The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial

Camargo, Wesley Henrique Bueno de; Pereira, Rita; Tanita, Marcos Toshiyuki; Heko, Lidiane; Grion, Isadora C; Festti, Josiane; Mezzaroba, Ana Luiza; Grion, Cíntia Magalhães Carvalho

doi:10.1155/2018/3712067

Cited by 15 publications

(21 citation statements)

References 29 publications

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“…With only a few ripple mattresses available in the health facilities, more equipment and pressure reducing devices need to be purchased to support patient care. The findings compare with a randomized clinical trial conducted in Brazil, which found reduced incidences of Pressure ulcers among moderate or higher risk critically ill patients who used viscoelastic support surfaces (Bueno de Camargo et al, 2018). This also agrees with the findings of a study conducted in Ethiopia on the prevalence and risk factors associated with Pressure ulcers which reported pressure-relieving devices as significant in reducing the prevalence of Pressure ulcers (Bereded, Salih & Abebe, 2018).…”

Section: Institutional Factors Affecting Management Of Pressure Ulcers Among Nursessupporting

confidence: 88%

Nurses’ Management of Patients with Pressure Ulcers in Selected Health Facilities in Murang’a County, Kenya

Njoroge

Kabue

Ochieng

2021

East Afr. j. health sci.

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Pressure ulcers are a common health problem in hospitalized patients, especially among patients with chronic illnesses and those with reduced mobility. The prevalence of pressure ulcers varies with health care settings and is highest in critically ill patients ranging between 15-20%. They affect the quality of life of patients and caregivers and have been associated with heavy financial burdens, extended hospital stays, higher morbidity and mortality. Inadequate prevention measures and lack of active management of pressure ulcers in early stages especially in high-risk patients result in recurrence and complicated pressure ulcers. In view of this, a descriptive cross-sectional study was conducted in Murang’a County, Kenya in selected health facilities with the objective of determining the management of patients with pressure ulcers. The study population was composed of one hundred and twenty-four (124) nurses working in medical and surgical wards in selected health facilities. Semi-structured questionnaires, observational checklists and focused group discussions were used to collect data. The qualitative data from the focus group discussions and observational checklist were transcribed and a summary written. The relationship between nurse’s knowledge, nurse-oriented factors and institutional factors affecting management of pressure ulcers among nurses were examined using Pearson correlation analysis and multiple regression analysis. The median age of the respondents was 37 years with at least 112 (90.3%) having diploma level of education, and 63 (50.9%) were from the medical department. The majority of the nurses (93.6%) agreed pressure ulcers can be avoided, while 58.1% preferred pressure ulcer risk assessment tools compared to 27.5% who preferred clinical judgment in the management of pressure ulcers. The majority of nurses (87.5%) who had adequate knowledge on the management of pressure ulcers mentioned immobility and bedridden patients, stroke, spinal injury, dry skin, stool and urine incontinence as major contributors to pressure ulcers. Regarding pressure ulcer risk assessment, 62.9% of nurses assessed patients for pressure ulcers though they relied on clinical judgement as 93.9% indicated there was no risk assessment scale in the wards and 5.1% were not sure. On institutional factors 61.3% of the nurses indicated that health facilities were lacking pressure ulcer reducing devices and those that had pillows and a few ripple mattresses. Regarding guidelines in the management of pressure ulcers, 75.8% of nurses indicated they were not available in the hospital. The study found an association between age and knowledge increasing the odds of effective management age (AOR = 6.83, p = 0.001); experience (AOR = 4.08, p = 0.01), and education (AOR = 22.9, p = 0.000). The nurse-oriented factors increasing the odds of effective management of pressure ulcers include nurse’s positive attitude on prevention of pressure ulcers (AOR = 2.3, p = 0.040) and nurse use of pressure ulcer risk assessment tool (AOR = 4.3, p = 0.010). On institutional factors, nurses trained on management of pressure ulcers were 4.47 times likely to effectively manage patients with pressure ulcers. Nurses who lack in-service training about pressure ulcers were less likely to effectively manage patients with pressure ulcers (AOR = 0.11, p = 0.000). The study concludes that the nurses had adequate knowledge in management of pressure ulcers, the nurses-oriented factors and institutional factors also influence the management of pressure ulcers

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Section: Institutional Factors Affecting Management Of Pressure Ulcers Among Nursessupporting

confidence: 88%

Nurses’ Management of Patients with Pressure Ulcers in Selected Health Facilities in Murang’a County, Kenya

Njoroge

Kabue

Ochieng

2021

East Afr. j. health sci.

