Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 22
Filter
1.
J Tissue Viability ; 31(2): 213-220, 2022 May.
Article in English | MEDLINE | ID: covidwho-1851676

ABSTRACT

AIM: This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions taken to prevent these injuries. METHOD: Relevant studies were retrospectively searched. Seven English keywords identified from MESH were used while searching. The search was carried out in five international databases by trying various combinations of these words during February 15-25, 2021. This systematic review was updated by rescanning databases on December 20, 2021 and a total of 611 studies were attained. RESULTS: 17 studies which met the study inclusion criteria, which were conducted mostly through online survey method in different study designs and which included a total of 24,889 healthcare professionals were examined. The incidence of PPE-related pressure ulcers was found to be between 30% and 92.8%. Grade I pressure ulcers were the most common (44.1%-82%). The incidence of skin problems except PPE-related pressure ulcers such as itching, redness and dry skin was found to be between 42.8-88.1%. Risk factors that frequently played a role in the development of PPE-related pressure ulcers and other skin problems were longer use of PPE and sweating. PPE-related pressure ulcers and other skin problems were more frequent over the nose (nasal bone/nasal bridge), ears, forehead and cheeks. PPE-related itching, redness and dry skin mostly occurred. Several dressing applications were found to be effective in the prevention of PPE-related pressure ulcers and other skin problems that might develop especially on the facial region. CONCLUSION: PPE-related pressure ulcers and other skin problems were found to be higher among healthcare professionals. Data regarding the sealing of dressing applications against viral transmission in the prevention of PPE-related pressure ulcers and other skin problems are limited. It is estimated that future studies will be performed to prevent device-related pressure ulcers in healthcare workers. It is suggested that there is a need to conduct studies with larger samples where expert researchers make observations for pressure ulcers in order to determine the prevalence and incidence of PPE-related pressure ulcers.


Subject(s)
COVID-19 , Pressure Ulcer , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Humans , Pandemics/prevention & control , Personal Protective Equipment/adverse effects , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Pressure Ulcer/prevention & control , Pruritus , Retrospective Studies
2.
Cells ; 11(8)2022 04 09.
Article in English | MEDLINE | ID: covidwho-1785540

ABSTRACT

The risk of complications following surgical procedures is significantly increased in patients with SARS-CoV-2 infection. However, the mechanisms underlying these correlations are not fully known. Spinal cord injury (SCI) patients who underwent reconstructive surgery for pressure ulcers (PUs) before and during the COVID-19 pandemic were included in this study. The patient's postoperative progression was registered, and the subcutaneous white adipose tissue (s-WAT) surrounding the ulcers was analyzed by proteomic and immunohistochemical assays to identify the molecular/cellular signatures of impaired recovery. Patients with SCI and a COVID-19-positive diagnosis showed worse recovery and severe postoperative complications, requiring reintervention. Several proteins were upregulated in the adipose tissue of these patients. Among them, CKMT2 and CKM stood out, and CKM increased for up to 60 days after the COVID-19 diagnosis. Moreover, CKMT2 and CKM were largely found in MGCs within the s-WAT of COVID patients. Some of these proteins presented post-translational modifications and were targeted by autoantibodies in the serum of COVID patients. Overall, our results indicate that CKMT2, CKM, and the presence of MGCs in the adipose tissue surrounding PUs in post-COVID patients could be predictive biomarkers of postsurgical complications. These results suggest that the inflammatory response in adipose tissue may underlie the defective repair seen after surgery.


Subject(s)
COVID-19 , Pressure Ulcer , Spinal Cord Injuries , Adipose Tissue/metabolism , COVID-19/complications , COVID-19 Testing , Creatine Kinase/metabolism , Creatine Kinase, Mitochondrial Form/metabolism , Humans , Pandemics , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Pressure Ulcer/surgery , Proteomics , SARS-CoV-2 , Spinal Cord Injuries/complications , Spinal Cord Injuries/surgery , Suppuration/complications , Up-Regulation
4.
J Nurs Manag ; 30(4): 1061-1068, 2022 May.
Article in English | MEDLINE | ID: covidwho-1735960

