Early detection and management of pressure ulcers among vulnerable patients at El Manial University Hospital

ABSTRACT

Pressure ulcers are serious problems that occur frequently in acute and long term facilities. Once they occur, pressure ulcer may lead to sepsis and death. A key to prevention is early detection of patients at-risk with a valid and reliable pressure ulcer risk assessment instrument. The Braden scale is one of the most intensively used tools designed to facilitate that assessment, the cost of treating a hospitalized-acquired pressure ulcer places a significant burden on health care facilities. Associated expenses potentially include increased supplies, equipment, specialty beds, staffing, nutritional support, laboratory testing, and hospital length of stay. So, the purpose of this study is to develop a system for early detection and management of patient at risk for pressure ulcers among vulnerable patients at El Manial university hospital. A quasi-experimental design pre-post test intervention was used. The sample recruited in the study was 100 patients [male and female] and 30 female nurses. Pre-post tests were used to assess the nurse's knowledge and practice toward the care of patients about pressure ulcers. The study results demonstrated that, the teaching sessions for nurses showed a significant improvement in nurse's knowledge and demonstrated a positive change in their performance. Using Braden scale helped nurses to identify the patient at risk for pressure ulcers and assisted them to make decisions about the methods of pressure ulcers prevention to be taken. Patients' observations were made every 72 hours for a minimum of I to a maximum of 4 weeks. The outcomes [presence/absence and stage of pressure ulcer] were documented at each assessment. 29% of subjects developed pressure ulcers. The incidence was 15% for stage I and 14% for stage 11, the Braden scale showed a 66.7% sensitivity, 100% specificity, 66.7% predictive value of positive test and predictive value of negative test was 96.3%, and the cut-off point for classifying the pressure ulcer risk was 18, with overall accuracy 92.5%. The study recommended using the Braden scale in all health care facilities, Also a regular in service education programs for all staff and orientation programs for all new employees are essential about how to use the Braden scale for predicting pressure ulcer risk and for refreshing nurse's knowledge and practice regarding the prevention of pressure ulcers