instrument, and only 2 nurses (5.2%) scored 90% or better. The items with the lowest accuracy are related to the use of devices such as water glove (23.6%), cushions (23.6%), and in relation to positioning and repositioning, in addition to bony prominence massage. Conclusion: It is concluded that there is a lack of knowledge of the nursing team of this hospital, which may directly compromise the care of the patient at risk for LPP


Objetivo: Identificar el conocimiento de los enfermeros asistenciales en cuanto a la prevención y cuidados con lesiones por presión (LPP) en unidades de clínica médica y quirúrgica de un hospital universitario de Brasilia. Métodos: Se trata de un estudio descriptivo, transversal con análisis cuantitativo. Los datos fueron recolectados por medio de la aplicación de un instrumento con informaciones acerca de la formación y conocimiento del enfermero acerca de la LPP. Resultados: La muestra fue de 38 enfermeros, donde 78.9%, acertaron entre 70 a 89% del instrumento, y solamente 2 enfermeros (5,2%) obtuvieron nota igual o mayor al 90% de acierto. Los elementos de menor acierto están relacionados al uso de dispositivos, como guante de agua (23,6%), cojines (23,6%), y en relación al posicionamiento y reposicionamiento, además del masaje en prominencia ósea. Conclusión: Se concluye que hay un déficit del conocimiento del equipo de enfermería de este hospital, lo que puede comprometer directamente en la asistencia principalmente del paciente en riesgo para LPP


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Lesão por Pressão/terapia , Educação em Enfermagem , Capacitação Profissional , Hospitais Universitários
3.
Br J Nurs ; 28(12): S38-S40, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31242116

RESUMO

Cheri Pearce, runner up at the BJN Awards 2019, describes the work she and her team did to be shortlsted.


Assuntos
Distinções e Prêmios , Enfermagem , Lesão por Pressão/enfermagem , Humanos , Reino Unido
4.
Pflege ; 32(4): 181-187, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31084289

RESUMO

Pressure ulcer risk assessment and preventive measures in mobile / chairfast / bedfast hospital patients Abstract. Background: Internationally, it is recommended to use the clinical view with a validated instrument for pressure ulcer risk assessment to determine subsequent measures. We could not identify any study investigating risk assessment and subsequent measures for mobile / chairfast / bedfast patients. Aim of the study: To identify the degree of agreement between the Bradenscale and clinical view regarding pressure ulcer risk in mobile / chairfast / bedfast patients and subsequent preventive measures. Method: Data from 5274 hospital patients from the "Nursing quality measurement 2015", a cross-sectional multicenter study, were collected. Results: Out of all mobile, chairfast or bedfast patients assessed as at risk of pressure ulcer with the Bradenscale, 22.3 % (mobile), 61.7 % (chairfast) and 86.1 % (bedfast) were also assessed as at risk by clinical view. More than 3 / 4 of the chairfast patients that were not at risk according to clinical view received preventive measures. Conclusion: The consequences over time for patients that received no measures due to discrepancies in the risk assessments should be focused. Furthermore the evaluation of measures in patients without a risk of pressure ulcer is of critical importance. The aspect of patient mobility deserves special attention due to the low agreement of the risk assessments in chairfast and mobile patients.


Assuntos
Hospitalização , Avaliação em Enfermagem , Lesão por Pressão/enfermagem , Estudos Transversais , Humanos , Medição de Risco
5.
J Clin Nurs ; 28(17-18): 3177-3188, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30938908

RESUMO

BACKGROUND: Pressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self-efficacy in managing PUs could predict patients' outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task-specific self-efficacy has not yet been developed. OBJECTIVES: To develop a valid and reliable scale to assess nurses' self-efficacy in managing PUs, that is, the pressure ulcer management self-efficacy scale for nurses (PUM-SES). METHODS: This study had a multi-method and multi-phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items' generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three-step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM-SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM-SES and an established general self-efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency. RESULTS: PUM-SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM-SES had four domains, labelled as follows: assessment, planning, supervision and decision-making. These domains were predicted by the same second-order factor, labelled as PU management self-efficacy. CONCLUSION: PUM-SES is a 10-item scale to measure nurses' self-efficacy in PU management. A standardised 0-100 scoring is suggested for computing each domain and the overall scale. PUM-SES might be used in clinical and educational research. RELEVANCE TO CLINICAL PRACTICE: Optimising nurses' self-efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs.


