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The Cost Effectiveness Of Prevention Strategies For Pressure Ulcers In Long Term Care Homes In Ontario
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Book Synopsis The Cost-effectiveness of Prevention Strategies for Pressure Ulcers in Long-term Care Homes in Ontario by : THETA.
Download or read book The Cost-effectiveness of Prevention Strategies for Pressure Ulcers in Long-term Care Homes in Ontario written by THETA. and published by . This book was released on 2008 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Cost-effectiveness of Prevention Strategies for Pressure Ulcers in Long-term Care Homes in Ontario by :
Download or read book The Cost-effectiveness of Prevention Strategies for Pressure Ulcers in Long-term Care Homes in Ontario written by and published by . This book was released on 2009 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The cost-effectiveness of prevention strategies for pressure ulcers in long-term care homes in Ontario by :
Download or read book The cost-effectiveness of prevention strategies for pressure ulcers in long-term care homes in Ontario written by and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the US, the in the US have a PU.2,3 In Canada, the expenditures for treating PUs have been prevalence of PUs is estimated to be 30% in estimated at $11 billion per year.13 In the UK in long-term care (LTC) settings, 25% in acute care 1992, PUs cost the average health district settings, and 15% in community care settings.4 approximately £300,000 to £750,000 ($420,000 The overall prevalence for P [...] The purpose of this report is to advise the Ontario Ministry of Health and Long Term Care (MOHLTC) through the Medical Advisory Secretariat (MAS) on the cost-effectiveness of provincial implementation of PU prevention strategies, with several objectives: examine the economic attractiveness of evidence-based prevention strategies to reduce the burden of PUs in Ontario; and estimate the budget impac [...] Its linkage to the population-based Model structure Minimum Data Set (MDS) for LTC homes in Ontario23 and the Canadian Institute of Health The model (Figure 2.1) was structured to be Information Hospital Discharge Abstracts consistent with current biologic and clinical Database (CIHI-DAD), and the process of model understanding of the development and calibration are described. [...] The following outcome measures were used to assess the clinical impact of different modifications in the natural history of PU: (1) Underlying risk for pressure ulcer the prevalence of PU; (2) the lifetime probability of developing co-morbidities that placed Each week (i.e., one cycle), LTC residents could residents at high risk for PU; (3) the lifetime develop PU according to their time-dependent [...] The proportion of residents developing PU over a 3-month assessment was estimated by the ratio of two factors: 1) the number of residents developing a PU over a 3-month assessment THETA| 6BChapter 2: Natural history model of pressure ulcer 10 Other data from published literature 2. Age-specific incidence and healing estimates were scaled (e.g., 0.5 to 1.5) in order for the The mean healing time.
Book Synopsis Emerging Technologies for the Prevention of Pressure Ulcers in Acute Care Settings by :
Download or read book Emerging Technologies for the Prevention of Pressure Ulcers in Acute Care Settings written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :U. S. Department of Health and Human Services Publisher :CreateSpace ISBN 13 :9781490574592 Total Pages :490 pages Book Rating :4.5/5 (745 download)
Book Synopsis Pressure Ulcer Treatment Strategies: Comparative Effectiveness by : U. S. Department of Health and Human Services
Download or read book Pressure Ulcer Treatment Strategies: Comparative Effectiveness written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-29 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: Uninterrupted pressure exerted on the skin, soft tissue, muscle, and bone can lead to the development of localized ischemia, tissue inflammation, shearing, anoxia, and necrosis. Pressure ulcers affect up to three million adults in the U.S. Pressure ulcer healing rates—which depend on comorbidities, clinical interventions, and ulcer severity—vary considerably. Ulcer severity is assessed using a variety of different staging or grading systems, but the National Pressure Ulcer Advisory Panel (NPUAP) staging system is the most commonly used. Comorbidities predisposing toward pressure ulcer development and affecting ulcer healing include those affecting patient mobility (e.g., spinal cord injury), wound environments (e.g., incontinence), and wound healing (e.g., diabetes and vascular disease). Delayed healing can add to the length of hospitalization and impede return to full functioning. Prevalence of pressure ulcers is used as an indicator of quality for long-term care facilities, and progression of pressure ulcers in hospitalized patients is often considered an avoidable complication representing failure of inpatient management. Given the negative impact pressure ulcers have on health status and patient quality of life, as well as health care costs, treatments are needed that promote healing, shorten healing time, and minimize the risk of complications. Pressure ulcer treatment involves a variety of different approaches, including interventions to treat the conditions that give rise to pressure ulcers (support surfaces and nutritional support); interventions to protect and promote healing of