• 기본간호학회지
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• 제21권4호
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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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• 제11권2호
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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.

• 디지털융복합연구
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• 제18권2호
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• pp.323-331
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• 2020

본 연구의 목적은 욕창에 대한 예방적 중재방법과 영향요인을 비교, 분석하기 위해 기존문헌을 체계적으로 고찰하였으며 논문은 PRISMA(Preferred reporting items for systematic reviews) 지침에 따라 자료를 수집하고 분석하였다. 문헌은 2010년부터 2019년 6월까지 국내외에서 발표된 논문을 대상으로 하였다. 본 연구의 논문 선정기준에 따라 총 30의 논문이 선택되었으며 실험연구가 8편, 코호트 연구가 3편, 단면조사연구가 19편 이었다. 논문검색어는 국내논문의 경우 욕창, 압박욕창, 압박궤양, 예방, 중재의 단어를 조합하여 검색하였다. 분석결과 욕창의 예방적 중재와 예측요인을 통합적으로 제시하였으며 특히 체위변경과 압력 감소 장치 적용한 중재는 욕창 발생률을 감소시켰으며 욕창 발생 감소와 욕창예방에 중요한 중재임이 확인되었다. 본 연구결과를 토대로 각 의료기관에 적합한 욕창의 예방적 중재를 위한 기초 자료를 제공하고자 한다.

• 성인간호학회지
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• 제27권3호
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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.

• 대한간호학회지
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• 제36권3호
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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.

• 보건행정학회지
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• 제30권4호
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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.

• 임상간호연구
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• 제16권3호
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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.

• 기본간호학회지
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• 제13권2호
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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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• 제25권2호
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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.

• 한국산학기술학회논문지
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• 제14권7호
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• pp.3390-3399
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• 2013

본 연구는 2009년 한 해 동안 건강보험심사평가원의 요양급여 전체 청구자료를 통계적으로 표본 추출 한 환자표본자료를 이용하여 의료기관 종류 별 욕창 발생현황과 이중 요양병원 환자의 욕창 발생에 영향을 주는 요인을 규명하기 위해 시도되었다. 전체 의료기관 입원환자의 3.2%(n=25,339)에서 욕창이 발생하였다. 의료기관 종별로는 요양병원 입원환자의 8.2%(n=11,895)에서 욕창이 발생하여 종합병원(2.7%, n=8,052), 일반병원(1.7%, n=5,059) 보다 상대적으로 높은 비율을 보였다. 요양병원 입원환자(n=144,523)의 욕창발생에 영향을 주는 요인을 분석한 결과 의학적 진단 중 요실금을 가진 환자 군이 가지지 않은 군에 비해 욕창 발생이 2.46배 유의하게 높게 나타났다(Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974). 더하여, 고혈압질환(OR=1.456, CI=1.400-1.515), 말초혈관 질환(OR=1.357, CI=1.200-1.534)군 순으로 욕창 발생에 영향을 미쳤다. 진단 수(OR=1.193, CI=1.187-1.199)와 나이(OR=1.011, CI=1.009-1.012) 및 100침상 당 의사 수(OR=1.063, CI=1.035-1.091)가 증가할수록, 의료기관의 전체 침상수(OR=.889, CI =.869-.909)가 적을수록 욕창발생은 유의하게 높은 것으로 나타났다.