Assuntos
Enfermagem/normas , Lesão por Pressão/enfermagem , Autoeficácia , Inquéritos e Questionários/normas , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Autogestão
7.
Rev. enferm. UFPE on line ; 13(4): 1115-1123, abr. 2019. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1021227

RESUMO

Objetivo: analisar a incidência de lesões por pressão em uma Unidade de Cuidados Especiais. Método: tratase de um estudo quantitativo, descritivo e exploratório, com intervenção educacional, em um hospital público de médio porte. Compô-se a amostra por 10 participantes. Elencou-se a técnica de coleta de dados por meio de observação direta não participante, e os resultados apresentaram-se em forma de tabelas. Resultados: observaram-se 50 amostras (n=50) onde se constatou uma incidência de lesões por pressão de 48% (n=24), com destaque para as lesões relacionadas a dispositivos médicos (15%) e sacrais (10%). Constituiu-se a capacitação teórica de dez funcionários (n=10) e observou-se que 90% dos funcionários erraram questões relacionadas à atual classificação das lesões por pressão, entretanto, 90% souberam identificar possíveis formas preventivas. Conclusão: demonstra-se, pelos resultados obtidos, que, apesar de ser um fenômeno evitável, continua presente na prática diária, necessitando da implantação de medidas de qualificação profissional como estratégia de redução desse agravo.(AU)


Objective: to analyze the incidence of pressure ulcers in a Special Care Unit. Method: this is a quantitative, descriptive and exploratory study, with educational intervention, in a medium-sized public hospital. The sample was composed by 10 participants. The technique of data collection was established through direct non-participant observation, and the results were presented in the form of tables. Results: 50 samples (n = 50) were observed, with an incidence of 48% (n = 24), with emphasis on ulcers related to medical devices (15%) and sacral (10%). The theoretical qualification of ten employees (n = 10) was established, and 90% of the employees missed questions related to the current classification of pressure ulcers, however, 90% were able to identify possible preventive forms. Conclusion: it is demonstrated by the results obtained that, despite being an avoidable phenomenon, it continues to be present in daily practice, necessitating the implementation of professional qualification measures as a strategy to reduce this aggravation.(AU)


Objetivo: analizar la incidencia de lesiones por presión en una Unidad de Cuidados Especiales. Método: se trata de un estudio cuantitativo, descriptivo y exploratorio, con intervención educativa, en un hospital público de mediano porte. Se compone la muestra por 10 participantes. Se elaboró la técnica de recolección de datos por medio de observación directa no participante, y los resultados se presentaron en forma de tablas. Resultados: se observaron 50 muestras (n = 50) donde se constató una incidencia de lesiones por presión de 48% (n = 24), con destaque para las lesiones relacionadas con dispositivos médicos (15%) y sacros (10%). Se constituyó la capacitación teórica de diez funcionarios (n = 10) y se observó que el 90% de los funcionarios erraron cuestiones relacionadas a la actual clasificación de las lesiones por presión, sin embargo, el 90% supieron identificar posibles formas preventivas. Conclusión: se demuestra, por los resultados obtenidos, que, a pesar de ser un fenómeno evitable, sigue presente en la práctica diaria, necesitando la implantación de medidas de calificación profesional como estrategia de reducción de ese agravio.(AU)


Assuntos
Humanos , Masculino , Feminino , Qualidade da Assistência à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Lesão por Pressão , Lesão por Pressão/enfermagem , Lesão por Pressão/epidemiologia , Educação Continuada , Hospitalização , Capacitação em Serviço , Equipe de Enfermagem , Epidemiologia Descritiva , Hospitais Públicos
8.
Enferm. clín. (Ed. impr.) ; 29(2): 67-73, mar.-abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182595

