• Title/Summary/Keyword: Pressure ulcers

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Performance of Comprehensive Nursing Care Service in an Acute Care Hospital: Focusing on Accidental Falls and Pressure Injuries (급성기병원에서의 간호 · 간병통합서비스 운영 전후 낙상 및 욕창 발생 변화)

  • Nam, Seung Nam;Ryu, Hye Ran;Kim, Se Hyun;Seo, Su Ryang;Oh, Yoon Hee;Choi, Sun Mi;Chung, Eun Jin
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.1
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    • pp.56-66
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    • 2023
  • Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

Development of Pressure Ulcer Management Guideline by Adaptation Process (수용개작방법을 활용한 욕창간호 실무지침 개발)

  • Jeong, Ihn Sook;Kim, Shinmi;Jeong, Jae Sim;Hong, Eun Young;Lim, Eun Young;Seo, Hyun Ju;Park, Kyung Hee;Hong, Yong Eun;Hwang, Ji Hyeon
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.40-52
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    • 2014
  • Purpose: This study was done to develop an evidence-based nursing clinical practice guideline (PU CPG) for pressure ulcer prevention and management in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by Gu et al. (2012) which consists of three main phases and 9 modules including a total of 24 steps. Results: The newly developed PU CPG included the introduction, pressure ulcers, summary of recommendations, recommendations, references, appendices, and glossary. The total number of recommendations was 148 in 4 sections (organizational policy, assessment, pressure ulcer prevention and management, and education) and 16 domains. Of the recommendations 4.7% were graded A, 16.9%, B, and 78.4%, C. Conclusion: Results indicate that this new PU CPG is an evidence-based practice guidance for pressure ulcer prevention and management and can be recommended for dissemination and utilization by nurses nationwide to improve the quality of pressure ulcer prevention and management. Regular revision is recommended.

Application of a paste-type acellular dermal matrix for coverage of chronic ulcerative wounds

  • Jeon, Minseok;Kim, So Young
    • Archives of Plastic Surgery
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    • v.45 no.6
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    • pp.564-571
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    • 2018
  • Background Chronic wounds occur due to failure of the normal healing process, associated with a lack of deposition of cellular components and a suitable microenvironment such as the extracellular matrix (ECM). Acellular dermal matrix (ADM) is viewed as an ECM substitute, and a paste-type ADM has recently been introduced. We hypothesized that CGPaste, an injectable paste-type ADM, could serve as a scaffold and promote wound healing. Methods We retrospectively studied seven patients in whom CGPaste was applied between 2017 and 2018, who had pressure ulcers, necrotizing fasciitis, diabetic foot ulcers, traumatic defects, and osteomyelitis. The goal of applying CGPaste was to achieve complete wound healing with re-epithelialization or growth of granulation tissue, depending upon the wound bed status. CGPaste was injected based on the wound size along with the application of a dressing. Results Four of the seven patients showed granulation tissue on their wound bed, while the other three patients had a bony wound bed. The mean wound area was $453.57mm^2$ and the depth was 10.71 mm. Wound healing occurred in five of the seven patients (71.43%). The mean duration of complete healing was 2.4 weeks. Two patients showed failure due to paste absorption (29.57%); these patients had wound beds comprising bone with relatively large and deep wounds ($40{\times}30$ and $30{\times}20mm^2$ in area and 15 and 10 mm in depth). Conclusions CGPaste is an effective option for coverage of small and deep chronic wounds for which a flap operation or skin grafting is unfeasible.

Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy (정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계)

  • Kang, Young Ae;Bae, Su Jin;Song, Chie Eun
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.66-76
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    • 2016
  • Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.

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Clinical Nurses' Knowledge and Visual Differentiation Ability in Pressure Ulcer Classification System and Incontinence-associated Dermatitis (임상간호사의 욕창분류체계와 실금관련피부염에 대한 지식과 시각적 감별 능력)

  • Lee, Yun Jin;Park, Seungmi;Kim, Jung Yoon;Kim, Chul-Gyu;Cha, Sun Kyung
    • Journal of Korean Academy of Nursing
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    • v.43 no.4
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    • pp.526-535
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    • 2013
  • Purpose: This study was done to compare clinical nurses' knowledge and visual differentiation diagnostic ability for the pressure ulcer classification system (PUCS) and incontinence-associated dermatitis (IAD). Methods: A convenience sample of 602 nurses took the pressure ulcer classification system and incontinence-associated dermatitis knowledge test (PUCS & IAD KT) and completed the visual differentiation tool (VDT), consisting of 21 photographs with clinical information. Results: The overall mean score for correct answers was 14.5 (${\pm}3.2$) in PUCS & IAD KT and 11.15 (${\pm}4.9$) in PUCS & IAD VDT. Incorrect responses were most common for statements related to stage III, IAD for PUCS & IAD KT, and suspected deep tissue injury (SDTI), unstageable, and stage III for PUCS & IAD VDT. Significant correlations were found between PUCS & IAD KT and VDT (r=.48, p<.001). Factors affecting scores for PUCS & IAD VDT were PUCS & IAD KT, frequency of pressure ulcer, IAD management and participation in wound care education programs. Conclusion: Results indicate that nurses have an overall understanding of PUCS & IAD, but low visual differentiation ability regarding stage III, SDTI, and unstageable ulcers. Continuing education is needed to further improve knowledge and visual differentiation ability for PUCS & IAD.

