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Objetivo: determinar a frequência dos componentes do diagnóstico de enfermagem Risco de lesão por pressão e sua relação com a escala de Braden. Método: estudo transversal desenvolvido entre 2020 e 2021 com 105 pacientes de uma unidade de terapia intensiva que estavam em risco de desenvolver lesão por pressão. Foi realizada análise descritiva e analítica. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: o fator de risco, população em risco e condições associadas mais frequentes foram redução da mobilidade (99,0%), extremo de idade (39,0%) e anemia (46,7%) respectivamente. Pacientes que apresentaram forças de cisalhamento, história de acidente vascular encefálico, imobilização física, alteração na função cognitiva e alteração na sensibilidade apresentaram menores pontuações na escala de Braden. Conclusão: a utilização de escalas validadas e diagnósticos de enfermagem ampliam o julgamento crítico do enfermeiro sobre os motivos que elevam o risco de desenvolvimento de lesão por pressão.
Objective: to determine the frequency of the components of the nursing diagnosis of risk of pressure injury and their relation with the Braden scale. Method: in 2020 and 2021 this cross-sectional study performed a descriptive and analytical investigation of 105 patients in an intensive care unit who were at risk of developing pressure injury. The study was approved by the research ethics committee. Results: the risk factor, population at risk and associated condition with the highest frequencies were, respectively, reduced mobility (99.0%), extremes of age (39.0%) and anemia (46.7%). Patients who presented shear forces, history of stroke, physical immobility, impaired cognitive function, and sensory impairment scored lower on the Braden scale. Conclusion: use of a validated measurement scale and nursing diagnoses expands critical thinking in nursing about the reasons that heighten the risk of developing pressure injuries.
Objetivo: determinar la frecuencia de los componentes del diagnóstico de enfermería, Riesgo de lesión por presión y su relación con la Escala Braden. Método: estudio transversal llevado a cabo entre 2020 y 2021 junto a 105 pacientes de una Unidad de Cuidados Intensivos que estaban en riesgo de desarrollar lesión por presión. Se realizaron análisis descriptivo y analítico. El Comité de Ética en Investigación aprobó la investigación. Resultados: el factor de riesgo, población en riesgo y condiciones asociadas más frecuentes fueron reducción de la movilidad (99,0%), extremo de edad (39,0%) y anemia (46,7%). Pacientes que presentaron Fuerzas de cillazamiento, Historia de accidente vascular encefálico, Inmovilización física, alteración en la función cognitiva y alteración en la sensibilidad presentaron puntajes más bajos en la Escala de Braden. Conclusión: el uso de escalas validadas y diagnósticos de enfermería amplía el juicio crítico del enfermero en cuanto a los motivos que aumentan el riesgo de desarrollo de lesión por presión.
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Objective To test the clinical validity of use of the Chinese version of Munro adult pressure ulcer risk-assessment scales (Munro scales),Braden scales,Qian Weiming operation pressure ulcer risk-assessment scales (self-designed scales) in the patients with general anesthesia surgery.Methods Three investigators respectively used the Munro scales,Braden scales and self-designed scales to conduct the pressure ulcer risk-assessment on 261 patients with general anesthesia surgery before operation,at the end of operation and at exiting from anesthesia recovery room.The sensitivity,specificity,positive predictive value and negative predictive value of each assessment tool were calculated.Results The best critical values of the Munro scales before operation,at the end of operation and at exiting from anesthesia recovery room were 8.0,24.5,28.5 points respectively;which of the Braden scale were 18.5,11.5,13.5 points respectively;which of self-made scale were 12.5,13.5,13.5 points respectively.The area under the ROC curve of the three different scales at the beginning of the operation above was 0.653,0.596,0.652.The area under the ROC curve of the three different scales at the end of the operation above was 0.872,0.548,0.792.The areas under the ROC curve of the three different scales before operation were 0.868,0.773 and 0.813 respectively.Conclusion The Chinese version of Munro scales is more suitable for the assessment of operative patient's pressure ulcer risk than the Braden scale and self-designed scales,but the preoperative risk assessment needs to be improved.