RESUMO

Objetivo: Describir las características de la gestión de casos en cuanto a población atendida, intervenciones, utilización de servicios y los desenlaces mortalidad, reingresos, úlceras por presión, caídas, problemas con medicamentos e institucionalización. Método: Estudio de seguimiento de una cohorte a partir del registro multicéntrico RANGECOM de Andalucía. La población de estudio son pacientes atendidos en la cartera de servicios de gestión de casos de centros de salud y sus cuidadores familiares. Resultados: Se presentan datos de 835 pacientes con edad media de 76,8años (DE:12,1), un 50,24% mujeres. Presentan una comorbilidad importante (Charlson 3,1; DE:2,5) y dependencia elevada (Barthel 37,5; DE:31,4). El 60,2% de las intervenciones desplegadas por las gestoras de casos se aglutina en tres dominios: conductual (26,0%), sistema sanitario (20,2%) y seguridad (14,1%). La mortalidad fue del 34,4% y los ingresos hospitalarios, del 38,1%. Los pacientes con más reingresos hospitalarios tenían más visitas a urgencias (OR:1,41; IC95%: 1,22-1,63), más intervenciones telefónicas de las gestoras de casos (OR:1,12; IC95%: 1,02-1,24) y pruebas de imagen (OR:1,37; IC95%: 1,17-1,60), junto con un mayor cansancio en la cuidadora (OR:1,31; IC95%: 1,08-1,59), la presencia de dispositivos médicos en domicilio (OR:1,69; IC95%: 1,00-2,87) y recibían menos la intervención «Gestión de Casos». Conclusiones: Los pacientes que absorben la demanda de las enfermeras gestoras de casos presentan una alta complejidad, frente a la cual despliegan intervenciones conductuales, de navegación por el sistema sanitario y de seguridad clínica


Objective: To describe the characteristics of case management in terms of population served, interventions, use of services and outcomes such as mortality, readmissions, pressure ulcers, falls, drug problems and institutionalization. Method: Follow-up study of a cohort, from the RANGECOM Multicentric Registry of Andalusia. The study population were patients included in the case management services of Health Centres and their family caregivers. Results: Data from 835 patients with a mean age of 76.8years (SD:12.1), 50.24% women, are presented. They had an important comorbidity (Charlson 3.1, SD:2.5) and high dependence (Barthel 37.5, SD:31.4). Sixty-two point two percent of the interventions deployed by the case managers were grouped into three domains: behavioural (26.0%), health system (20.2%) and safety (14.1%). Mortality was 34.4% and hospital admissions 38.1%. Patients with more hospital readmissions had more visits to the Emergency Department (OR:1.41; 95%CI: 1.22-1.63), more telephone interventions by case managers (OR:1.12; 95%CI: 1.02-1.24) and imaging tests (OR:1.37; 95%CI: 1.17-1.60), together with greater caregiver burden (OR:1.31; 95%CI: 1.08-1.59), the presence of medical devices at home (OR:1.69; 95%CI: 1.00-2.87) and received less "Case Management" intervention. Conclusions: The patients who absorb the demand of case management nurses present high complexity, for which they deploy behavioural interventions, navigation through the health system and clinical safety


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Prática Avançada de Enfermagem , Lesão por Pressão/enfermagem , Acidentes por Quedas , Acesso aos Serviços de Saúde , Seguimentos , Estudos de Coortes , Estudos Longitudinais
9.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 560-566, abr.-maio 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-987467

RESUMO

Objetivo: Avaliar o conhecimento dos enfermeiros sobre Lesão por Pressão. Métodos: Trata-se de um estudo descritivo e exploratório, com abordagem quantitativa. Realizado com 26 Enfermeiros que compõem o quadro funcional de todos os setores de um Hospital Privado em Teresina ­PI. O questionário possui duas partes: a primeira engloba os dados de caracterização dos participantes e a segunda é composta por 41 itens a serem assinalados como verdadeiro (V), falso (F) e não sei. Os dados foram analisados por meio do software SPSS. Resultados: Quanto aos acertos, 74% dos enfermeiros acertaram entre 80 a 90% do teste, 9% dos profissionais acertaram entre 60 e 69%, sendo que 9% dos profissionais acertaram entre 70 e 79% do teste, demonstrando falhas de conhecimento nos itens abordados, 9% acertaram acima de 90%, onde estes demonstraram conhecimento desejado em relação aos assuntos do teste. Conclusão: Foi possível evidenciar que a maioria dos profissionais da enfermagem demonstrou conhecimento insatisfatório sobre LPP


