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strategies for skin care and prevention of the pressure ulcers

Zena Eh Moore, Joan Webster
BACKGROUND: Pressure ulcers, localised injuries to the skin or underlying tissue, or both, occur when people cannot reposition themselves to relieve pressure on bony prominences. These wounds are difficult to heal, painful, expensive to manage and have a negative impact on quality of life. Prevention strategies include nutritional support and pressure redistribution. Dressing and topical agents aimed at prevention are also widely used, however, it remains unclear which, if any, are most effective...
December 6, 2018: Cochrane Database of Systematic Reviews
Carlo Biz, Ilaria Fantoni, Nicola Crepaldi, Filippo Zonta, Lisa Buffon, Marco Corradin, Alessandra Lissandron, Pietro Ruggieri
BACKGROUND: Femoral fractures are a major healthcare problem worldwide. One of the most difficult issues is their preoperative care, which is still managed by either skeletal or skin traction in some countries, including Italy. These issues are discussed and compared with the contemporary literature. OBJECTIVE: This study aims to analyse the distribution of these treatment options within the orthopaedic community and the reasons for their use, as well as to identify how this may impact nursing care in terms of pain management, hygiene care, venous thromboembolism (VTE)prophylaxis and prevention of pressure ulcers...
October 12, 2018: International Journal of Orthopaedic and Trauma Nursing
Aby Mitchell
Pressure ulcers (PUs) are caused by tissue damage when the blood supply to an area of skin is diminished as a result of pressure. Although most pressure ulcers are preventable, all patients are at risk. Nurses have a central role in prevention and management of pressure areas. They should be able to assess patients' risk of developing PUs using evidence-based practice, recognised risk assessment tools and by completing a holistic assessment. Nurses must be able to identify the risk factors associated with developing PUs and implement appropriate measures to deliver harm-free care...
October 4, 2018: British Journal of Nursing: BJN
Gillian O'Brien, Zena Moore, Declan Patton, Tom O'Connor
AIM: To explore the relationship between nurses' visual assessment of early pressure ulceration and assessment using sub epidermal moisture measurement (a measure of skin and tissue water). MATERIALS AND METHODS: A descriptive prospective observational study design was employed. Following ethical approval and written informed consent, data were collected daily, for four weeks, from at risk patients within an acute care facility in Ireland. Data included nurses documented assessment of the patient's skin condition and researcher led sub epidermal moisture measurement, over the sacrum and both heels...
June 25, 2018: Journal of Tissue Viability
Kerstin Hug, Caroline Stumm, Isabelle Debecker, Carolina Saskia Fellinghauer, Claudio Peter, Margret Hund-Georgiadis
BACKGROUND: Pressure ulcers (PUs) are a common and severe health condition in persons with spinal cord injury (SCI). Skin-care strategies for PU prevention are usually provided during initial rehabilitation. However, individuals with SCI often do not perform these strategies continuously, especially after discharge. The influence of psychological factors such as general self-efficacy (GSE) on the performance of PU prevention behavior has not yet been sufficiently explored. OBJECTIVE: To investigate whether persons with greater levels of GSE are more likely to perform skin-care strategies for PU prevention regularly...
June 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Martin Wf van Leen, Joseph Mga Schols, Steven Er Hovius, Ruud Jg Halfens
Pressure ulcers (PUs) are an important and distressing problem in Dutch nursing homes. A secondary analysis of longitudinal data from the Dutch National Prevalence Measurement of Care Problems (LPZ) - an annual, multicenter, point-prevalence survey - was conducted for the years 2005-2014 to determine the use of specific recommended PU preventive measures from the European Pressure Ulcer Advisory Panel 1998, the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel 2009, and the 2002 and 2011 Dutch PU guidelines...
September 2017: Ostomy/wound Management
Suzanne E Courtwright, Kari A Mastro, Christa Preuster, Navid Dardashti, Sandra McGill, Myrlene Madelon, Donna Johnson
PURPOSE: This review focuses on identifying (1) evidence of the effectiveness of care bundle methodology to reduce hospital-acquired pressure ulcers (HAPUs) in pediatric and neonatal patients receiving extracorporeal membrane oxygenation (ECMO) therapy and (2) barriers to implementing HAPU care bundles in this at-risk population. DESIGN AND METHODS: An integrative review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
October 2017: Journal for Specialists in Pediatric Nursing: JSPN
Donna Martin, Lisa Albensi, Stephanie Van Haute, Maria Froese, Mary Montgomery, Mavis Lam, Kendra Gierys, Rob Lajeunesse, Lorna Guse, Nataliya Basova
BACKGROUND: In 2013, an observational survey was conducted among 242 in-patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence-based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled "Healthy Skin Wins" with an online tutorial about PU prevention. AIMS: To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP...
