Pressure ulcers in the intensive care unit: the relationship between nursing workload, illness severity and pressure ulcer risk

Cremasco, Mariana Fernandes; Wenzel, Fernanda; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

doi:10.1111/j.1365-2702.2012.04216.x

Cited by 122 publications

(123 citation statements)

References 25 publications

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“…No significant differences were found between PU and changing position, conflicting with the literature. This can be ascribed to the fact that PU results from many factors (9)(10)(11)(12)21,25).…”

Section: Discussionmentioning

confidence: 99%

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The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

et al. 2016

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IntroductionA pressure ulcer (PU) is localized tissue damage in the dermis and subdermis caused by compression, friction, shearing, and other factors (1). It is commonly encountered in all hospitalized patients, especially those in intensive care units (ICUs) (2). The incidence of PU was found to increase from 4% to 49% in Denmark and vary from 38% to 24% in Germany (3) and from 14% to 42% in the United States (4,5). Studies from Turkey showed that the incidence of PU varied between 15% and 29% (6-8).Mobilization, sensorial perceptions, and consciousness in patients in ICUs are impaired due to the administration of sedative and anesthetic agents (9-11). It has been shown that vasopressin administered to maintain sufficient cardiac output in ICUs leads to constriction in the capillary circulation, which prevents oxygen and blood supply to the skin. This creates a risk of PU (12). Changes in metabolism resulting from such conditions as major surgery, burns, major trauma, and sepsis in ICUs increase the risk of PU development (9-13). In addition, the risk of PU is increased due to impairment of hemodynamic status, cardiovascular diseases, circulatory failure, impaired oxygenation, diabetes mellitus, anemia, infection, edema, catabolic disorders, and pressure (4,10,11,14). In a systematic review, it was reported that PU is not caused by a single factor, but rather develops due Background/aim: This study aimed to determine the incidence of pressure ulcers in patients on mechanical ventilation and selected risk factors likely to play a role in pressure ulcer development. Materials and methods:The study included 110 patients recruited from an anesthesia critical care unit of a university hospital. Data were collected with a demographic and clinical characteristics form. The form was composed of questions about demographic characteristics and clinical features including diagnosis, duration of mechanical ventilation, general well-being, oxygenation, perfusion, and skin condition. Results:The incidence of pressure ulcer was 15.5%. Duration of mechanical ventilation was longer and the body mass index was higher in patients developing pressure ulcers than in those without pressure ulcers. Additionally, 90.11% of patients with pressure ulcers had edema and 82.35% of patients with pressure ulcers received vasopressin. The patients with pressure ulcers had higher PH levels, lower PaO2 levels, higher PCO2 levels, lower SaO2 levels, and higher urine output. Conclusion:It can be recommended that nurses and other health professionals should be aware of factors playing a role in pressure ulcer development and should be able to conduct appropriate interventions to prevent pressure ulcers.

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Section: Discussionmentioning

confidence: 99%

“…Nurses can enhance the quality of nursing care, decrease the length of stay in ICUs and at the hospital, reduce health costs by diagnosing risk factors of PUs completely, and use appropriate strategies for prevention of PU (21). There have been few studies on this issue in Turkey (17).…”

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confidence: 99%

The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

et al. 2016

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“…The higher the score, the greater the time required for nursing care. The NAS has been used in both public and private hospitals, (6,(18)(19) and is widely used to measure the workload of nursing staff.…”

Section: Discussionmentioning

confidence: 99%

Carga de trabalho de enfermagem: preditor de infecção relacionada à assistência à saúde na terapia intensiva?

Nogueira

Ferretti-Rebustini

Poveda

et al. 2015

Rev. esc. enferm. USP

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RESUMO Objetivo Analisar a influência da carga de trabalho de enfermagem na ocorrência de infecção relacionada à assistência à saúde (IRAS) em pacientes na Unidade de Terapia Intensiva (UTI), segundo o tipo de tratamento. Método Estudo de coorte retrospectivo desenvolvido em nove UTI em São Paulo, Brasil, de setembro a dezembro de 2012. A carga de trabalho de enfermagem foi mensurada pelo Nursing Activities Score (NAS). Os testes T-Student, Exato de Fisher e regressões logísticas foram utilizados nas análises. Resultados A casuística foi composta por 835 pacientes (54,3±17,3 anos; 57,5% do sexo masculino), dentre os quais 12,5% adquiriram IRAS na UTI. O NAS dos pacientes admitidos para tratamento clínico foi de 71,3±10,9 e para cirúrgico, 71,6±9,2. O tempo de permanência na unidade e a gravidade foram fatores preditivos para ocorrência de IRAS em pacientes admitidos nas UTI para tratamento clínico ou cirúrgico e o sexo masculino apenas para pacientes cirúrgicos. Ao considerar as admissões independentes do tipo de tratamento, além das variáveis citadas, o índice de comorbidades também permaneceu no modelo de regressão. O NAS não foi fator preditivo de IRAS. Conclusão A carga de trabalho de enfermagem não exerceu influência na ocorrência de IRAS nos pacientes deste estudo.

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“…De acordo com outro estudo (13) , a elevada demanda de pacientes para um contingente insuficiente de enfermeiros aumenta expressivamente a ocorrências de incidentes associados à assistência. O presente estudo evidenciou que a excessiva carga de trabalho da equipe de enfermagem aumenta proporcionalmente a incidência de UP, quedas e erros de medicação, pois a razão entre as horas disponíveis de enfermagem para o quantitativo de profissionais relaciona-se diretamente à segurança do paciente e a assistência de qualidade (14) .…”

Section: Discussionunclassified

Fatores De Risco Dos Diagnósticos De Enfermagem Do Domínio Segurança/Proteção: Revisão Integrativa

Moura¹,

Araújo²,

Pitombeira³

et al. 2016

Cogitare Enferm.

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Pressure ulcers in the intensive care unit: the relationship between nursing workload, illness severity and pressure ulcer risk

Cited by 122 publications

References 25 publications

The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

The incidence of pressure ulcer in patients on mechanical ventilation andeffects of selected risk factors on pressure ulcer development*

Carga de trabalho de enfermagem: preditor de infecção relacionada à assistência à saúde na terapia intensiva?

Fatores De Risco Dos Diagnósticos De Enfermagem Do Domínio Segurança/Proteção: Revisão Integrativa

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