Objective: The study's purpose has been to assess nurses' knowledge about pressure injury. Methods: It is a descriptive-exploratory study with a quantitative approach, which was carried out with 26 participating nurses who comprise the staff of all sectors from a private hospital in Teresina city, Piauí State. The questionnaire used has two parts, as follows: the first includes the participants' characterization data, and the second is composed of 41 items to be answered as True (T), False (F) and I do not know. Data were analyzed using the SPSS software. Results: Considering the correct answers, 74% of the nurses scored between 80 and 90% of the test, 9% of the professionals scored between 60 and 69%, and 9% of the professionals scored between 70 and 79% of the test, then demonstrating the lack of knowledge about the addressed subject. Also, 9% scored above 90%, where they demonstrated desired knowledge in relation to the subjects of the test. Conclusion: Through this research, it was possible to verify that the majority of the Nursing professionals showed unsatisfactory knowledge with regards to pressure injury


Objetivo: Evaluar el conocimiento de las enfermeras sobre la lesiones por presión. Métodos: Se realizó un estudio descriptivo y exploratório con enfoque cuantitativo. Realizado con 26 enfermeras que componen la fuerza de trabajo de todos los sectores de un hospital privado en Teresina-PI. El cuestionario tiene dos partes: la primera incluye los datos de caracterización de los participantes y el segundo consiste en 41 elementos para ser marcado como verdadero (V), falsa (F) y no saben. Los datos fueron analizados utilizando el software SPSS. Resultados: En cuanto a los golpes, 74% de las enfermeras acordado entre el 80-90% de la prueba, el 9% de los encuestados acordados entre 60 y 69%, y 9% de los encuestados acordado entre el 70 y el 79% de la prueba, lo que demuestra lagunas de conocimiento en temas abordados, 9% tiene más de 90%, que presentó estos conocimientos deseada con respecto a los sujetos de prueba. Conclusión: La evidencia de que la mayoría de los profesionales de enfermería mostraron poco conocimiento de la LPP


Assuntos
Humanos , Masculino , Feminino , Adulto , Competência Profissional , Conhecimentos, Atitudes e Prática em Saúde , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle
10.
Br J Nurs ; 28(6): S6-S11, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-30925250

RESUMO

A pressure ulcer prevalence of 17.3% at Odense University Hospital in Denmark in 2010 prompted action and a quality improvement project was planned. This had two aims: to reduce pressure ulcers at the hospital by 50% and to have no pressure ulcers at or above category 3. An project was established with a steering committee, a pressure ulcer specialist nurse, local dedicated nurses and nurse assistants to implement a pressure ulcer bundle in clinical practice at all departments at the hospital. Six years later the pressure ulcer prevalence was down to approximately 2% and in 2018 only one stage 3 pressure ulcer occurred in the hospital. Pressure ulcer prevention is now incorporated into clinical practice in all departments at the hospital.


Assuntos
Padrões de Prática em Enfermagem , Lesão por Pressão/prevenção & controle , Higiene da Pele/normas , Dinamarca , Hospitais Universitários , Humanos , Pacotes de Assistência ao Paciente , Lesão por Pressão/enfermagem , Melhoria de Qualidade
12.
Br J Nurs ; 28(5): 290-294, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30907641

RESUMO

Wound care is increasingly nurse led. This article describes the types and causes of wounds, the six domains needed for systematic wound assessment and the principles nurses can apply to ensure evidence-based wound care. The author argues for the importance of a patient-focused approach in the care of people with chronic and acute wounds. It highlights, when specialist referral may be needed and presents a case study explaining the difficulties of managing a patient with a wound at the end of life. Nurses care for people with wounds in a broad range of clinical settings and it is a real challenge to provide optimum patient outcome (wound healing) and a positive patient experience.