the ulcer (wound dressings, topical applications, and various adjunctive therapies, including vacuum-assisted closure, ultrasound therapy, electrical stimulation, and hyperbaric oxygen therapy); and surgical repair of the ulcer. Most ulcers are treated using a combination of these approaches. The following Key Questions are the focus of our report. KQ1. In adults with pressure ulcers, what is the comparative effectiveness of treatment strategies for improved health outcomes, including but not limited to: complete wound healing, healing time, reduced wound surface area, pain, and prevention of serious complications of infection? KQ1a. Does the comparative effectiveness of treatment strategies differ according to features of the pressure ulcers, such as anatomic site or severity at baseline? KQ1b. Does the comparative effectiveness of treatment strategies differ according to patient characteristics, including but not limited to: age, race/ethnicity, body weight, specific medical comorbidities, and known risk factors for pressure ulcers, such as functional ability, nutritional status, or incontinence? KQ1c. Does the comparative effectiveness of treatment strategies differ according to patient care settings, such as home, nursing facility, or hospital, or according to features of patient care settings, including but not limited to nurse/patient staffing ratio, staff education and training in wound care, the use of wound care teams, and home caregiver support and training? KQ2. What are the harms of treatments for pressure ulcers? KQ2a. Do the harms of treatment strategies differ according to features of the pressure ulcers, such as anatomic site or severity at baseline? KQ2b. Do the harms of treatment strategies differ according to patient characteristics, including age, race/ethnicity, body weight, specific medical comorbidities, and known risk factors for pressure ulcers, such as functional ability, nutritional status, or incontinence? KQ2c. Do the harms of treatment strategies differ according to patient care settings, such as home, nursing facility, or hospital, or according to features of patient care settings, including but not limited to nurse/patient staffing ratio, staff education and training in wound care, the use of wound care teams, and home caregiver support and training?
Book Synopsis Pressure Ulcer Prevention in Long-term Care by : Tan Vatanadilok
Download or read book Pressure Ulcer Prevention in Long-term Care written by Tan Vatanadilok and published by . This book was released on 2008 with total page 87 pages. Available in PDF, EPUB and Kindle. Book excerpt: Problem: In Long Term Care Facilities (LTCFs), about 70% of all pressure ulcers occur in persons older than 70. The direct care costs associated with pressure ulcers in LTCF exceed $3.5 billion, while costs related to legal liability are even more substantial. Litigations in LTCF are likely to favor LTCF residents in up to 87% of cases while prevention of pressure ulcers offers high-quality, cost-effective outcomes. A systematic review of healthcare evidence reveals that while the development of pressure ulcers can have a devastating impact of LTCF populations, simple EBP steps such as using supporting surfaces, repositioning the patient, optimizing nutritional status, and moisturizing sacral skin can have a positive impact on reducing physical and emotional pain and associated healthcare costs. Purpose and Scope: The purpose of this Evidence-Based Practice (EBP) project was to describe the level of healthcare knowledge regarding pressue ulcer prevention (PUP) before and after participation in a PUP teaching intervention for LTCF staff. Using descriptive-interventional methodology, the study variable of nursing knowledge regarding pressure ulcer prevention was measured before and after participation in the PUP teaching intervention by the Pressure Ulcer Knowledge Tool. The instrumentation included a 47-item questionnaire with 3 subscales assessing knowledge regarding ulcers, wounds, and prevention/risk. Goal and Objectives: The goal of the project was to successfully implement a PUP teaching intervention to LTCF staff. The objectives were: (a) to describe aggregate demographic characteristics of the LTCF participants, (b) to describe PUP pre-intervention level of knowledge, (c) to describe PUP post-intervention level of knowledge, and (d) to describe PUP level of knowledge before and after LTCF staff participation in a PUP teaching intervention. Plan and Evaluation: Phase One: Conduct a literary needs assessment using a published evidence-based critique template. Phase Two: Design a PUP teaching intervention using the EBP approach. Phase Three: Implement a PUP teaching intervention for selected LTCF staff. Phase Four: Evaluate the level of PUP knowledge before and after LTCF staff participation in the PUP teaching intervention. Ouotcomes and Results: Pre-intervention and post-intervention meaures revealed a statistically significant increase in PUP knowledge from an aggregate percentage performance of .81 at pre-test to an aggregate percentage performance of .98 at post-test. Moreover, scaled reliability estimates based on internal consistency for the full instrument achieved significance with regard to the tool's performance in this interventional design. Although further inquiry is warranted, the findings suggest that LTCF staff can increase PUP knowledge with focused educational intervention regarding the concept, and that PUP education in LTCF may serve as a practice change outcome worthy of further consideration.