ABSTRACT

AIM: To evaluate the completion of nursing records through scheduled audits to analyse risk outcome indicators. BACKGROUND: Nursing records support clinical decision-making and encourage continuity of care, hence the importance of auditing their completion in order to take corrective action where necessary. METHOD: This was an observational descriptive study carried out from February to November 2020 with a sample of 1131 electronic health records belonging to patients admitted to COVID-19 hospital units during three observation periods: pre-pandemic, first wave, and second wave. RESULTS: A significant reduction in nursing record completion rates was observed between pre-pandemic period and first and second waves: Braden scale 40.97%, 28.02%, and 30.99%; Downton scale: 43.74%, 22.34%, and 33.91%; Gijón scale: 40.12%, 26.23%, and 33.64% (p < 0.001). There was an increase in the number of records completed between the first and second waves following the measures adopted after the quality audit. CONCLUSIONS: The use of scheduled audits of nursing records as quality indicators facilitated the detection of areas for improvement, allowing timely corrective actions. IMPLICATIONS FOR NURSING MANAGEMENT: Support from nursing managers at health care facilities to implement quality assessment programmes encompassing audits of clinical record completion will encourage the adoption of measures for corrective action.


Subject(s)
COVID-19 , Pressure Ulcer , Accidental Falls , COVID-19/epidemiology , Humans , Nursing Records , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Pressure Ulcer/prevention & control , 34658
5.
Br J Nurs ; 31(4): S22-S32, 2022 Feb 24.
Article in English | MEDLINE | ID: covidwho-1716169

ABSTRACT

OBJECTIVE: Many patients with COVID-19 admitted to intensive care undergo prone positioning. These patients are at risk of developing facial pressure ulcers (PUs). This study aimed to identify evidence-based recommendations to prevent or reduce their incidence. METHOD: A multi-case study was undertaken using secondary data published between November 2020 and April 2021 discussing facial PUs in patients with COVID-19. CINAHL and MEDLINE electronic databases were analysed. Sixteen publications met the inclusion criteria. The overall quality of evidence was low. RESULT: Studies reported a high incidence of facial PUs. The evidence suggests key preventive areas are skin assessment, pressure-redistribution surfaces, eye coverings, education, medical devices and prophylactic dressings. Recommendations included skin cleaning and moisturising, eye coverings, replacing endotracheal tube holders and using hydrocolloid or film dressings. CONCLUSION: Considering the severe implications for patients and healthcare systems caused by facial PUs, ICUs should develop strategies to prevent and minimise them.


Subject(s)
COVID-19 , Pressure Ulcer , Humans , Intensive Care Units , Pressure Ulcer/epidemiology , Pressure Ulcer/prevention & control , SARS-CoV-2 , Ulcer
6.
J Nurs Care Qual ; 37(2): 162-167, 2022.
Article in English | MEDLINE | ID: covidwho-1703352

ABSTRACT

BACKGROUND: COVID-19 negatively impacts many organ systems including the skin. One of the most significant skin-associated adverse events related to hospitalization are pressure injuries. PURPOSE: The aim of this study was to determine 8 risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic. METHODS: A retrospective, descriptive analysis was conducted in an urban academic health science center located in the southeastern United States. RESULTS: There were 247 of 23 093 patients who had pressure injuries and 1053 patients who had a positive COVID-19 diagnosis. Based on the generalized estimating equation model, diagnosis of COVID-19, age, male gender, risk of mortality, severity of illness, and length of stay are statistically significant factors associated with the development of HAPIs. CONCLUSIONS: Further study should explore pathology of COVID-19 skin changes and what interventions are effective against HAPIs in the COVID-19 population taking into consideration current treatments.


Subject(s)
COVID-19 , Pressure Ulcer , COVID-19 Testing , Hospitalization , Hospitals , Humans , Male , Pandemics , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Retrospective Studies , SARS-CoV-2
7.
J Nurs Care Qual ; 37(2): 162-167, 2022.
Article in English | MEDLINE | ID: covidwho-1455413

ABSTRACT

BACKGROUND: COVID-19 negatively impacts many organ systems including the skin. One of the most significant skin-associated adverse events related to hospitalization are pressure injuries. PURPOSE: The aim of this study was to determine 8 risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic. METHODS: A retrospective, descriptive analysis was conducted in an urban academic health science center located in the southeastern United States. RESULTS: There were 247 of 23 093 patients who had pressure injuries and 1053 patients who had a positive COVID-19 diagnosis. Based on the generalized estimating equation model, diagnosis of COVID-19, age, male gender, risk of mortality, severity of illness, and length of stay are statistically significant factors associated with the development of HAPIs. CONCLUSIONS: Further study should explore pathology of COVID-19 skin changes and what interventions are effective against HAPIs in the COVID-19 population taking into consideration current treatments.