Assuntos
Padrões de Prática em Enfermagem , Lesão por Pressão/terapia , Higiene da Pele/enfermagem , Ferimentos e Lesões/terapia , Humanos , Lesão por Pressão/enfermagem , Medicina Estatal , Reino Unido , Ferimentos e Lesões/enfermagem
13.
Int Wound J ; 16(2): 550-555, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30864302

RESUMO

Pressure ulcers (PUs) are a serious health care problem for nursing home residents and a key quality metric for regulators. Three initiatives were introduced at a 128-bed facility to improve PU prevention. First, a Quality Assurance and Performance Improvement project and a Root Cause Analysis were conducted to improve the facility's wound care programme. Second, a digital wound care management solution was adopted to track wound management. Third, the role of skin integrity coordinator was created as a central point of accountability for wound care-related activities and related performance metrics. Improvements in PU prevention were tracked using Centers of Medicare and Medicaid data, specifically (a) the percentage of long-stay high-risk residents with PUs and (b) the percentage of short-stay residents with PUs that are new or have worsened. PU prevalence for long-stay high-risk residents was 12.99% (Q4 2016), and upon implementation of these initiatives, the facility saw continued reductions in PU prevalence to 2.9% (Q4 2017), while PUs for short-stay residents were maintained at zero throughout this period. This study highlights the power of effective management combined with real-time data analytics, as enabled by digital wound care management, to make significant improvements in health care delivery.


Assuntos
Casas de Saúde/normas , Guias de Prática Clínica como Assunto , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Qualidade da Assistência à Saúde/normas , Instituições de Cuidados Especializados de Enfermagem/normas , Higiene da Pele/normas , Humanos , West Virginia
14.
Ann Palliat Med ; 8(Suppl 1): S5-S14, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30818954

RESUMO

BACKGROUND: Pressure injury is a common clinical parameter of patient care outcome. Various risk factors increase the risk of palliative care patients to pressure injuries and difficult wound healing. Healthcare professionals are aware that wound healing is difficult, but they still focus on this process instead of providing the needs of patients with unhealed wounds. METHODS: This study aims to identify the clinical parameters of pressure injuries in relation to patients with advanced illness. A retrospective analysis of the records of patients with pressure injuries admitted over 18 months was performed. Descriptive analysis and Spearman's correlation coefficient were used. RESULTS: A total of 127 clinical records were reviewed. The study revealed that patients of old age, high creatinine level, advanced wound age, reduced palliative performance scale (PPS) and low Norton scores are prone to suffer from unhealed wounds. CONCLUSIONS: Pressure injuries are prone to non-healing in patients with old age, high creatinine level, advanced wound stage, low PPS and low Norton scores. Further studies involving patients in earlier stage can be considered.


Assuntos
Lesão por Pressão/fisiopatologia , Cicatrização/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Humanos , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Lesão por Pressão/enfermagem , Estudos Retrospectivos , Fatores de Risco
15.
Gerokomos (Madr., Ed. impr.) ; 30(1): 28-33, mar. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182785

RESUMO

Objetivo: Evaluar la efectividad de la EPA-HCC en el cuidado de los pacientes con úlceras por presión. Métodos: Se realiza un estudio de tipo cuasi experimental, multicéntrico, con dos mediciones sin grupo control, en cuanto a las medidas preventivas y tratamientos aplicados a pacientes con úlceras por presión (UPP) en los distritos o áreas de gestión sanitaria donde se está pilotando la EPA-HCC: Distrito Sanitario Poniente, Área de Gestión Sanitaria Jaén Norte-Nordeste y Área de Gestión Sanitaria Serranía de Ronda, entre septiembre 2015 y octubre 2016. Se utilizó un documento autoadministrado ad-hoc para todas las enfermeras que tenían pacientes a su cargo, y se realizó un análisis descriptivo de los mismos. Resultados: Respondieron un total de 335 profesionales en 2015 y 308 en 2016 (tasa de respuesta del 89,1%); los tres distritos atienden a una población total de 707.814 habitantes. En cuanto a las medidas preventivas del uso de sistemas especiales para el manejo de la presión (SEMP), se ha producido un incremento de un 6% en su uso de un año a otro, un descenso de un 4% del total de UPP, un descenso en el consumo de apósitos de hidrofibra con plata casi del 50% y un descenso de la escala RESVECH en un 52% del primer año al segundo. Conclusiones: Se constata una mejora en la optimización de los recursos, en las medidas preventivas puestas en marcha para conseguir los objetivos marcados y se crea la necesidad de seguir formando en tratamientos locales y tipos de desbridamientos a realizar