Book Synopsis COST-EFFECTIVENESS OF PRESSURE ULCER PREVENTION AND CALIBRATION ANALYSIS OF DECISION-ANALYTIC MODELS. by : Ba' Pham
Download or read book COST-EFFECTIVENESS OF PRESSURE ULCER PREVENTION AND CALIBRATION ANALYSIS OF DECISION-ANALYTIC MODELS. written by Ba' Pham and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Pressure ulcers are common in the very ill, the elderly, and immobile or neurologically compromised individuals. In Ontario, the estimated prevalence is approximately 15% among hospital patients. Affected patients experience pain and reduced quality of life. The burden of pressure ulcers in Canada is estimated to exceed $1 billion annually, or approximately one-eighth the total health care cost of cardiovascular diseases in Canada. Current guidelines recommend early prevention to reduce the burden of pressure ulcers but the economic evidence supporting these recommendations is limited. This thesis reports on studies evaluating the cost effectiveness of strategies to prevent pressure ulcers in targeted high-risk patients. In order to conduct the cost-effectiveness analysis, it was necessary to resolve calibration issues in the decision-analytic model that simulates the natural history of pressure ulcers. Model calibration is the practice of comparing projected data from a decision model with corresponding observed data in order to determine unknown model parameters. A literature review was conducted to provide an inventory of methods for the calibration of decision models and categorize these methods according to their methodological approaches. The first study describes the development of a two-stage random search algorithm for model calibration. The second study reports on the cost-effectiveness analysis of strategies to prevent pressure ulcers in elderly patients seeking help in the emergency departments. The third study describes the cost-effectiveness analysis of strategies to prevent pressure ulcers originating intra-operatively in surgical patients. Results from the first study show that the proposed two-stage random search algorithm is suitable for routine calibration of moderately complex decision models. Results from the cost-effectiveness studies show that the evaluated prevention strategies are more cost-effective than current practice. The economic evidence supports the implementation of these early prevention strategies to reduce the burden of pressure ulcers in high-risk patients.
Book Synopsis Acute and Chronic Wounds - E-Book by : Ruth Bryant
Download or read book Acute and Chronic Wounds - E-Book written by Ruth Bryant and published by Elsevier Health Sciences. This book was released on 2023-05-18 with total page 851 pages. Available in PDF, EPUB and Kindle. Book excerpt: Acute & Chronic Wounds, 6th Edition provides the latest diagnostic and treatment guidelines to help novice to expert clinicians provide evidence-based, high-quality care for patients with wounds. This textbook presents an interprofessional approach to maintaining skin integrity and managing the numerous types of skin damage, including topics that range from the physiology of wound healing, general principles of wound management, special patient populations, management of percutaneous tubes, and specific care instructions to program development. Written by respected wound experts Ruth Bryant and Denise Nix, this bestselling reference also provides excellent preparation for all wound certification exams. Comprehensive approach addresses the prevention and management of acute and chronic wounds, making it the preeminent resource for skin health and wound management across all disciplines involved in wound care, from novice to expert. Learning Objectives at the beginning of each chapter emphasize the most important content. Clinical Consult feature in each chapter provides a synthesis of the chapter content, illustrating how to assess, manage, and document a realistic clinical encounter using the ADPIE or SBAR framework. Checklists provide a concise list of actions necessary to achieve the best patient care outcomes or satisfy a particular objective. Practical tools and algorithms help in performing risk assessment, differential diagnosis, classification, treatment, and documentation. Coverage of practice development issues addresses outcomes and productivity in agencies and institutions, home care, acute care, long-term care, and long-term acute care settings. Self-assessment questions help you test your knowledge and prepare for certification exams. Helpful appendices provide answers to self-assessment questions, as well as various tools, policies and procedures, competencies, patient and family education guidance, and more. NEW! Chapters on Postacute Care Settings; Telehealth and Wound Management; Quality Tracking Across the Continuum; and Medications and Phytotherapy: Impact on Wounds provide evidence-based coverage of these important topics. UPDATED! Consolidated pressure injuries content puts everything you need to know into one chapter. Expanded full-color insert includes 50 new images — for a total of 95 color plates with more than 160 images — that visually reinforce key concepts. New information presents the latest developments in biofilm assessment and management, topical oxygen therapy, skin manifestations related to COVID-19, and strategies to enhance engagement, as well as updated product photos and more authors who are clinical experts and providers.
