• Korean Journal of Adult Nursing
• /
• v.16 no.2
• /
• pp.183-190
• /
• 2004

Purpose: The purpose of this study was To exam the skin and pressure sore and To evaluate the predictive validity for the new pressure sores risk assessment scale. Method: There was finally 211 neurosurgery subject admitted in Chung-Ang Univ. Hospital from Nov, 11, 2002 to Feb, 11, 2003. Data was collected three times per week from 48-72hr after admission until incidence of pressure sores or discharge or die. Inclusion criteria were; (1) no pressure sores at admittance, (2) at least 3 times assessment, (3) adults older than 16yrs, (4) patients consent to participate in study. Result: 1. 34 case of 211 developed pressure sores(11.6%). 2. The coccyx area was the most common occurrence site of pressure sores. 3. At the cutoff point 23 of sensitivity 100%, specificity 76.3% was higher in 2003 than specificity 63.8% at the cutoff point 26 of sencitivity 100% in 1991. 4. "Moisture" of subscale for pressure sores risk factor was the strongest predictor. Conclusion: This study shows that the New Pressure Sores Risk Assessment Scale still predict the risk of developing pressure sores in neurosurgical subject.

• Journal of Korean Critical Care Nursing
• /
• v.12 no.2
• /
• pp.26-38
• /
• 2019

Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

• Journal of Korean Clinical Nursing Research
• /
• v.28 no.1
• /
• pp.45-53
• /
• 2022

Purpose: The purpose of this study was to evaluate risk factors of pressure injuries in patients after neurosurgery. Methods: A retrospective case-control study was conducted using 273 patients undergoing neurosurgery admitted to a general hospital from 2015 to 2021. Data were collected from September 1 to 30, 2021. The data were analyzed using the SPSS/WIN 26.0 program. Results: Risk factors significantly influencing the occurrence of pressure injuries in the patients undergoing neurosurgery were hypertension (OR=3.12, p=.024), postoperative hypoalbuminemia (OR=0.30, p=.028), and prolonged operative duration (OR=1.00, p=.001). The regression model explained 86.0% of the variance of the outcome variable. Conclusion: In order to prevent surgery-related pressure injuries in patients undergoing neurosurgery, thorough blood pressure management, avoidance of hypoalbuminemia, and preventive nursing intervention considering operative duration are required.

• Journal of the Korea Convergence Society
• /
• v.11 no.11
• /
• pp.443-450
• /
• 2020

The purpose of this study was to examine the inter-rater and intra-rater reliability of the oral mucosa pressure ulcer classification system based on the photographs. The study consisted of two stages; development and evaluation. In the developmental stage, 9 photographs of 82 were selected. In the evaluation stage, a total of 49 participants were invited web-based survey by e-mail. Cohen's weighted kappa and Krippendorff's alpha were used to define the inter-rater reliability. Nine photographs consisted of two, three, three, and one in normal, stage 1, stage 2, and stomatitis, respectively. The inter-rater reliabilities of wound care nurse specialist, intensive care nurse specialist, and dentist groups were 0.75, 0.70, and 0.78, respectively. The intra-rater reliability was 0.73. The inter-rater and intra-rater reliabilities of the oral mucosa pressure ulcer classification system showed substantially good agreement.

• Journal of the Korea Society of Computer and Information
• /
• v.27 no.12
• /
• pp.69-76
• /
• 2022

This paper proposes a method of refining and processing time-series data using Medical Information Mart for Intensive Care (MIMIC-IV) v2.0 data. In addition, the significance of the processing method was validated through a machine learning-based pressure ulcer early warning system using a dataset processed based on the proposed method. The implemented system alerts medical staff in advance 12 and 24 hours before a lesion occurs. In conjunction with the Electronic Medical Record (EMR) system, it informs the medical staff of the risk of a patient's pressure ulcer development in real-time to support a clinical decision, and further, it enables the efficient allocation of medical resources. Among several machine learning models, the GRU model showed the best performance with AUROC of 0.831 for 12 hours and 0.822 for 24 hours.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.11
• /
• pp.635-644
• /
• 2018

This descriptive study examined the practical nursing guidelines for the prevention of pressure injuries (PI) in operating rooms and their application. Method: Four general hospitals and three specialized hospitals located in Seoul, Incheon, and Gyeonggido province were selected through an online randomization program and nurses at these hospitals who participated in operations and had at least six months work experience were surveyed. Data were collected from January to April 2018 through a survey distributed to 150 nurses, 129 of whom returned the survey (86% recovery rate). The results showed that 43 nurses provided PI prevention care for patients in a lateral position (33.3%), 37 for patients in a supine position (28.7%), and 36 for patients in a prone position (27.9%). Gel was most widely used as the supporting surface material (102 nurses; 79.1%), followed by sponge (62 nurses; 48.1%), and cotton (47 nurses; 36.4%). Skin was often inspected twice, before and after the use of a supporting surface (90nurses; 69.8%), but no designated tool was used to determine the risk of PI developing (76 nurses; 58.9%). Additionally, the patient's position during surgery (83 nurses; 64.3%) and the length of the operation (i.e., more than two hours, in this case) (49 nurses; 38.0%) were determining factors for whether to use a supporting surface. The operating room nurses used the gel, sponge, and cotton as the supporting surfaces for the prevention of PI and confirmed that the cutoff operation time for the use of a supporting surface was more than 2 hours.

• Journal of Korean Clinical Nursing Research
• /
• v.17 no.3
• /
• pp.433-442
• /
• 2011

Purpose: The purpose of this study was to conduct a retrospective investigation on the general characteristics of pressure ulcer and influencing factors of pressure ulcer stage during hospitalization. Methods: A total of 614 patients were selected between January 1, and December 31, 2009 from one acute university hospital if they had pressure ulcers on admission or newly developed pressure ulcer during hospitalization. The data were analyzed using the SPSS WIN 12.0 with percentage, mean, standard deviation, t-test, Chi-square test, ANOVA, and multiple regression analysis. Results: Influencing factors of pressure ulcer stage at discharge were eating (${\beta}=-.068$, p=.047), elimination (${\beta}=-.145$, p<.001), active exercise and movement (${\beta}=-.505$, p<.001), albumin levels (${\beta}=.166$, p<.001), and inflammatory markers (CRP)(${\beta}=-.091$, p=.005). These variables accounted 55.8% of the variance in ulcer stage. Conclusion: Study results indicate that nurses' active role on pressure ulcer care and systematic approach are necessary to manage acutely ill inpatients' pressure ulcers.

• Journal of Korean Academy of Nursing
• /
• v.41 no.3
• /
• pp.423-431
• /
• 2011

Purpose: The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers. Methods: Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and .II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method. Results: Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR. Conclusion: Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.

• Journal of Korean Academy of Nursing
• /
• v.44 no.6
• /
• pp.595-607
• /
• 2014

Purpose: The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development. Methods: Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. Results: Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies. Conclusion: The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

• Journal of Korean Biological Nursing Science
• /
• v.21 no.1
• /
• pp.54-61
• /
• 2019

Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.