Objective: To evaluate the effectiveness of EPA-HCC in the care of patients with pressure ulcers. Methods: A multi-center quasiexperimental study with two measurements without a control group was carried out, in terms of preventive measures and treatments applied to patients with UPP in the Districts or Sanitary Management Areas where the EPA-HCC is being piloted: District Sanitario Poniente, Jaén North-Northeast Health Management Area, Serrania de Ronda Sanitary Management Area, between September 2015 and October 2016. A self-administered ad-hoc document was used for all the nurses who had patients under their care, performing a descriptive analysis thereof. Results: A total of 335 professionals responded in 2015 and 308 in 2016 (response rate of 89.1%), attending the three districts to a total population of 707,814 inhabitants. Regarding the preventive measures of the use of Special Systems for the Management of the Pressure (SEMP) there has been an increase of 6% its use from one year to another, a decrease of 4% the total of UPP, a decrease in the consumption of hydrofiber dressings with silver almost 50% and with a decrease of RESVECH in 52% of the first year to the second. Conclusions: There is an improvement in the optimization of resources, in the preventive measures put in place to achieve the objectives set and the need to continue training in local treatments and types of debridement to be created


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Prática Avançada de Enfermagem , Atenção Primária à Saúde , Lesão por Pressão/enfermagem , Estudos de Casos e Controles , Resultado do Tratamento , Efetividade , Índice de Gravidade de Doença
16.
Gerokomos (Madr., Ed. impr.) ; 30(1): 42-44, mar. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182787

RESUMO

El éxito de los resultados en la gestión avanzada de heridas depende de su correcta valoración. Objetivo: El objetivo de este caso clínico es presentar los resultados del tratamiento de una lesión relacionada con la dependencia combinada o mixta: úlcera por presión de categoría III como complicación de una lesión asociada a la humedad de grado 2A en zona sacra en una paciente con dependencia severa debido a enfermedad degenerativa demencial. Metodología: Gestión avanzada de heridas con apósitos especializados y cuidados de enfermería específicos; este caso cumple con los aspectos éticos de recogida de datos y autorización de familiar a cargo. Resultados: Cicatrización de las lesiones. Conclusiones: La correcta valoración permite proporcionar cuidados específicos y oportunos, con resultados favorables


The good results in wound scar depends on the correct classification. Objective: the objective of this clinical case is to present the results of the treatment of injury related to combined or mixed dependence: pressure ulcer category III as a complication of a lesion associated with grade 2A humidity in the sacral area in a patient with severe dependence due to disease Degenerative dementia. Methodology: Advanced wound management with specialized dressings and specific nursing care; this case complies with the ethical aspects of data collection and authorization of dependent family member. Results: Wound healing. Conclusions: The correct valuation allows the delivery of specific and timely care, with favorable results


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/enfermagem , Lesão por Pressão/etiologia , Lesão por Pressão/enfermagem , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Gerokomos (Madr., Ed. impr.) ; 30(1): 45-47, mar. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182788

RESUMO

Introducción: La mayor dificultad en el tratamiento de las úlceras por presión es el manejo del exudado y de la infección. Es vital la elección de apósitos que simplifiquen las curas, tratando ambos problemas al mismo tiempo de forma eficiente. Objetivo: Realizar el mejor abordaje posible de la lesión desde una visión holística de la paciente. Metodología: Realizamos un estudio clínico descriptivo, prospectivo y longitudinal de 3 meses de duración, basado en el proceso de atención enfermera y en las curas en ambiente húmedo. Resultados: El uso de la tecnología alveolar gelificante ha sido satisfactoriamente costo-efectivo, al mejorar la calidad de vida de la paciente y reducir el tiempo de enfermería. Conclusión: Este caso clínico pone de manifiesto que un plan de cuidados individualizados basados en la evidencia científica y el uso de la cura en ambiente húmedo son clave para obtener resultados óptimos en la curación de heridas


Introduction: The most difficult part of the treatment of pressure ulcers is handling exudate and infection. It is crucial to choose the dressing that simplifies cures, treating efficiently both problems at the same time. Aim: To carry out the best possible approach to the wound from a holistic point of view of the patient. Methodology: We carried out a descriptive, prospective and longitudinal case study in three months based on the nursing care process and moist wound healing. Results: The usage of gelifying alveolar technology has had a very successful result in terms of cost-effectiveness, improving the patient quality of life and reducing the nursing timing. Conclusions: This case study shows that a customized treatment based on scientific evidence and the usage of moist wound healing are crucial to reach optimal results in wound healing