Subject(s)
COVID-19 , Pressure Ulcer , COVID-19 Testing , Hospitalization , Hospitals , Humans , Male , Pandemics , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Retrospective Studies , SARS-CoV-2
8.
Arch Phys Med Rehabil ; 102(10): 1932-1938, 2021 10.
Article in English | MEDLINE | ID: covidwho-1439853

ABSTRACT

OBJECTIVE: To determine if the incidence of pressure injuries (PIs) on admission to an inpatient rehabilitation hospital (IRH) system of care was increased during the early coronavirus disease 2019 (COVID-19) pandemic period. DESIGN: Retrospective survey chart review of consecutive cohorts. Admissions to 4 acute IRHs within 1 system of care over the first consecutive 6-week period of admitting patients positive for COVID-19 during the initial peak of the COVID-19 pandemic, April 1-May 9, 2020. A comparison was made with the pre-COVID-19 period, January 1-February 19, 2020. SETTING: Four acute IRHs with admissions on a referral basis from acute care hospitals. PARTICIPANTS: A consecutive sample (N=1125) of pre-COVID-19 admissions (n=768) and COVID-19 period admissions (n=357), including persons who were COVID-19-positive (n=161) and COVID-19-negative (n=196). MAIN OUTCOME MEASURES: Incidence of PIs on admission to IRH. RESULTS: Prevalence of PIs on admission during the COVID-19 pandemic was increased when compared with the pre-COVID-19 period by 14.9% (P<.001). There was no difference in the prevalence of PIs in the COVID-19 period between patients who were COVID-19-positive and COVID-19-negative (35.4% vs 35.7%). The severity of PIs, measured by the wound stage of the most severe PI the patient presented with, worsened during the COVID-19 period compared with pre-COVID-19 (χ2 32.04%, P<.001). The length of stay in the acute care hospital before transfer to the IRH during COVID-19 was greater than pre-COVID-19 by 10.9% (P<.001). CONCLUSIONS: During the early part of the COVID-19 pandemic time frame, there was an increase in the prevalence and severity of PIs noted on admission to our IRHs. This may represent the significant burden placed on the health care system by the pandemic, affecting all patients regardless of COVID-19 status. This information is important to help all facilities remain vigilant to prevent PIs as the pandemic continues and potential future pandemics that place strain on medical resources.


Subject(s)
COVID-19/epidemiology , Patient Admission , Pressure Ulcer/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , Female , Hospitals, Rehabilitation , Humans , Incidence , Inpatients , Male , Middle Aged , Pandemics , Retrospective Studies , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires , United States/epidemiology , Young Adult
9.
J Tissue Viability ; 30(4): 478-483, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1336688

ABSTRACT

AIM OF STUDY: The main objective of this study was to ascertain whether severe alterations in hypoxemic, inflammatory, and nutritional parameters in patients diagnosed with SARS-CoV-2 infection were associated with the occurrence and severity of developed dependency-related injuries. The secondary objective was to determine whether there were prognostic factors associated with the occurrence and severity of developed dependency-related injuries during the SARS-CoV-2 pandemic. MATERIAL AND METHODS: A retrospective, single-centre, case-control study was conducted to compare SARS-CoV-2 patients who developed dependency-related injuries after the first 48 h after admission with a control group made up of SARS-CoV-2 patients without dependency-related injuries. The cases of the 1987 patients diagnosed with SARS-CoV-2 infection during the study period were reviewed. Data from 94 patients who developed dependency-related injuries and from 190 patients who did not develop them during hospital admission were analysed. RESULTS: High baseline dependency levels, prolonged hospital stays, and low oxygen saturation levels on arrival in emergency department triage were associated with the occurrence of dependency-related injuries among patients diagnosed with SARS-CoV-2 infection. CONCLUSIONS: SARS-CoV-2 infection can lead to complications such as dependency-related injuries. Although there are several non-modifiable variables associated with the occurrence of dependency-related injuries in these patients, it is essential to conduct further research and introduce consensus guidelines to reduce their incidence and prevalence.


