Preventing Pressure Ulcers: A Systematic Review

Reddy, Madhuri; Gill, Sudeep S.; Rochon, Paula A.

doi:10.1001/jama.296.8.974

Cited by 702 publications

(557 citation statements)

References 83 publications

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“…These guidelines show strong evidence for using a low interface pressure mattress rather than a normal mattress with patients at risk of developing PUs (19) . Specialized support surfaces (such as mattresses, beds and pillows) help reduce or relieve the pressure that the weight of the body of the patient has on the skin and subcutaneous tissues when they are pressed against the surface of the bed or chair (20) .…”

Section: Results Regarding the Preventive Measuresmentioning

confidence: 99%

“…The aim of the repositioning and of the support surfaces is to reduce or eliminate the interface pressure and, thus, to improve the microcirculation in the regions of the body that are at risk (20) . The change in decubitus position and hydration of the skin of patients at risk for PU depend solely on the nurse making the prescription and the implementation of it by the nursing team.…”

Section: Results Regarding the Preventive Measuresmentioning

confidence: 99%

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Validade preditiva da escala de Braden para pacientes de terapia intensiva

Costa¹,

Caliri

2011

Acta paul. enferm.

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Objectives: To evaluate the predictive validity of the Braden Scale scores in patients in an intensive care unit and to describe the preventive measures implemented by the nursing staff. Methods: A prospective, descriptive study with data collected from medical records, physical examination, and application of the Braden Scale in 23 patients. Results: The results of tests of predictive validity produced scores of 14, 13 and 12 with the most efficient in predicting risk for pressure ulcers, in the first, second and third assessments, with their respective values of sensitivity (95%, 95% and 94%) and specificity (45%, 55% and 77%). Conclusion: We concluded that the Braden Scale is an efficient tool for early identification of risk and to support the development of a plan of care to prevent skin damage in critically ill patients. Keywords: Pressure ulcer/prevention & control; Inpatients; Intensive care units; Predictive value of tests; Sensitivity and specificity RESUMOObjetivos: Avaliar a validade preditiva dos escores da escala de Braden em pacientes de um Centro de Terapia Intensiva e descrever as medidas preventivas implementadas pela equipe de enfermagem. Métodos: Estudo prospectivo descritivo cujos dados foram coletados por meio de prontuário, exame físico e aplicação da Escala de Braden em 23 pacientes. Resultados: O resultado dos testes de validade preditiva apontou os escores 14, 13 e 12 como os mais eficientes na predição de risco para úlcera por pressão, nas primeira, segunda e terceira avaliações, com seus respectivos valores de sensibilidade (95%, 95% e 94%) e especificidade (45%, 55% e 77%).Conclusão: Concluiu-se que a escala de Braden é um instrumento eficiente para identificar precocemente o risco e para subsidiar a elaboração de um plano de cuidado capaz de prevenir danos na pele de pacientes em estado críticos. Descritores: Úlcera por pressão/prevenção; controle; Pacientes internados; Unidades de Terapia Intensiva; Valor preditivo dos testes RESUMEN Objetivos: Evaluar la validez predictiva de los escores de la escala de Braden en pacientes de un Centro de Cuidados Intensivos y describir las medidas preventivas implementadas por el equipo de enfermería. Métodos: Estudio prospectivo descriptivo cuyos datos fueron recolectados por medio de la historia clínica, examen físico y la aplicación de la Escala de Braden a 23 pacientes. Resultados: El resultado de los tests de validez predictiva apuntó los escores 14, 13 y 12 como los más eficientes en la predicción de riesgo para úlcera por presión, en las primera, segunda y tercera evaluaciones, con sus respectivos valores de sensibilidad (95%, 95% y 94%) y especificidad (45%, 55% e 77%). Conclusión: Se concluyó que la escala de Braden es un instrumento eficiente para identificar precozmente el riesgo y para subsidiar la elaboración de un plan de cuidados capaz de prevenir daños en la piel de pacientes en estado crítico.