December 2017: Worldviews on Evidence-based Nursing
Jennifer A Whitty, Elizabeth McInnes, Tracey Bucknall, Joan Webster, Brigid M Gillespie, Merrilyn Banks, Lukman Thalib, Marianne Wallis, Jose Cumsille, Shelley Roberts, Wendy Chaboyer
BACKGROUND: Pressure ulcers are serious, avoidable, costly and common adverse outcomes of healthcare. OBJECTIVES: To evaluate the cost-effectiveness of a patient-centred pressure ulcer prevention care bundle compared to standard care. DESIGN: Cost-effectiveness and cost-benefit analyses of pressure ulcer prevention performed from the health system perspective using data collected alongside a cluster-randomised trial. SETTINGS: Eight tertiary hospitals in Australia...
October 2017: International Journal of Nursing Studies
Jenny Alderden, June Rondinelli, Ginette Pepper, Mollie Cummins, JoAnne Whitney
OBJECTIVE: To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients. DESIGN: We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. DATA SOURCES: We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus...
June 2017: International Journal of Nursing Studies
Helen E Edwards, Anne M Chang, Michelle Gibb, Kathleen J Finlayson, Christina Parker, Maria O'Reilly, Jan McDowell, Patricia Shuter
AIMS AND OBJECTIVES: To evaluate the implementation of the Champions for Skin Integrity model on facilitating uptake of evidence-based wound management and improving skin integrity in residents of aged care facilities. BACKGROUND: The incidence of skin tears, pressure injuries and leg ulcers increases with age, and such wounds can be a serious issue in aged care facilities. Older adults are not only at higher risk for wounds related to chronic disease but also injuries related to falls and manual handling requirements...
December 2017: Journal of Clinical Nursing
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
Minjuan He, Amao Tang, Xuedi Ge, Jie Zheng
OBJECTIVE: The aim of this study was to determine whether skin barrier factors were associated with the common complication of pressure ulcers (PrUs) in intensive care unit (ICU) patients. It is unclear whether skin barrier factors influence the development of PrUs. PATIENT POPULATION: The sample was composed of 102 ICU patients (54 men, 48 women). The patients ranged in age from 23 to 88 years, with a mean age of 55.7 (SD, 19.1) years. METHODS: Demographic variables and the score for the Acute Physiology and Chronic Health Evaluation IV were recorded on admission...
November 2016: Advances in Skin & Wound Care
Nahla Tayyib, Fiona Coyer
BACKGROUND: Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention...
December 2016: Worldviews on Evidence-based Nursing
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
February 2017: International Wound Journal
Justine Baron, Jillian Swaine, J Presseau, Arlene Aspinall, Susan Jaglal, Barry White, Dalton Wolfe, Jeremy Grimshaw
BACKGROUND: Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI...
September 6, 2016: Systematic Reviews
Lisa Heuch, Judith Streak Gomersall
BACKGROUND: The incidence of foot ulceration related to diabetes is increasing. Many foot care professionals recommend offloading measures as part of management strategies for modulating excess pressure to prevent development of diabetic foot ulcers (DFUs). These measures may include padding, insoles/orthotic devices and footwear. There is a lack of evidence-based guidance on the effectiveness of the different offloading options for preventing primary ulceration in those with diabetes...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
Nahla Tayyib, Fiona Coyer
The objective of this review is to identify the effectiveness of pressure ulcer (PU) prevention strategies on the incidence of hospital-acquired PUs in the intensive care unit (ICU).More specifically, the objectives are to identify the effectiveness of utilizing PU prevention strategies such as risk assessment, skin assessment, skin care, nutrition, position and repositioning, education and training, medical devices care or other strategies designed to manage the risk factors for PU development and reduce the incidence of PUs in ICUs...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Natalie Campbell
This article describes how an interprofessional project in a London NHS Foundation Trust was undertaken to develop an intranet-based medical device-related pressure ulcer prevention and management pathway for clinical staff working across an adult critical care directorate, where life-threatening events require interventions using medical devices. The aim of this project was to improve working policies and processes to define key prevention strategies and provide clinicians with a clear, standardised approach to risk and skin assessment, equipment use, documentation and reporting clinical data using the Trust's CareVue (electronic medical records), Datix (incident reporting and risk-management tool) and eTRACE (online clinical protocol ordering) systems...
August 11, 2016: British Journal of Nursing: BJN
Haitham W Tuffaha, Shelley Roberts, Wendy Chaboyer, Louisa G Gordon, Paul A Scuffham
OBJECTIVE: To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. DESIGN: An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. PATIENTS: Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year...
June 2016: Advances in Skin & Wound Care
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