Book Synopsis Long-Term Care Risk Management by : Karen S. Clay
Download or read book Long-Term Care Risk Management written by Karen S. Clay and published by HC Pro, Inc.. This book was released on 2004 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Role of Pressure Ulcer in Costs, Length of Stay and Discharge Location in Acute Care Setting by : Nisha D. Patel
Download or read book The Role of Pressure Ulcer in Costs, Length of Stay and Discharge Location in Acute Care Setting written by Nisha D. Patel and published by . This book was released on 2010 with total page 94 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: The objective of the study was to determine whether the occurrence of pressure ulcer in acute care hospital increases the cost, length of stay and if it alters the discharge location. The mediatory effect of length of stay on cost controlled for pressure ulcer was evaluated. A retrospective secondary database analysis was performed on the data from 2006 National Inpatient Sample. The hospital length of stay, total charges and discharge location to skilled nursing facility between patients with and without pressure ulcer was statistically significant. Unexpectedly the results were opposite to those hypothesized, which may reflect improved effectiveness of the intervention and treatment strategies, or improved preparedness of health care providers or due to limitations in the data collected or the study design itself. Further clinical trials are warranted to get a clearer picture on the implications of pressure ulcer with special attention on prevention strategies and on hospital acquired pressure ulcers.
Download or read book Pressure Ulcers written by Barbara Acello and published by Hcpro Incorporated. This book was released on 2014-05-14 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides strategies to help long-term care nurses assess, prevent, and treat pressure ulcers in accordance with NPUAP and CMS guidelines. With this resource, not only will staff be able to overcome documentation problems and understand how to assess wounds and infections, but it provides good practices to help your facility achieve a high Quality Measure rating and accurately code Section M on the MDS 3.0. With Pressure Ulcers: Long-Term Care Clinical Manual you will: *Employ prevention strategies to reduce the risk of a deficiency under F314 *Get simplified, step-by-step instructions for proper wound assessment that comply with NPUAP and CMS guidelines *Individualize resident care plans in less time with improved accuracy using time-tested care plan approaches *Customize the CD-ROM packed with more than 50 forms and resources to save time in clinical practice and staff education
Book Synopsis A Study of Pressure Ulcer Complaints in Long Term Care Facilities Pre and Post Training by Peer Review Organization by : Sheryl M. Giordano
Download or read book A Study of Pressure Ulcer Complaints in Long Term Care Facilities Pre and Post Training by Peer Review Organization written by Sheryl M. Giordano and published by . This book was released on 2004 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pressure ulcers can cause significant health problems such as pain and infection for the elderly and debilitated. The objective of this project was to evaluate the effectiveness of a federally sponsored training by HealthInsight, the peer review organization (PRO) for the State of Nevada. The training on pressure ulcers was provided to all health care providers July 29 & 30, 2003. The methods of the project included a structured instrument developed to evaluate the training program effectiveness pre- and post pressure ulcer training. The results of the project revealed that a total of 23 long-term care facilities in Nevada attended the pressure ulcer training. A total of 87 complaints related to "In-house developed" pressure ulcers were identified in the study. The statistical findings revealed confidence interval was 71%, which was not statistically significant. Those facilities that did not attend the training had an increase in substantiated "in-house developed" pressure ulcer complaints. The confidence interval was 86%, which was not statistically significant. A third analysis compared the number of substantiated complaints for those facilities who attended the training versus those who did not, after July 20, 2003 thru July 30, 2004. The confidence interval was 82 &, which was not statistically significant. The conclusion of the project found there would be no valid basis to recommend continued pressure ulcer training. The implications for nursing of the project would suggest continued education with future redesign of the project. The researcher supports education as a tool to increase the confidence intervals, improve resident outcomes and quality of life related to pressure ulcer prevention and care.
