Pressure ulcer prevention in intensive care patients: guidelines and practice |
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Authors: | Eman S M Shahin BSc MSc RN PhD Theo Dassen PhD RN and Ruud J G Halfens PhD |
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Institution: | Student, Department of Nursing Science, Centre for the Humanities and Health Sciences, Charité, Universitätsmedizin Berlin, Berlin; Professor, Head of Department of Nursing Science, Centre for the Humanities and Health Sciences, Charité, Universitätsmedizin Berlin, Berlin; Associate Professor, Health Care Studies/Section Nursing Science, Faculty of Health Sciences, Universiteit Maastricht, the Netherlands |
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Abstract: | Background Pressure ulcers are a potential problem in intensive care patients, and their prevention is a major issue in nursing care. This study aims to assess the allocation of preventive measures for patients at risk for pressure ulcers in intensive care and the evidence of applied pressure ulcer preventive measures in intensive care settings in respect to the European Pressure Ulcer Advisory Panel (EPUAP) and Agency for Health Care Policy and Research (AHCPR) guidelines for pressure ulcer prevention. Design The design of this study was a cross-sectional study (point prevalence). Setting The study setting was intensive care units. The sample consisted of 169 patients – 60 patients from surgical wards, 59 from interdisciplinary wards and 50 from medical intensive care wards. Results The study results revealed that pressure reducing devices like mattresses (alternating pressure air, low air loss and foam) are applied for 58 (36.5%) patients, and all of these patients are at risk for pressure ulcer development. Most patients receive more than one nursing intervention, especially patients at risk. Nursing interventions applied are skin inspection, massage with moisture cream, nutrition and mobility (81.8%, 80.5%, 68.6% and 56.6%) respectively. Moreover, all applied pressure ulcer preventive measures in this study are in line with the guidelines of the EPUAP and AHCPR except massage which is applied to 8.8% of all patients. Conclusions The use of pressure reducing devices and nursing interventions in intensive care patients are in line with international pressure ulcer guidelines. Only massage, which is also being used, should be avoided according to the recommendation of national and international guidelines. |
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Keywords: | AHCPR EPUAP guidelines ICU pressure ulcer prevention |
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