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Introducción: las úlceras por presión prolongan la estancia hospitalaria, generan un impacto negativo en la persona hospitalizada y elevan costos de atención, por lo que constituyen un problema de salud pública y un indicador de la calidad del cuidado de enfermería. Objetivo: identificar el cumplimiento de las actividades de enfermería en la prevención de úlceras por presión. Método: estudio descriptivo, transversal, en tres instituciones de salud de Barranquilla durante 2010. Universo 97 enfermeras y auxiliares de enfermería. Se utilizó el instrumento cumplimiento de criterios básicos en la prevención de ulceras por presión a pacientes hospitalizado, formato F1PUPPH/05. Se conformó una base de datos en Microsoft Excel. Para evaluar el comportamiento de las variables del estudio se utilizó la estadística descriptiva (medidas de tendencia central y variabilidad, normalidad y detección de datos atípicos y ausentes). Resultados: los criterios de cumplimiento en la prevención de ulceras por presión más empleados fueron: ejecuta el plan de cuidados, utiliza los elementos disponibles en la prevención con un 54,53 por ciento y registra factores de riesgo con un 53,60 por ciento, los menos empleados: valora el riesgo utilizando las escalas reconocidas y revalora y ajusta de acuerdo al estado del paciente, con un 58,76 por ciento cada uno. El 45,36 por ciento de la muestra alcanza el nivel de No cumplimiento de las acciones de prevención y el 35,05 por ciento obtuvo un nivel de excelente. Conclusiones: la debilidad en la competencia de la aplicación de escalas de valoración de riesgo de úlceras por presión confirma la importancia del cumplimiento de las actividades de prevención como indicador de calidad del cuidado de enfermería, así mismo genera un aporte al currículo, investigación y práctica de enfermería(AU)
Introduction: pressure ulcers lengthen hospital stay, produce a negative impact on the hospitalized person and raise care costs, a reason why they constitute a public health concern and an indicator of the quality of nursing care. Objective: to identify the accomplishment of nursing activities in the prevention of pressure ulcers. Method: descriptive cross-sectional study carried out at three health facilities of Barranquilla during 2010. Target group: 97 nurses and nursing assistants. We used the instrument accomplishment of basic criteria for pressure ulcer prevention in hospitalized patients (F1-PUPPH/05). We created a database in Microsoft Excel. To assess the behavior of the studied variables, we used descriptive statistics (central tendency and variability measures, normality and detection of atypical and absent data). Results: the most used accomplishment criteria for pressure ulcer prevention were the care plan execution; the use of elements available in prevention, with a 54.53 percent; and risk factors recording, with a 53.60 percent. The least used were risk assessing by using the recognized scores; and reassessment and adjustment according to the patient's state, with 58.76 percent each. 45.36 percent of the sample reaches the level of unaccomplishment of the prevention actions and 35.05 percent obtained a level of excellent. Conclusions: competence weakness in applying pressure ulcer risk assessment scores confirms the importance of prevention activities accomplishment as a nursing care quality indicator, and produces a contribution to the resume, research and nursing practice(AU)
Asunto(s)
Humanos , Indicadores de Salud , Úlcera por Presión/prevención & control , Hospitalización , Atención de Enfermería/métodos , Epidemiología Descriptiva , Estudios Transversales , Factores de RiesgoRESUMEN
Objective To evaluate and compare the predictive validity of the Braden Q and Braden pressure ulcer risk assessment scales in the acute pediatric patients, and explore the cutoff score of the scales. Methods We adopted the prospective cohort study design.The settings included three PICU of three different children's hospitals. Two nurses were appointed as the data collectors, and they were in charge of both the scoring and the skin assessment separately. Results We collected 145 samples. There were 9 patients who developed the pressure ulcers, and the incidence rate was 6.2%. The cutoff score of Braden Q and Braden scale was 17 and 14. The AUC of the ROC curve of the two scales was 0.481 and 0.398. Conclusions The Braden Q scale is more suitable for the pediatric patients. Further study is neededed to improve the scale.
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Objective To compare and evaluate the reliability and validity of the application of three pressure ulcer risk assessment scales in hospitalized elderly patients by Norton,Braden and Waterlow pressure ulcer risk assessment scales. Methods We selected 271 elderly patiehts from a certain thirdclass and first-grade hospital and assessed their pressure ulcer risks by 3 assessment scales.The reliability and validity of these Scales were evaluated and compared by the following methods such as Cronbaeh's α coefficient,content validity index,factor analysis and ROC curve. Results The Cronbach's α coefficient of these 3 scales were 0.71,0.79 and 0.32 respectively.The content validity indices of them were 0.85,0.91and 0.87.The cumulative variance explained were 71.73%,70.34%and 65.76%respectively.The sensitivity and specificity upon cut-off points were(0.75,0.62),(0.74,0.59)and(0.86,0.59).Conclusion The Waterlow scale showed insufficient internal consistency but good predictive ability.The Braden scale showed moderate reliability and validity but with a lower predictive ability compared with the Norton and Waterlow scales.
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This study is aims to study the risk levels and the occurrence of pressure ulcers in hospitalized patients with limited activity. The study was conducted in a medical setting at Siriraj Hospital from January 15th to May 31st, 2001. One Hundred patients were enrolled into the study. The data collection procedure included the completion of Braden's pressure ulcer risk assessment form and Bergstrom's skin assessment form on day of admission and this continued throughout the study. The results showed that 28 % of the patients had no risk of pressure ulcer development, while 25 % showed a low risk level, 22 % showed a moderate risk level, and 25 % showed a high risk level. The incidence of pressure ulcer was 40 %. Sixty-five % of those who developed pressure ulcers were age 60 and over and 83 % of them had chronic illnesses such as diabetes or hypertension before hospital admission. There were 96 ulcers found in 40 patients. Of these ulcers, 59 ulcers were stage I while 37 ulcers were stage II. The ulcers most frequently occurred during the first week of hospitalization. The average length of hospital stay of patients who had a pressure ulcer was 14 days while in those who did not have pressure ulcer the stay was only 10 days. The occurrence of pressure ulcers on hospitalization and the number of patients at risk of pressure ulcer development highlight the magnitude of the problem. The results support the need for risk assessment and skin assessment at the time of admission and periodically throughout the hospital stay and could contribute to establishment of a pressure ulcer risk assessment tool as a guideline in nursing practice for predicting and preventing pressure ulcers.