Book Synopsis Pressure Ulcer Prevention Protocols Effect on Occurrence of Pressure Ulcers in Long Term Care Facilities by : Patricia A. Opal
Download or read book Pressure Ulcer Prevention Protocols Effect on Occurrence of Pressure Ulcers in Long Term Care Facilities written by Patricia A. Opal and published by . This book was released on 2003 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Pressure Ulcer Prevention Toolkit by : Joint Commission Resources, Inc
Download or read book Pressure Ulcer Prevention Toolkit written by Joint Commission Resources, Inc and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Despite increased attention to the pressure ulcer problem and evidence that indicates many pressure ulcers can be avoided with proper care, pressure ulcers very common in various health care settings around the world. In response to this global health care issue, the Pressure Ulcer Prevention Toolkit and accompanying CD of tools provides practical and effective tips, strategies, forms, and illustrations for preventing and mitigating pressure ulcers. Read about theoretical and practical information needed to immediately incorporate improvements to your organization's pressure ulcer prevention initiatives or develop a new program based on the following: * Care Challenges and Prevention: Users will be able to make an informed decision and apply safer care based on informative evidence-based guidelines and recommendations for the prevention and treatment of pressure ulcers * National Patient Safety Goal and Accreditation Standards: Staff will learn how to become compliant with The Joint Commission's National Patient Safety Goal related to pressure ulcer care and Joint Commission International standards and requirements * Assessment and Reassessment: Staff will become knowledgeable on care protocols to improve assessment and reassessment methods for pressure ulcers * Sustaining Improvements: Users can create, benchmark, compare, and implement policies and procedures developed by organizations from around the world * Educational Tools: Use the accompanying CD to develop an educational training tool for staff to immediately and effectively incorporate improvements to your organization's pressure ulcer prevention activities
Book Synopsis Dressing Materials for the Treatment of Pressure Ulcers in Patients in Long-term Care Facilities by : Canadian Agency for Drugs and Technologies in Health
Download or read book Dressing Materials for the Treatment of Pressure Ulcers in Patients in Long-term Care Facilities written by Canadian Agency for Drugs and Technologies in Health and published by . This book was released on 2013 with total page 13 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pressure ulcers are regions of localized damage to the skin and underlying tissues that usually develop over bony prominences. They occur as a result of uninterrupted pressure exerted on the skin, soft tissues, muscle, and bone leading to the development of localized ischemia, followed by a cascade of processes resulting in necrosis. Areas of the body commonly predisposed to pressure ulcers include heels, hip, elbows, shoulders, back of the head, knees, thighs, and toes. Ulcer severity is assessed in a variety of ways, but the US National Pressure Ulcer Advisory Panel (NPUAP) staging system is the most commonly used. The NPUAP system includes a four-stage categorization, representing progressive severity from intact skin with non-blanchable redness of localized area in Stage I, to full thickness tissue loss with exposed bone in Stage IV. People with impaired mobility (e.g., stroke or spinal cord injury patients) are most vulnerable to pressure ulcers. Conditions such as poor nutrition, poor sensation, urinary and fecal incontinence, and poor overall physical and mental health are predisposing factors to pressure ulcer formation. The incidence of pressure ulcers vary according to settings, with a range of 2.2 to 23.9 percent in long-term nursing facilities. Prevalence of pressure ulcers is used as an indicator of quality for long-term care facilities, and progression of pressure ulcers in hospitalized patients is often considered an avoidable complication representing failure of inpatient management. Higher prevalence is reported for the elderly, the acutely ill, and those who have sustained spinal cord injuries. In Canada, pressure ulcer prevalence is reported to range between 5.0% in the hospital setting and up to 30% for spinal cord injured patients in the community. Three fundamental approaches that may be employed sequentially in pressure ulcer wound care are reduction or elimination of underlying contributing conditions such as modifying support surfaces and providing nutritional support; provision of local wound care, including but not limited to wound dressing and topical applications to promote healing; and surgical repair of the ulcer, where appropriate. Pressure ulcer wound care modalities are influenced by clinical practice guidelines and local practice patterns, patient-related issues such as comorbidities and nutritional status, and the