A critique of ‘at risk’ pressure sore assessment tools

Smith, Lawrence D.; Booth, Nicholas H.; Douglas, D. M.; Wg, Robertson; Walker, Andrew; Durie, M; Fraser, Alasdair R.; Hillan, E H; Swaffield, Jean

doi:10.1111/j.1365-2702.1995.tb00200.x

Cited by 45 publications

(29 citation statements)

References 16 publications

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“…The HAPU prevention program was planned during 2012, and the following interventions were • Braden scores 1 were grouped into risk categories (at risk, 15-18; moderate risk, 13-14; high risk, ≤12), 13 which were used to indicate specific steps for proper management of moisture, nutrition, mobility, friction, and shear in hospitalized patients.…”

Section: Methodsmentioning

confidence: 99%

Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit

Swafford

Culpepper

Dunn

2016

American Journal of Critical Care

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Background Hospital-acquired pressure ulcers (HAPUs) are a costly and largely preventable complication occurring in a variety of acute care settings. Because they are considered preventable, stage III and IV HAPUs are not reimbursed by Medicare. Objectives To assess the effectiveness of a formal, year-long HAPU prevention program in an adult intensive care unit, with a goal of achieving at least a 50% reduction in 2013, compared with 2011. Methods Planning for the prevention program began in 2012, and the program was rolled out in the first quarter of 2013. Program components included use of Braden scores, a revised skin care protocol, fluidized repositioners, and silicone gel adhesive dressings. Efforts were made to educate and motivate staff and encourage them to be more proactive in detecting patients at risk of HAPUs. Results Incidence of HAPUs in the unit was reduced by 69% (n = 17; 3% of patients in 2013 vs n = 45, 10% of patients in 2011), despite a 22% increase in patient load. The potential cost saving as a result of this decrease was approximately $1 million. Conclusions A comprehensive, proactive, collaborative ulcer prevention program based on staff education and a focus on adherence to protocols for patient care can be an effective way to reduce the incidence of HAPUs in intensive care units.

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Section: Methodsmentioning

confidence: 99%

Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit

Swafford

Culpepper

Dunn

2016

American Journal of Critical Care

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“…The predictive value of a diagnostic test or risk scale, however, depends on the prevalence of the condition in the target population. Hence, in case of high prevalence levels, the probability that a positive test will better predict the condition increases (4) .…”

Section: Introductionmentioning

confidence: 99%

“…The latter, created in the United States in 1987, went through validation and adaptation to Portuguese and was also adapted to the pediatric population in the Braden Q version. This scale has been the most used and widely tested so far (4,(8)(9) , as it shows the best operational definition and demonstrates higher sensitivity and specificity levels than other scales, as it serves to assess six risk factors (sub-scales) in the client (1)(2)5,10) .…”

Section: Introductionmentioning

confidence: 99%

Avaliação de risco para úlcera por pressão em pacientes críticos

Gomes

Bastos

Matozinhos

et al. 2011

Rev. esc. enferm. USP

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Portuguese / English: www.scielo.br/reeusp RESUMO Pacientes acamados apresentam risco de desenvolver úlceras por pressão e representam um grupo prioritário para o estudo e identificação deste agravo. Para tal, utilizamse instrumentos de avaliação específicos para o problema. O objetivo deste estudo foi analisar os fatores de risco para o desenvolvimento de úlcera por pressão em pacientes adultos internados em CTIs. Trata-se de um estudo seccional analítico no qual foram avaliados 140 pacientes, internados em 22 CTIs, utilizando-se a escala de Braden. Os resultados mostraram que pacientes internados por 15 dias ou mais apresentavam alguma categoria de risco. As maiores freqüências de úlcera por pressão foram encontradas em pacientes que estavam nas categorias: percepção sensorial (completamente limitado), umidade (constantemente úmida), mobilidade (completamente imobilizado), atividade (acamado), nutrição (adequado) e fricção e cisalhamento (problema). Conclui-se que a utilização dessa escala traduz-se em estratégia importante no cuidar de pacientes em terapia intensiva. DESCRITORES ABSTRACTBedridden patients are in risk to developing pressure ulcers and represent a priority group to be studied to identify this condition. To reach this goal, specific instruments are used to assess this problem. The objective of this study was to analyze the risk factors to developing pressure ulcers in adult patients hospitalized in ICUs. This is a sectional analytical study, in which evaluations were performed on 140 patients, hospitalized in 22 ICUs, using the Braden scale. Results showed that patients hospitalized from 15 days or more showed some level of risk. The highest frequencies of pressure ulcers were found in patients in the following categories: sensorial perception (completely limited), moistness (constantly moist), mobility (completely immobilized), activity (bedridden), nutrition (adequate) and friction and shear (problem). In conclusion, the use of this scale is an important strategy when providing care to patients in intensive treatment. DESCRIPTORS Pressure ulcer Risk assessment Intensive Care Units Nursing RESUMENLos pacientes internados presentan riesgo de desarrollar úlceras por presión y representan un grupo prioritario para el estudio e identificación de este agravamiento. A tal fin, se utilizaron instrumentos de evaluación específicos. El estudio objetivó analizar los factores de riesgo para el desarrollo de úlcera por presión en pacientes adultos internados en CTIs. Estudio seccional analítico, fueron evaluados 140 pacientes internados en 22 CTIs, usándose la Escala de Braden. Los resultados mostraron que pacientes internados por 15 días o más presentaban alguna categoría de riesgo. Se encontró mayor frecuencia de úlceras por presión en pacientes de las categorías: percepción sensoria (completamente limitado), humedad (constantemente húmeda), movilidad (completamente inmovilizado), actividad (en cama), nutrición (adecuado) y fricción y descamado (problema). Se concluye en que la utilización de la escala ...