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Celulite/microbiologia , Proteus mirabilis/isolamento & purificação , Infecções por Proteus/enfermagem , Staphylococcus aureus/isolamento & purificação , Infecções Estafilocócicas/enfermagem , Lesão por Pressão/microbiologia , Lesão por Pressão/enfermagem , Estudos Prospectivos , Estudos Longitudinais
18.
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
19.
J Wound Ostomy Continence Nurs ; 46(2): 106-112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30801563

RESUMO

PURPOSE: The aim of this study was to assess nurses' knowledge of pressure injuries in order to gather benchmark data, identify knowledge gaps, and based on results, implement educational strategies to improve practice. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: The study setting was a large Australian tertiary general hospital employing approximately 2500 nurses in both full-time and part-time roles. A proportional sample (25%) stratified by experience, preparation, and facility-generated categories (nursing grade) was generated. The sample included nursing students and nursing assistants. Three hundred six participants completing the survey. INSTRUMENT: The Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZPUKT) version 2, comprising 72 statements, with 3 subscales (prevention/risk, staging, and wound description) was used to measure pressure injury knowledge. Item responses are "True," "False," and "Don't know." For the purpose of analyses, correct responses were scored 1, and incorrect or "don't know" responses were scored 0. Generally accepted ranges of scoring for the original PZPUKT specify less than 70% as unsatisfactory, 70% to 79.9% as satisfactory, 80% to 89.9% as good, and 90% and greater as very good knowledge of pressure injury prevention. METHODS: The survey was advertised throughout the hospital by strategically placed posters, computer screen savers within the hospital, and e-mails. Respondents completed paper-based questionnaires and data were manually entered online. Data were collected between September 2015 and October 2016. Descriptive and nonparametric inferential statistical tests (Mann-Whitney U, Kruskal-Wallis H) were used to analyze within sample differences in scores. RESULTS: The overall mean knowledge score was 65%; approximately two-thirds of the sample (68%) scored 60% and greater, reflecting an unsatisfactory knowledge level of pressure injury prevention according to the original PZPUKT scores. The lowest mean scores were found in the "wound description" subscale. Participants who sought pressure injury information via the Internet or had read pressure injury guidelines scored significantly higher than those who did not (P = .001 and P < .001, respectively). Seventeen items were answered incorrectly by over half of participants, identifying important knowledge deficits, particularly within the wound description subscale. CONCLUSIONS: When compared with results from studies using the PZPUKT, we contend that a cutoff score of 60% and greater (instead of ≥70%) should be used to indicate an overall satisfactory score. Our results identified deficits in pressure injury knowledge related to seating support and seated individuals and wound dressings as areas where nurses would benefit from focused education strategies.


Assuntos
Competência Clínica/normas , Enfermeiras e Enfermeiros/normas , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Queensland , Estatísticas não Paramétricas , Inquéritos e Questionários
20.
Int Wound J ; 16 Suppl 1: 51-61, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30793861

RESUMO

The incidence rate of patients developing pressure ulcers associated with medical device use is underreported in Korea. This study aims to determine clinical nurses' perceived importance and performance towards medical device-related pressure injury prevention. A total of 620 nurses from seven hospitals attending continuing education programmes in Korea responded to self-administered questionnaires. Data were collected from March to December 2017 on a 4-point-Likert scale on nurses' perceived importance and performance for prevention of medical device-related pressure ulcer (MDRPU). Secondary data analysis was performed through reported pressure injury incidence, and questionnaire data were analysed using descriptive statistics, t-test, and anova. The overall rates of hospital-acquired pressure ulcers and MDRPU were 16.9% and 0.8%, respectively. The proportion of MDRPU was 5.02%. Its perceived importance (3.56 ± 0.48) was also higher than prevention performance (3.13 ± 0.90) among nurses. Education level and participation in pressure injury management training was found to enhance prevention performance by nurses. Therefore, informational and educational programmes based on clinical practice are necessary for clinical nurses to focus on perceived importance and performance towards prevention of medical device-related pressure injury and pressure ulcer care.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem de Cuidados Críticos/métodos , Equipamentos e Provisões/efeitos adversos , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Lesão por Pressão/enfermagem , Lesão por Pressão/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/etiologia , República da Coreia
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