stage and features of the wound. Though complete healing with the restoration of functional integrity of skin to highest extent possible is the goal of therapy in most cases, the goal of therapy may be palliative for certain patients such as the terminally ill, focusing on reducing discomfort and/or deterioration of the pressure ulcer. In a systematic review involving 14,000 patients from 45 health care institutions to determine the prevalence of pressure ulcers in health care settings across Canada, the median prevalence of pressure ulcers in Canada, regardless of health care settings, is reported to be 26%. A study in Ontario, Canada showed that pressure ulcers increase the risk of mortality among geriatric patients by as much as 400%, increase the frequency and duration of hospitalization, and decrease the quality of life of affected patients. It is a source of significant economic burden, estimated to cost approximately $9,000 (Cdn) per patient per month in the community setting. In the United States, it is estimated that total annual cost of treatment of pressure ulcers is $11 billion with treatment cost per case ranging between $37,800 and $70,000. Dressings are an integral part of proper pressure ulcer wound care. They protect ulcers from trauma and contamination, and promote healing by absorbing exudate to prevent maceration while providing moisture balance to prevent desiccation which can hinder epithelial cell migration. A wide variety of dressings are available; including many with various combinations of properties such as wound bed preparation (debridement), antimicrobial activity, and moisture control. The purpose of this review is to provide information on comparative effectiveness of currently used dressing products to help inform management policy on stage 3 and 4 pressure ulcer.
Book Synopsis Use of Pressure Relieving Mattresses for the Prevention of Hospital Acquired Pressure Ulcers by : Ancy John
Download or read book Use of Pressure Relieving Mattresses for the Prevention of Hospital Acquired Pressure Ulcers written by Ancy John and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pressure ulcer is common healthcare issue that can leads to harmful effects on patients, healthcare organizations and the overall healthcare system. In Unites states, there are about 16 million patients develop pressure ulcers in acute care settings annually (Nicosia, G., Gliatta, A., Woodbury, M., and Houghton, P, 2007). Accountability and liability towards the hospital acquired pressure ulcer has been increased therefore the health care organizations give much importance for the preventive aspect of pressure ulcers by implementing effective pressure ulcer prevention measures on patients who are at a great risk for developing pressure ulcer while at the hospital. The treatment of pressure ulcer is expensive so the increased cost of pressure ulcers and lengthy hospitalizations may lead to loss of revenue to the healthcare organizations ((Agency For Healthcare Research and Quality AHRQ, 2013). Uses of pressure relieving mattresses are one of the important pressure ulcer strategies in the acute care settings. 0−́Pressure ulcers are expensive in human (physical and mental burden) as well as in financial terms; consequently, prevention is an important topic for clinical practice0+́ (Heyneman, A., Vanderwee, K., Grypdonck, M., and Defloor, T, 2009). The prevention of hospital acquired pressure ulcers based on reduction of the duration and magnitude of pressure and shearing forces (Heyneman, et. al, 2009). The duration of shear and pressure can be decreased by using alternating pressure air mattresses or repositioning the patient (Heyneman, et. al, 2009). Therapeutic support surfaces are an integral intervention for both the prevention and treatment of pressure ulcers (The National Pressure Ulcer Advisory Panel (NPUAP), 2013).A large amount research has been conducted to evaluate the effectiveness of pressure relieving mattresses and support surfaces in preventing the occurrence of hospital acquired pressure ulcers. The author of this paper reviewed 15 peer reviewed research articles to determine the effectiveness of pressure relieving mattresses for preventing incidence of hospital acquired pressure ulcers among elderly patients in acute and long term care settings as compared to standard hospital mattresses. The evidence based data's collected from these literatures were reviewed and based on these data's new pressure ulcer prevention action plan was developed. Approval for launching a new pressure ulcer prevention plan was obtained from the facility management and the information was communicated to the nurses and other employees appropriately. During the implementation phase proper use of pressure prevention mattress was combined with other prevention strategies to reduce the incidence of pressure ulcers. After the successful implementation of new pressure ulcer prevention plan the effectiveness of the of pressure ulcer prevention project was evaluated by using auditing, direct observation, employees survey, questionnaire and patient survey.
