• Title/Summary/Keyword: Pressure ulcer

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Development of an Algorithm for the Prevention and Management of Pressure Ulcers (입원 환자의 욕창예방과 중재를 위한 알고리즘 개발)

  • Kim, Jin-Mi;Park, Jeong-Sook
    • Korean Journal of Adult Nursing
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    • v.22 no.4
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    • pp.353-364
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    • 2010
  • Purpose: The purpose of this study was to develop an algorithm for preventing and managing of pressure ulcer and to verify the its appropriateness. Methods: The first step was development of a pre-algorithm through a literature review and expert opinion. The second step was to establish content validity by submitting the algorithm questionnaires about the content to 12 experts. The third step was the revision of the algorithm. The fourth and last step was to establish the clinical validity of the algorithm with 25 experienced nurses. Results: For the ease of the practitioner the algorithm for prevention and the management of pressure ulcers was confined to one page depicting the main algorithm pathway and seven stepwise guidelines. The guidelines included skin care of pressure ulcer prevention, mechanical loading care, support surface care, reposition care of pressure ulcer, and Stages II, III and IV explanations along with debridement/wound irrigation and infection control. Most of all algorithm courses chosen more than 80% of agreement by expert index of content validity. The usefulness, appropriateness, and convenience of the algorithm were demonstrated through clinical validity with intensive care unit and ward nurses. Conclusion: The algorithm will improve the quality of pressure ulcer nursing care as it provides a model for decision making for clinical nurses as well as providing consistent and integrated nursing care for patients with pressure ulcer throughout an institution.

Risk Factors for Medical Device-related Oral Mucosa Pressure Ulcer Development of Intubated Patients in Adult Intensive Care Unit (성인 중환자실에서 인공기도를 가진 환자의 의료기기 관련 구강점막욕창 발생의 위험요인)

  • Kang, Min Kyeong;Kim, Myoung Soo
    • Journal of Korean Biological Nursing Science
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    • v.22 no.4
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    • pp.271-278
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    • 2020
  • Purpose: This study was performed to identify the risk factors for oral mucosa pressure ulcer development in intubated patients in adult intensive care unit. Methods: Comparative descriptive study design using prospective observational design and medical record review was used. The inclusion criteria of case was that a) patients of 18 years in their age, b) patients with endotracheal tube. Data of 34 patients were analysed. Descriptive statistics, chi-square test, Fisher's exact test, Mann-whitney test, Spearman's rho correlation coefficients, and multiple logistic regression analysis were used. Resampling methods such as bootstrap was used in this study because of small number of patients. Results: Oral mucosa pressure ulcer developed in 44.1% of the intubated patients. The risk factors of oral mucosa pressure ulcer were steroid use, biteblock use and serum albumin level. Compared to the non-user of steroid, user of steroid had 32.59 times (95% CI: 1.47-722.44) higher risk of developing oral mucosa pressure ulcer. The user of biteblock had 18.78 times (95% CI: 1.00-354.40) and albumin level had 0.03 times (95% CI: 0.00-0.80) higher risk of oral mucosa pressure ulcer incidence. Conclusion: Based on the results of this study, tailored pressure relief strategies considering sex and therapeutic condition should be provided to decrease oral mucosa pressure ulcer.

Factors affecting Healing of Stage 2 Pressure Ulcer (2단계 욕창 치유에 영향을 주는 요인 분석)

  • Park, Kyung-Hee;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.3 no.2
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    • pp.1-11
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    • 2010
  • Purpose: This study was designed to identify the factors affecting healing of Stage 2 pressure ulcer in an acute care facility in Korea. Methods: 286 Stage 2 pressure ulcers of 145 patients were examined. Data were collected in the period between October $1^{st}$, 2006 and September $30^{th}$, 2007. Data were analyzed with Kaplan-Meier survival analysis for cumulative recovery rate of Stage 2 pressure ulcers. Cox proportional hazard model was used to examine effects of multiple variables simultaneously. Results: Out of 286 initial Stage 2 pressure ulcers, 204 (71.3%) pressure ulcers healed completely. The median time to heal was 15 days according to Kaplan-Meier survival analysis. Cox proportional hazard model showed that the Stage 2 pressure ulcers healed more quickly when pressure redistribution surfaces were used (p<.001, HR=2.184), patients were administered with vitamins (p= .038, HR=1.451), and the size of the pressure ulcers were small (${\leq}3.0cm^2$, p= .006, HR=1.765). Conclusion: The factors contributing to the healing of Stage 2 pressure ulcer in an acute care setting were the application of pressure redistribution surface, small ulcer size (${\leq}3.0cm^2$), and the administration of vitamins.

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A Phenomenological Study on Illness Experience of Patients with Pressure Ulcer (욕창 환자들의 질병 체험에 관한 현상학적 연구)

  • Yoo, Misoo;Yi, Myungsun
    • Korean Journal of Adult Nursing
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    • v.27 no.5
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    • pp.515-526
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    • 2015
  • Purpose: The purpose of this study was to describe the illness experience of patients with pressure ulcer. Methods: A phenomenological methodology was used for the study. The data were collected by individual in-depth interview with seven participants with pressure ulcer during 2013~2014. All interviews were audio-taped and verbatim transcripts were made for the analysis. The data were analyzed using Colaizzi's phenomenological method. Results: All participants had underlying disease, such as spinal paralysis and diabetes. Average period of having pressure ulcer was 18 months, ranged from 3 to 36 months. A total of seven theme clusters were derived from the analysis; unexpected wound, inherent vulnerability to infection, reversal of the treatment policy, unpleasant and strange feeling of wound, sweeping fear and helplessness, socioeconomic burden, and healing through specific actions and reflection. The participants faced various contradictory and paradoxical situations in managing their pressure ulcers as well as underlying diseases in their everyday life. However, they slowly overcome these situations by strictly practicing concrete action-oriented strategies that they have learned through suffering and appreciating miraculous wound healing. Conclusion: The results of this study can help developing a patient-specific intervention program with sufficient emotional support by providing insights of the paradoxical illness experience of patients with pressure ulcer.

