Title |
Reducing pressure ulcers in patients with prolonged acute mechanical ventilation: a quasi-experimental study
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Published in |
Revista Brasileira de Terapia Intensiva, January 2017
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DOI | 10.5935/0103-507x.20170007 |
Pubmed ID | |
Authors |
Cecilia Inés Loudet, María Cecilia Marchena, María Roxana Maradeo, Silvia Laura Fernández, María Victoria Romero, Graciela Esther Valenzuela, Isabel Eustaquia Herrera, Martha Teresa Ramírez, Silvia Rojas Palomino, Mariana Virginia Teberobsky, Leandro Ismael Tumino, Ana Laura González, Rosa Reina, Elisa Estenssoro |
Abstract |
To determine the effectiveness of a quality management program in reducing the incidence and severity of pressure ulcers in critical care patients. This was a quasi-experimental, before-and-after study that was conducted in a medical-surgical intensive care unit. Consecutive patients who had received mechanical ventilation for ≥ 96 hours were included. A "Process Improvement" team designed a multifaceted interventional process that consisted of an educational session, a pressure ulcer checklist, a smartphone application for lesion monitoring and decision-making, and a "family prevention bundle". Fifty-five patients were included in Pre-I group, and 69 were included in the Post-I group, and the incidence of pressure ulcers in these groups was 41 (75%) and 37 (54%), respectively. The median time for pressure ulcers to develop was 4.5 [4 - 5] days in the Pre-I group and 9 [6 - 20] days in the Post-I group after admission for each period. The incidence of advanced-grade pressure ulcers was 27 (49%) in the Pre-I group and 7 (10%) in the Post-I group, and finally, the presence of pressure ulcers at discharge was 38 (69%) and 18 (26%), respectively (p < 0.05 for all comparisons). Family participation totaled 9% in the Pre-I group and increased to 57% in the Post-I group (p < 0.05). A logistic regression model was used to analyze the predictors of advanced-grade pressure ulcers. The duration of mechanical ventilation and the presence of organ failure were positively associated with the development of pressure ulcers, while the multifaceted intervention program acted as a protective factor. A quality program based on both a smartphone application and family participation can reduce the incidence and severity of pressure ulcers in patients on prolonged acute mechanical ventilation. |
X Demographics
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Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 51 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 7 | 14% |
Student > Master | 7 | 14% |
Student > Postgraduate | 4 | 8% |
Other | 2 | 4% |
Student > Ph. D. Student | 2 | 4% |
Other | 4 | 8% |
Unknown | 25 | 49% |
Readers by discipline | Count | As % |
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Nursing and Health Professions | 13 | 25% |
Medicine and Dentistry | 6 | 12% |
Unspecified | 1 | 2% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Business, Management and Accounting | 1 | 2% |
Other | 3 | 6% |
Unknown | 26 | 51% |