• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.4
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• pp.413-422
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• 2014

Purpose: The purpose of this study was to identify the nutrition-related factors influencing the prevalence of pressure ulcers among patients admitted to an intensive care unit. Methods: Research participants were 112 patients who were admitted to the ICU of a university hospital. Data were collected through questionnaires which included general characteristics, diet-related characteristics, nutritional status, and pressure ulcer status. Multivariate logistic regression was used to identify independent factors association with prevalence of pressure ulcer Results: The prevalence of pressure ulcers was 58 patients (51.8%) at 10th day after ICU admission. In multivariate analysis, prevalence of pressure ulcers at 10th day in ICU was significantly higher in the nutritional risk group (OR=6.43), malnutrition group (OR=88.02), and deceased serum albumin group (OR=28.83). Conclusion: The results of this research indicate that scores on MNA (Mini Nutritional Assessment) and serum albumin were significant predictors of pressure ulcer prevalence in ICU patients. Therefore, regular MNA-SF and albumin checkups are needed to identify risk for pressure ulcer for ICU patients. In the case of decreased MNA-SF scores and serum albumin levels, more intensive pressure ulcer care is needed for ICU patients.

• Journal of Korean Biological Nursing Science
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• v.11 no.2
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• pp.99-104
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• 2009

Purpose: An animal model of pressure ulcers was experimentally-induced with the use of greater trochanter of rats. Methods: Twelve male Sprague-Dawley rats were used in this study and they were randomly divided into 4 groups: Group I (n=3, 120 mmHg, 2 hr), Group II (n=3, 120 mmHg, 3 hr), Group III (n=3, 140 mmHg, 3 hr) and Group IV (n=3, 140 mmHg, 4 hr). The rats were anesthetized with 100 mg/kg of ketamine. The pressure ulcers were induced by using a personally-designed pressing apparatus. After 5 days, the wounds were photographed and excised. Results: After 5 days of induced pressure ulcers, it was observed that Group I and Group II responded with Grade I and Grade II, respectively, while Group III and Group IV responded with Grade III. Conclusion: According to the result of this study, it can be concluded that the pressure ulcers were induced the characteristic grades of pressure ulcer classification by adjusting the degree and the duration of compression.

• Journal of Digital Convergence
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• v.18 no.2
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• pp.323-331
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• 2020

This study was to perform a systematic review to examine pressure ulcer preventive intervention and risk factors. PRISMA flow diagram in accordance with the selection process of this research was done. The literatures were retrieved from domestic and international study from 2010 to June, 2019. A total of 30 literatures were selected according to the selection criteria of this study. The literatures were searched electronically using the search engine with the key words of 'pressure ulcers', 'bedsore', 'decubitus ulcers', 'intervention', 'prevention'. The results of this study suggest that mediation with position change and pressure reduction device reduced the incidence of pressure sores and was important for prevention. Based on the results of this study, we provide basic data for preventive intervention of pressure ulcers that are appropriate for each medical institution.

• Korean Journal of Adult Nursing
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• v.27 no.3
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• pp.347-357
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• 2015

Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by ${\chi}^2$-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.523-531
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• 2006

Purpose: The purpose of this study was to examine the effects of the ulmus root-bark dressing on tissue regeneration in experimentally-induced pressure ulcers in rats. Method: A randomized pretest/post-test control group time-series study design was used. Thirty-three male Sprague-Dawley rats were used in this study. The rats were anesthetized with 100mg/kg of ketamine. Pressure ulcers were induced at 140mmHg for three hours using a personally-designed pressing apparatus. For four weeks, the ulmus root-bark dressing was applied every other day in the experimental group (n=18) and a wet gauze dressing in the control group (n=15). For data analysis, the statistical program SPSS WIN 12 was used. The wounds were examined by light microscopy andelectron microscopy. Result: There were significant statistical differences in the size of the pressure ulcers as time went by(p=0.006). It should be noted that there were no significant statistical differences in the number of capillaries. Using light microscopy the inflammatory infiltration and neovascularization in the dermis in the experimental group emerged densely in the early stages, but recovered rapidly at the latter stages. In addition, the reepithelization of the epidermis occurred earlier than in the control group. By electron microscopy, the cell organelles of the capillary endothelial cells and the basal lamina of capillaries in the experimental group showed a more rapid maturation during the latter stages, compared with the control group. Conclusion: According to this study, it can be concluded that the ulmus root-bark dressing is effective regarding the healing of pressure ulcers.

• Health Policy and Management
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• v.30 no.4
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.5-23
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• 2010

Purpose: This study was conducted to determine the validity and reliability of performance measurement tools based on the nursing process for prevention and management of pressure ulcers, falls and pain. Methods: The performance measurement tools were reviewed by a panel of experts and refined on the basis of the panel's suggestions. The validity of the performance measurement tools was measured by surveying hospital nurses. The reliability of these tools was tested by having nursing experts use the tools in five nursing units to assess nursing performance in prevention and management of pressure ulcers, falls and pain. Results: The performance measurement tools in this study were found to be acceptable as tools to evaluate quality of nursing care in pressure ulcers, falls and pain. The reliability of the performance measurement tools was acceptable. Conclusion: These results indicate that the performance measurement tools developed in this study are valid and reliable instruments to monitor and improve quality of nursing care in prevention and management of pressure ulcers, falls and pain.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.2
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• pp.190-199
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• 2006

Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

• Child Health Nursing Research
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• v.25 no.2
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• pp.133-142
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• 2019

Purpose: This prospective study was conducted to determine the incidence and related characteristics of respiratory medical device-related pressure ulcers (MDRPU) in children admitted to a pediatric intensive care unit (PICU). Methods: The participants were 184 children who were admitted to the PICU of P University Hospital from April 2016 to January 2017. Data were collected on the occurrence of respiratory MDRPU and characteristics regarding the application of respiratory medical devices. Results: Respiratory MDRPU occurred in 11.9% of participants (58.3%: stage I ulcers, 37.5%: mucosal ulcers). The devices associated with respiratory MDRPU were endotracheal tubes (54.2%), high-flow nasal cannulas (37.5%), and oximetry probes (8.3%). Respiratory MDRPU associated with an endotracheal tube were significant differences according to the site and strength of fixation, the use of a bite block and adhesive tape, skin dryness, and edema. In high-flow nasal cannulas, significant differences were found according to the site of fixation, immobility after fixation, and skin dryness. Conclusion: The occurrence of respiratory MDRPU is significantly affected by the method and strength of fixation, as well as skin dryness and edema. Therefore, appropriate consideration of these factors in nursing care can help prevent respiratory MDRPU.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.7
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• pp.3390-3399
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• 2013

The purpose of this study was to examine the incidence rates of pressure ulcers depending on the types of healthcare organizations and to determine whether the characteristics of patients and facilities influence on the incidence of pressure ulcers in long term facilities. We analyzed data on 796,857 patients of the 2009 National Patient Sample which was extracted from to claims for medical fees to Health Insurance Review & Assesment Service(HIRA). A total of 3.2% of patients(n=25,339) had at least 1 pressure ulcer during their hospitalization. The pressure ulcer rates were highest in long term care facilities(8.2%, n=11,895) following general hospital(2.7%, n=8,052), hospital(1.7%, n= 5,059). According to logistic regression analysis, urinary incontinence (Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974), hypertension(OR=1.456, CI=1.400-1.515), peripheral vessel diseases (OR=1.357, CI=1.200-1.534) were significant predictors of pressure ulcers. As the number of diagnoses, age, and the number of doctors per 100 beds increased, the incidence of pressure ulcers increased. In addition, more number of beds was associated with fewer pressure ulcers.