A Case Report of Stage 4 Pressure Ulcer Patient Treated with Acupuncture and the Herbal Medicine Gamisipjeon-tang (침구 치료와 가미십전탕을 병행하여 호전된 4도 욕창 환자 치험 1례)

  • Ryu, Hae-rang;Kang, Eun-jin;Kim, Young-kyun;Kim, Kyoung-min
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.619-627
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    • 2017
  • Objectives: The purpose of this case study is to report the effect of oriental medicine on pressure ulcers. Methods: We treated a patient with a pressure ulcer with acupuncture, Jaungo, and Gamisipjeon-tang. We started with herbal medicine only, and then added the acupuncture treatment after one month. We treated the sore for a total of 4 months. We measured the size and depth of the ulcer and graded it with a National Pressure Ulcer Advisory Panel (NPUAP) score once every two weeks. Results & Conclusions: Even though the wound was not cured completely, the total size of the pressure ulcer was reduced and the NPUAP stage was improved from 4 to 3. Therefore, Korean medicine could be an effective treatment for improving pressure ulcers.

Analysis of Pressure Ulcer Nursing Records with Artificial Intelligence-based Natural Language Processing (인공지능 기반 자연어처리를 적용한 욕창간호기록 분석)

  • Kim, Myoung Soo;Ryu, Jung-Mi
    • Journal of the Korea Convergence Society
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    • v.12 no.10
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    • pp.365-372
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    • 2021
  • The purpose of this study was to examine the statements characteristics of the pressure ulcer nursing record by natural langage processing and assess the prediction accuracy for each pressure ulcer stage. Nursing records related to pressure ulcer were analyzed using descriptive statistics, and word cloud generators (http://wordcloud.kr) were used to examine the characteristics of words in the pressure ulcer prevention nursing records. The accuracy ratio for the pressure ulcer stage was calculated using deep learning. As a result of the study, the second stage and the deep tissue injury suspected were 23.1% and 23.0%, respectively, and the most frequent key words were erythema, blisters, bark, area, and size. The stages with high prediction accuracy were in the order of stage 0, deep tissue injury suspected, and stage 2. These results suggest that it can be developed as a clinical decision support system available to practice for nurses at the pressure ulcer prevention care.

A Novel Air-cell Mattress Based on Approximate Anthropometric Model for Preventing Pressure Ulcer

  • Moon, In-Hyuk;Kang, Sung-Jae;Kim, Gyu-Seok;Mun, Mu-Seong
    • 제어로봇시스템학회:학술대회논문집
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    • 2005.06a
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    • pp.1278-1282
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    • 2005
  • Air mattress is now used widely to prevent the pressure ulcer by reducing the localized pressure peaks. In this paper an air-cell mattress and its pressure control method based on an approximate anthropometric model are presented. The air-cell mattress has eighteen cylindrical air cells made of porous material allowing air leakage to contribute in reducing the development of pressure ulcer by lowering the pressure peak, temperature and humidity. To determine an optimal air-cell pressure appropriate for each user, we divide the parts of the body into four sections such as head, trunk, hip, and leg. Then, the pressure of each section is independently calculated from the weight of each part based on the individual body height and weight and the approximate anthropometric model. Air supply system for the air-cell mattress is implemented by using four electronic solenoid valves and an air compressor, and it is driven by a real-time micro-controller. The experimental results with seven subjects shows that the proposed air-cell mattress is effective for the prevention of the pressure ulcer.

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A Structural Equation Model of Pressure Ulcer Prevention Action in Clinical Nurses (임상간호사의 욕창예방행위 구조모형)

  • Lee, Sook Ja;Park, Ok Kyoung;Park, Mi Yeon
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.572-582
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    • 2016
  • Purpose: The purpose of this study was to construct and test a structural equation model for pressure ulcer prevention action by clinical nurses. The Health Belief Model and the Theory of Planned Behavior were used as the basis for the study. Methods: A structured questionnaire was completed by 251 clinical nurses to analyze the relationships between concepts of perceived benefits, perceived barriers, attitude, subjective norm, perceived control, intention to perform action and behavior. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting pressure ulcer prevention action among clinical nurses. Results: The model fitness statistics of the hypothetical model fitted to the recommended levels. Attitude, subjective norm and perceived control on pressure ulcer prevention action explained 64.2% for intention to perform prevention action. Conclusion: The major findings of this study indicate that it is essential to recognize improvement in positive attitude for pressure ulcer prevention action and a need for systematic education programs to increase perceived control for prevention action.

Survey on Pressure Ulcers and Influencing Factors of Stage Change in Acute University Hospital Inpatients (일개 대학병원 입원환자의 욕창 실태와 욕창상태 영향요인)

  • Kim, Kyoung Nam;Kang, Kyung Ja;Lee, Hyun Sook;Shin, Yeon Hee;Kim, Sun Kyung;Park, Kwang Hee;Kim, Hye Young
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.433-442
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    • 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.