Combined Effects of Gami-sipjeondaebo-tang Administration, Acupuncture, and Wet Dressing in a Patient with Grade 4 Pressure Ulcer: A Case Report (4도 욕창 환자에 대한 가미십전대보탕 투여 및 침치료와 습윤드레싱의 병행 효과 : 치험 1례)

  • Sunny Kang;Ju-hwan Song;Sang-ho Ji;Cheol-hyun Kim;Sang-kwan Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1318-1326
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    • 2023
  • Introduction: Pressure ulcers, often found in patients with mobility issues, particularly elderly patients, are increasing in prevalence. Their treatment is complex, with recovery more challenging in advanced stages, and certain factors can delay healing. Case Presentation: An 87-year-old male developed a grade IV pressure ulcer on his left greater trochanter following lumbar fractures and subsequent percutaneous vertebroplasty in 2021. Despite potential surgical recommendations, his treatment consisted of daily wet dressings, acupuncture from July 2021 to February 2022, and Gami-sipjeondaebo-tang beginning August 2021. The ulcer, initially measuring 6 cm×6 cm and showing a red wound without necrosis, healed completely and showed no signs of recurrence as of August 2023. Conclusion: A grade IV pressure ulcer was effectively treated using wet dressing, acupuncture, and Gami-sipjeondaebo-tang, demonstrating no recurrence over a 1.5-year period.

Analysis on satisfactory degree influence factor of welfare equipment rental users (복지용구 대여 이용자의 만족도 영향 요인 분석)

  • Yoo, Jae-Seong;Park, Tae-Sun;Kim, Bong-Sun
    • Journal of the Korea Safety Management & Science
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    • v.13 no.2
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    • pp.211-217
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    • 2011
  • The government has been operating the long-term care insurance since 2008. In June 2010, the government manual wheelchairs, electric beds, manual beds, mattresses prevent pressure ulcers, mobile tub, bath lifts, including six items were changed to rental-only item. For the successful settlement of welfare equipment rental system, The efforts to prevent inconvenience of welfare equipment user's and improvement of the system for the activation is needed. The main object of this study is to identify the factors affecting satisfaction of welfare equipment rental and seek to proposals of revitalizing equipment rental system.

The Effect of Preoperative Nutritional Status on Postoperative Outcome in Elderly Patients (노인 환자의 수술 전 영양상태가 수술 후 임상경과에 미치는 영향)

  • Kim, Min Young
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.292-299
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    • 2019
  • Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

Development of System Monitoring Physical Posture & Urine and Feces to Prevent Pressure Ulcers (욕창 예방을 위한 자세 및 대소변 모니터링 시스템 개발)

  • Lee, Chee-Hoon;Kim, Su-Jin;Kim, Keun-Jik;Song, Bo-Jeong;Lee, Byung-Soo
    • Proceedings of the Korea Information Processing Society Conference
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    • 2011.04a
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    • pp.1120-1123
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    • 2011
  • 본 논문에서는 거동이 불편한 일부 노인들의 욕창 예방을 목적으로 만들어진 U-Health 에 대한 시스템 구축을 제안한다. 제안된 시스템은 구김에 강한 필름 형 압력 센서를 사용하여 무선으로 데이터의 송수신이 가능한 시스템이다. 이러한 시스템은 간병인 및 간호사들이 실시간으로 환자의 대소변 여부나 자세 고정 시간을 확인할 수 있도록 하여 보다 정확한 환자의 상태 관리가 가능하다. 또한 데이터를 통한 체압 측정의 특정 메커니즘을 도입하여 체압 데이터의 신뢰성을 보였다.

Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients (중환자실 환자의 욕창 관련 경계압력 예측요인)

  • Shine, Ji Seon;Kim, Soo Jin;Lee, Ji Hyun;Yu, Mi
    • Journal of Korean Academy of Nursing
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    • v.47 no.6
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    • pp.794-805
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    • 2017
  • Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.