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“…Esto ha permitido a diferentes autores (10,20,(23)(24)(25)(26)(27)(28) describir los requisitos que debe reunir la escala ideal o, lo que es igual, los criterios exigibles a una EVRUPP y, por tanto, los míni-mos necesarios para evaluar y validar una escala. Estos criterios serían:…”

Section: Objetivosunclassified

Escalas de valoración del riesgo de desarrollar úlceras por presión

Fernández¹,

Hidalgo²,

Ágreda

et al. 2008

Gerokomos

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RESUMENLas úlceras por presión (UPP) constituyen un importante problema de salud que afecta a todos los sistemas sanitarios desarrollados. Existe un amplio grado de consenso en considerar que la prevención constituye el método más eficiente de abordar el problema. La valoración del riesgo es un aspecto clave en la prevención. El objetivo de la valoración del riesgo es la identificación de los individuos que necesitan medidas de prevención y la identificación de los factores específicos que los ponen en situación de riesgo. Para ello se utilizan las escalas de valoración del riesgo. El presente documento técnico repasa el estado actual del conocimiento, deteniéndose en la definición y los objetivos de las escalas, en su desarrollo conceptual, que dota de las herramientas al investigador para validar cualquier escala, y repasa las cinco escalas validadas hasta la fecha: Braden, Norton, EMINA, Waterlow y Cubbin-Jackson. Seguidamente el documento hace un repaso de las evidencias disponibles en la literatura científica actual y las engloba en el apartado de recomendaciones para la práctica. El documento finaliza con el capítulo de recomendaciones a los investigadores donde se sugieren líneas de investigación para los próximos años en lo relacionado con las mismas. PALABRAS CLAVEEscalas de valoración, úlceras por presión, evidencias, documentos técnicos. SUMMARY Pressure ulcers are an important health problem worldwide. There is a wide consensus to consider prevention as the most efficient method to avoid this problem. Risk assessment is a key component in prevention. The aim of risk assessment is the identification of patients who need preventive measures and their specific risk factors. Risk assessment scales are tools to make the risk assessment. This technical report updates the knowledge about risk assessment scales, its definition and ob- INTRODUCCIÓNLas úlceras por presión (UPP) constituyen un importante problema de salud que afecta a todos los sistemas sanitarios desarrollados (1). En España tienen un considerable impacto epidemiológico, tanto por su prevalencia (que los datos del año 2005 estiman en 8,91% en hospitales y 9,11% en centros de Atención Primaria y en un 13% en residencias geriátricas (2)), como por su mortalidad (3).Existe un amplio grado de consenso entre las asociaciones científicas que consideran que la prevención constituye el método más eficiente de abordar el problema de las UPP (4-8).Habitualmente, se consideran cuatro grandes áreas en la aplicación de medidas de prevención (8):1. Valoración del riesgo de desarrollar una UPP. 2. Cuidados de la piel. 3. Reducción de la presión: con medidas generales, mediante el uso de superficies especiales de manejo de la presión, y locales, mediante apósito y otros materiales específicos. 4. Educación.

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A critique of ‘at risk’ pressure sore assessment tools

Cited by 45 publications

References 16 publications

Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit

Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit

Avaliação de risco para úlcera por pressão em pacientes críticos

Escalas de valoración del riesgo de desarrollar úlceras por presión

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