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“…The result showed that there was a significant difference in pressure injury prevention (p=0.44). This was in line with a study by de Camargo et al (2018) which found that pressure injury incidence with support surface was about 32.2% compared to the group with no support surface 80.6% (p≤0.001); viscoelastic could redistribute pressure and affect micro climate that could reduce skin moisture to prevent pressure injuries. Studies showed that the use of pressure air mattress and pillow to position patients successfully reduced pressure injuries, statistically significant about 4.1-17% (Lupe et al, 2015;Uzun et al, 2015).…”

Section: Support Surface (5 Th Strategy)supporting

confidence: 91%

Effects and Interventions of Pressure Injury Prevention Bundles of Care in Critically Ill Patients: A Systematic Review

Trisnaningtyas

Retnaningsih

Rochana

2021

Nurs. Med. J. Nursing

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Background: Many studies on pressure injury prevention bundles have been conducted outside the Intensive Care Unit (ICU). The bundles, which include multi interventions, have proven effective in reducing pressure ulcer incidents compared to a single intervention. However, the existing review studies on pressure injury prevention in ICUs still only investigate a single intervention rather than multi interventions. Only few reviews, to our knowledge, involves prevention bundle strategies in the ICU.Purpose: This study aims to review the effects of the pressure injury prevention bundles of care on the incidents of pressure injury in critically ill patients and the intervention measures of the care bundles.Methods: This review searched published articles from several databases, namely EBSCO, ScienceDirect, PubMed, ProQuest, Google Scholar, and Scopus from 2009 up to 2020. PRISMA flowchart was used to select relevant articles using several inclusion and exclusion criteria, resulting in 17 article from 50 eligible full-text articles for assessment. The included studies were assessed for their quality using Joanna Briggs Institute (JBI) critical appraisal tools. The synthesis was then conducted narratively.Results: As many as 17 studies, which mostly had good quality yet evidence level of II, were included in the analysis. The findings showed that the pressure injury prevention bundles of care decreased pressure injury incidents as many as 4.3%-36.2% in developed countries and 4.16%-21% in developing countries. Moreover, the bundles of care which significantly reduced the incidents of pressure injury consisted of 7 intervention measures, which were pressure injury risk assessment using Cubbin Jackson scale, skin assessment and care, repositioning, nutrition, education, support surface, and medical device care.Conclusion:The review concluded that the pressure injury prevention bundles of care in critically ill patients significantly reduced the incidents of pressure injury. The study recommends more studies with stronger evidence levels to carry out and utilize 7 intervention measures as a preventive standard of care in critically ill patients.

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“…A similar randomized clinical trial conducted by Bueno de Camargo et al [18], aiming to analyze whether a viscoelastic mattress support (intervention group) surface can reduce the incidence of stage II PUs compared with a standard hospital mattress (control group) with pyramidal overlay in critically ill patients, found that the frequency of PU was higher in the control group compared with the intervention group.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study Between Two Support Surfaces for Pressure Ulcer Prevention and Healing in ICU Patients

Marvaki

Kourlaba

Kadda

et al. 2020

Cureus

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The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clinical Trial

Cited by 15 publications

References 29 publications

Nurses’ Management of Patients with Pressure Ulcers in Selected Health Facilities in Murang’a County, Kenya

Nurses’ Management of Patients with Pressure Ulcers in Selected Health Facilities in Murang’a County, Kenya

Effects and Interventions of Pressure Injury Prevention Bundles of Care in Critically Ill Patients: A Systematic Review

A Comparative Study Between Two Support Surfaces for Pressure Ulcer Prevention and Healing in ICU Patients

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