ABSTRACT
Purpose：We investigated the factors associated with medical device-related pressure ulcer (MDRPU) due to lower extremity orthosis in patients undergoing convalescent rehabilitation for stroke.Methods：This retrospective study included patients with stroke who wore ankle foot orthosis in the convalescent rehabilitation ward. We measured the following items at admission：Brunnstrom recovery stage, presence of sensory disturbance, exhibition of unilateral spatial neglect, functional independence measures at admission and discharge, and presence of MDRPU. In the statistical analysis, logistic regression analysis was performed to identify the significant factors associated with MDRPU.Results：Ninety-five participants were enrolled in this study (mean age：54.9 ± 11.6 years, Male：78.9%). In logistic regression analysis, Age (odds ratio＝1.05, 95% confidence interval＝1.01-1.10, p＜0.05) and the presence of sensory disturbance (odds ratio＝5.17, 95% confidence interval＝1.39-19.28, p＜0.05) at admission was extracted as the cause of MDRPU.Conclusion：Sensory disturbance at admission is associated with MDRPU in patients undergoing convalescent rehabilitation for stroke who wear ankle foot orthosis.
ABSTRACT
Purpose：We investigated the factors associated with medical device-related pressure ulcer (MDRPU) due to lower extremity orthosis in patients undergoing convalescent rehabilitation for stroke.Methods：This retrospective study included patients with stroke who wore ankle foot orthosis in the convalescent rehabilitation ward. We measured the following items at admission：Brunnstrom recovery stage, presence of sensory disturbance, exhibition of unilateral spatial neglect, functional independence measures at admission and discharge, and presence of MDRPU. In the statistical analysis, logistic regression analysis was performed to identify the significant factors associated with MDRPU.Results：Ninety-five participants were enrolled in this study (mean age：54.9 ± 11.6 years, Male：78.9%). In logistic regression analysis, Age (odds ratio＝1.05, 95% confidence interval＝1.01-1.10, p＜0.05) and the presence of sensory disturbance (odds ratio＝5.17, 95% confidence interval＝1.39-19.28, p＜0.05) at admission was extracted as the cause of MDRPU.Conclusion：Sensory disturbance at admission is associated with MDRPU in patients undergoing convalescent rehabilitation for stroke who wear ankle foot orthosis.
ABSTRACT
ABSTRACT Objective: to identify factors associated with medical-device-related pressure injury. Method: an integrative review of published articles on the subject related to the adult population in the databases of PUBMED, Scopus, MEDLINE, Latin American and Caribbean Health Sciences Literature (Literatura Latino-Americana e do Caribe em Ciências da Saúde, LILACS), Web of Science and Nursing Database (Banco de Dados em Enfermagem, BDENF), between 2013 and 2018. Results: medical-device-related pressure injuries were common in adults, especially in the elderly, due to capillary fragility, among other changes. Other observed factors were length of stay, critically ill patients or those requiring any type of medical device. Numerous medical devices have been associated with skin lesions; among the most frequent were breathing, feeding, and orthopedic devices, tubes, oximeters, neck collars, patches and nasogastric tubes. Conclusion: the first step towards prevention is exploration in terms of identifying the types of injury-causing devices and evidence-based interventions, and disseminating information to the entire multidisciplinary team.
RESUMEN Objetivo: identificar factores asociados con las lesiones por presión relacionadas a dispositivos médicos. Método: revisión integradora de artículos publicados sobre el tema relacionado a la población adultas en las siguientes bases de datos: PUBMED, Scopus, MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Web of Science y Banco de Dados em Enfermagem (BDENF), entre 2013 y 2018. Resultados: las lesiones por presión relacionadas con dispositivos médicos fueron comunes en adultos, principalmente en ancianos, debido a la fragilidad capilar, entre otras alteraciones. También se observaron otros factores como tiempo de permanencia, pacientes críticos o que necesitaban cualquier tipo de dispositivo médico. Se asoció un sinnúmero de dispositivos médicos a las lesiones de piel; entre los más frecuentes se pueden mencionar los dispositivos respiratorios, de alimentación y ortopédicos, los tubos, los oxímetros, los collares cervicales, los adhesivos y las sondas nasogástricas. Conclusión: el primer paso para la prevención es la exploración, en términos de identificar los tipos de dispositivos que causan la lesión y las intervenciones basadas en evidencias científicas, además de divulgar la información a todo el equipo multiprofesional.
RESUMO Objetivo: identificar fatores associados à lesão por pressão relacionada a dispositivo médico. Método: revisão integrativa de artigos publicados sobre o tema relacionado à população adulta nas bases de dados da PUBMED, Scopus, MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Web of Science e Banco de Dados em Enfermagem (BDENF), entre 2013 e 2018. Resultados: lesões por pressão relacionadas a dispositivo médico foram comuns em adultos, principalmente em idosos, devido à fragilidade capilar, entre outras alterações. Outros fatores observados foram tempo de permanência, pacientes críticos ou que necessitassem de qualquer tipo de dispositivo médico. Inúmeros dispositivos médicos foram associados às lesões de pele; entre os mais frequentes estiveram dispositivos respiratórios, de alimentação, ortopédicos, tubos, oxímetros, colares cervicais, adesivos e sondas nasogástricas. Conclusão: o primeiro passo para a prevenção é a exploração, em termos de identificação dos tipos de dispositivos que causam a lesão e intervenções baseadas em evidências científicas, além da divulgação das informações para toda a equipe multiprofissional.
Subject(s)
Humans , Adult , Wounds and Injuries , Pressure Ulcer , Nursing , Adult , Equipment and Supplies , Equipment SafetyABSTRACT
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.