How Early Intervention Prevents and Minimizes Pressure Ulcer Formation

How Early Intervention Prevents and Minimizes Pressure Ulcer Formation

Reference Problem Purpose Sample/population Data Collections Major Findings/Conclusions Relation to PICO
Cano, A., Anglade, D., Stamp, H., Lopez, J., Lupe, L., Schmidt, S.P., & Young, D.L. (2015, Sep). Improving outcomes by implementing a pressure ulcer prevention program (PUPP): Going beyond the basics. Healthcare (Basel), 3(3), 544-85.

 

Prevalence of hospital-acquired pressure ulcers. To identify the prevalence of hospital-acquired pressure ulcers (HAPU) at the University of Miami Hospital (UMH) and implement measures to reduce the incidence. 305 hospitalized patients at UMH The Braden Scale was used to determine pressure ulcer risk among patients. The equipment checks for factors like mobility, and nutrition of patients. Nurses were taught how to use the tool to ensure they report accurate information. Hospital mattresses were replaced with supporting surfaces that help patients’ skins to remain dry. New assessment program and monitoring of HAPUs patients was also implemented. Preventive measures were established for patients who scored under 18 on the Braden Scale while treatment was started for stage I and II patients with PUs.Monthly and quarterly surveillance of pressure ulcers was also conducted for two years to determine patients admitted with PUs and those that developed in hospital. 53 patients out of 305 had PUs and only two of them had acquired it in hospital. After the initial intervention, the rate of PUs dropped by 2.1% while the prevalence of HAPU during the first three quarters dropped and rose by 5.1% in the fourth quarter. After staff re-education was administered, the rate of HAPU dropped in the following four quarters but rose again in the first quarter. Since rates of HAPU decreased during the intervention and increased after, it is shown that replacing mattress surfaces and providing nursing education help to decrease the prevalence of PUs.
Fagan, M. (2015, Dec 22). Early prevention of pressure ulcers in the emergency department. Seton Hall University DNP Final Projects.

 

 

Pressure ulcers in the emergency department. To educate primary emergency room nurses on health and safety of patients at risk of PUs. To initiate early intervention strategies to prevent PUs. 50-bed emergency department. The Braden Scale was used to identify at-risk patients. Nurses were first taught how to use the PU screening tool to enable them to report cases of the condition once they encountered them in the emergency rooms. Patients were completely undressed and pressure redistribution mattresses and mattress overlays were used. Results indicated that that early intervention had a negative association on PUs pain and reduced lengths of hospital stay. Early intervention through educational learning that promotes use of pressure redistribution mattresses and mattress overlays minimize and prevent pressure ulcer formation.
Loikkanen, R. & Tammi, M. (2016, Nov 28). Pressure ulcer prevention and its implementation in practice – A literature review. Helsinki Metropolia University of Applied Sciences.

 

High prevalence of pressure ulcers. Describe the implementation of the guidelines of PUs prevention. Existing studies on pressure PUs prevention and guideline implementation. A literature review of existing research was conducted. A qualitative analysis of 12 articles was done. Data-driven content analysis was utilized to interpret the studies and provide knowledge. High compliance to PU guidelines was associated with a significant drop in the prevalence of PUs in one study. Another study on PU guidelines adherence with clinical support was analyzed. The results indicated that prevention of patients against PUs increased when seated on chair in experiment wards. No significant impact of clinical support was noted.The analysis revealed the need for more research on PU guidelines implementation due to inconsistent results. Adherence to PU guidelines was shown to prevent and reduce pressure ulcer formation.
Marangi, G.F., Pallara, T., Cagli, B., Schena, E., Giurazza, F., Faiella, E., Zobel, B.B., &Persichetti, P. (2014, April 10). Treatment of early-stage pressure ulcers by using autologous adipose tissue grafts. Plastic Surgery International.

 

Progression of early-stage PUs. To treat and prevent the progression of early-stage PUs through fat grafting. 42 patients with early-stage PUs at Campus Bio-Medico Ri Roma University in Italy. A longitudinal experiment was conducted for two years at Campus Bio-Medico Rio Roma University. The sampling criteria included patients with stage I PUs or deep tissue injury, bedsore stage PUs, patients that are resistant to common ulcer intervention, and those with wounds localized on the sacral. Ultrasonography was performed on patients to assess skin and subcutaneous tissue. Fat grafting surgery was then performed. There was a slight increase in the thickness of skin of PUs that was lower at baseline. In addition, the subcutaneous tissue at baseline indicated low vascularization relative to underlying tissue. After fat grafting, there was a significant increase in the density of vascular spots. Wounds healed faster and inflammation dropped. Other notable results were increased elasticity of skin, disappearance of fixed erythema, and increased distensibility of skin. Autologous adipose tissue grafting is an effective intervention of stage I PUs.

 

 

 

References

Cano, A., Anglade, D., Stamp, H., Lopez, J., Lupe, L., Schmidt, S.P., & Young, D.L. (2015, Sep). Improving outcomes by implementing a pressure ulcer prevention program (PUPP): Going beyond the basics. Healthcare (Basel), 3(3), 544-85. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939557/

Fagan, M. (2015, Dec 22). Early prevention of pressure ulcers in the emergency department. Seton Hall University DNP Final Projects. Retrieved from https://scholarship.shu.edu/cgi/viewcontent.cgi?article=1008&context=final-projects

Loikkanen, R. & Tammi, M. (2016, Nov 28). Pressure ulcer prevention and its implementation in practice – A literature review. Helsinki Metropolia University of Applied Sciences. Retrieved from https://www.theseus.fi/bitstream/handle/10024/118842/Rosa_Loikkanen%20Mariam_Tammi.pdf?sequence=1

Marangi, G.F., Pallara, T., Cagli, B., Schena, E., Giurazza, F., Faiella, E., Zobel, B.B., &Persichetti, P. (2014, April 10). Treatment of early-stage pressure ulcers by using autologous adipose tissue grafts. Plastic Surgery International. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003771/