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Section: Results Regarding the Preventive Measuresmentioning

confidence: 99%

Section: Results Regarding the Preventive Measuresmentioning

confidence: 99%

Validade preditiva da escala de Braden para pacientes de terapia intensiva

Costa¹,

Caliri

2011

Acta paul. enferm.

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“…Three were found, however these were not restricted to ENT, and/or did not perform extensive searches in databases, and/or had not been properly updated. The first review (16) included eight studies that dated from 1971 to 1995, the second (17) had four from 1990 to 2002, and the third (18) had seven studies from 1971 to 2006. In this review ten studies published between 1971 to 2012 were included, of which five had more recent publication years to the other reviews.…”

Section: Discussionmentioning

confidence: 99%

“…In 2008, an SR evaluating treatments available for PU nutritional interventions included seven RCTs and the authors found that the protein supplementation promoted the healing of ulcers compared with placebo (Scale Healing average score 3.55 [4.66] vs. 3.22 [4:11], p <0.05), but there is little evidence to justify routine use of ENT compared to the standard treatment for PU healing (18) .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Enteral Nutritional Therapy in the Healing Process of Pressure Ulcers: A Systematic Review

Blanc

Meier

Stocco

et al. 2015

Rev. esc. enferm. USP

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Efetividade da terapia nutricional enteral no processo de cicatrização das úlceras por pressão: revisão sistemática Efectividad de la terapia de nutrición enteral en el proceso de cicatrización de las úlceras por presión: revisión sistemática ABSTRACT Objective: To evaluate the effectiveness of enteral nutritional therapy (ENT) in the healing process of pressure ulcers (PU) in adults and the elderly. Method: A systematic review whose studies were identified through the databases of Cochrane, MEDLINE/ PubMed, SciELO, LILACS, EMBASE, CINAHL, Web of Science, and manual searches. It included randomized clinical trials (RCTs) without delimiting the period or language of publication, which addressed adults and elderly patients with pressure ulcers in a comparative treatment of enteral nutritional therapy and placebo or between enteral nutritional therapy with different compositions and dosages. Results: We included ten studies that considered different interventions. It resulted in more pressure ulcers healed in the groups that received the intervention. The included studies were heterogeneous with regard to patients, the type of intervention, the sample and the follow-up period, all of which made meta-analysis impossible. Conclusion: Although the enteral nutritional therapy demonstrates a promotion of pressure ulcer healing, sufficient evidence to confirm the hypothesis was not found.

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“…Pressure ulcer prevention requires regular follow-up to identify changes in clinical status and daily skin inspections to detect early evidence of pressure-induced skin damage [142]. For high-risk individuals, regular turning and repositioning schedule with particular attention to vulnerable tissue covering bony prominences are recommended [143]. Sufficient staffing levels are necessary for effective pressure ulcer prevention [144].…”

Section: Pressure Ulcersmentioning

confidence: 99%

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

Xing¹,

Mukamel²,

Glance³

et al. 2016

WHM

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2013ii Biographical SketchThe author was born in Shanghai, China. She attended Shanghai Second Medical This dissertation provides evidence that linking Medicaid reimbursement rate to each NH's own expenditures and incentivizing NHs to invest in direct care were effective ways in achieving quality improvement. Refinements of current Medi-Cal reimbursement policy might be needed to encourage NHs to make larger investments. However, maximizing NHs' spending on direct care cannot be relied on as the only policy strategy to improve quality of care. vii Contributors and Funding SourcesThis work was supervised by a dissertation committee consisting of Professors

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Preventing Pressure Ulcers: A Systematic Review

Cited by 702 publications

References 83 publications

Validade preditiva da escala de Braden para pacientes de terapia intensiva

Validade preditiva da escala de Braden para pacientes de terapia intensiva

Effectiveness of Enteral Nutritional Therapy in the Healing Process of Pressure Ulcers: A Systematic Review

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

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