Author :U. S. Department of Health and Human Services Publisher :CreateSpace ISBN 13 :9781490574738 Total Pages :362 pages Book Rating :4.5/5 (747 download)
Book Synopsis Pressure Ulcer Risk Assessment and Prevention: Comparative Effectiveness by : U. S. Department of Health and Human Services
Download or read book Pressure Ulcer Risk Assessment and Prevention: Comparative Effectiveness written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-06-29 with total page 362 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pressure ulcers are defined by the National Pressure Ulcer Advisory Panel (NPUAP) as “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction.” A number of risk factors are associated with increased risk of pressure ulcer development, including older age, black race, lower body weight, physical or cognitive impairment, poor nutritional status, incontinence, and specific medical comorbidities that affect circulation such as diabetes or peripheral vascular disease. Pressure ulcers are often associated with pain and can contribute to decreased function or lead to complications such as infection. In some cases, pressure ulcers may be difficult to successfully treat despite surgical and other invasive treatments. In the inpatient setting, pressure ulcers are associated with increased length of hospitalization and delayed return to function. In addition, the presence of pressure ulcers is associated with poorer general prognosis and may contribute to mortality risk. Recommended prevention strategies for pressure ulcers generally involve use of risk assessment tools to identify people at higher risk for developing ulcers in conjunction with interventions for preventing ulcers. A variety of diverse interventions are available for the prevention of pressure ulcers. Categories of preventive interventions include support surfaces (including mattresses, integrated bed systems, overlays, and cushions), repositioning, skin care (including lotions, dressings, and management of incontinence), and nutritional support. Each of these broad categories encompasses a variety of interventions. The purpose of this report is to review the comparative clinical utility and diagnostic accuracy of risk-assessment instruments for evaluating risk of pressure ulcers and to evaluate the benefits and harms of preventive interventions for pressure ulcers in different settings and patient populations. The following Key Questions are the focus of this report: KQ1. For adults in various settings, is the use of any risk-assessment tool effective in reducing the incidence or severity of pressure ulcers compared with other risk-assessment tools, clinical judgment alone, and/or usual care? KQ1a. Do the effectiveness and comparative effectiveness of risk-assessment tools differ according to setting? KeQ1b. Do the effectiveness and comparative effectiveness of risk-assessment tools differ according to patient characteristics and other known risk factors for pressure ulcers, such as nutritional status or incontinence? KQ2. How do various risk-assessment tools compare with one another in their ability to predict the incidence of pressure ulcers? KQ2a. Does the predictive validity of various risk-assessment tools differ according to setting? KQ2b. Does the predictive validity of various risk-assessment tools differ according to patient characteristics? KQ3. In patients at increased risk of developing pressure ulcers, what are the effectiveness and comparative effectiveness of preventive interventions in reducing the incidence or severity of pressure ulcers? KQ3a. Do the effectiveness and comparative effectiveness of preventive interventions differ according to risk level as determined by different risk-assessment methods and/or by particular risk factors? KQ3b. Do the effectiveness and comparative effectiveness of preventive interventions differ according to setting? KQ3c. Do the effectiveness and comparative effectiveness of preventive interventions differ according to patient characteristics? KQ4. What are the harms of interventions for the prevention of pressure ulcers? KQ4a. Do the harms of preventive interventions differ according to the type of intervention? KQ4b. Do the harms of preventive interventions differ according to setting? KQ4c. Do the harms of preventive interventions differ according to patient characteristics?