Subject(s)
COVID-19/epidemiology , Critical Care/methods , Pressure Ulcer/epidemiology , Adult , Case-Control Studies , Disease Progression , Female , Humans , Male , Middle Aged , Pressure Ulcer/prevention & control , Retrospective Studies , Risk Factors
10.
J Wound Care ; 30(7): 522-531, 2021 Jul 02.
Article in English | MEDLINE | ID: covidwho-1310245

ABSTRACT

This paper explores and reviews the relevant literature and examines the impact that the first wave of the COVID-19 pandemic has had on the tissue viability service (TVS) and the incidence of pressure ulcers (PUs) in a large UK teaching hospital NHS trust. A comparison has been undertaken of referral data to the TVS during two time periods-Oct-Dec 2019 and April-June 2020. Data show that the PU rate per 1000 beds increased from a pre-pandemic level of around 1 to over 2.7 in the first month of the pandemic, with an increase in device and prone position-related PUs, particularly in the expanded critical care patient population. Even though the bed occupancy decreased, the proportion of ungradable PUs increased, but there was little change in the number of Category 1 and 2 PUs.


Subject(s)
COVID-19 , Pressure Ulcer , Humans , Pandemics , Pressure Ulcer/epidemiology , SARS-CoV-2 , Tissue Survival
12.
J Healthc Qual ; 43(3): 137-144, 2021.
Article in English | MEDLINE | ID: covidwho-1217965

ABSTRACT

ABSTRACT: The impact of COVID-19, on the health and safety of patients, staff, and healthcare organizations, has yet to be fully uncovered. Patient adverse events, such as hospital-acquired pressure injuries (HAPIs), have been problematic for decades. The introduction of a pandemic to an environment that is potentially at-risk for adverse events may result in unintended patient safety and quality concerns. We use the learning health system framework to motivate our understanding of the impact of the COVID-19 pandemic on the incidence of HAPIs within our health system. Using a retrospective, observational design, we used descriptive statistics to evaluate trends in HAPI from March to July 2020. Hospital-acquired pressure injury numbers have fluctuated from a steady increase from March-May 2020, hitting a peak high of 90 cases in the month of May. However, the trend in the total all stage HAPIs began to decline in June 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study did not have a longitudinal increase in HAPIs from March-July 2020 during the COVID-19 pandemic, despite similarities in illness severity between the two time points. Our experience has demonstrated the ability of our organizational leaders to learn quickly during crisis.


Subject(s)
COVID-19/epidemiology , Iatrogenic Disease/epidemiology , Pressure Ulcer/epidemiology , Academic Medical Centers , Adult , Aged , Female , Hospitals, Urban , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Southeastern United States/epidemiology
13.
Adv Wound Care (New Rochelle) ; 10(5): 281-292, 2021 05.
Article in English | MEDLINE | ID: covidwho-1207238

ABSTRACT

Significance: Chronic wounds impact the quality of life (QoL) of nearly 2.5% of the total population in the United States and the management of wounds has a significant economic impact on health care. Given the aging population, the continued threat of diabetes and obesity worldwide, and the persistent problem of infection, it is expected that chronic wounds will continue to be a substantial clinical, social, and economic challenge. In 2020, the coronavirus disease (COVID) pandemic dramatically disrupted health care worldwide, including wound care. A chronic nonhealing wound (CNHW) is typically correlated with comorbidities such as diabetes, vascular deficits, hypertension, and chronic kidney disease. These risk factors make persons with CNHW at high risk for severe, sometimes lethal outcomes if infected with severe acute respiratory syndrome coronavirus 2 (pathogen causing COVID-19). The COVID-19 pandemic has impacted several aspects of the wound care continuum, including compliance with wound care visits, prompting alternative approaches (use of telemedicine and creation of videos to help with wound dressing changes among others), and encouraging a do-it-yourself wound dressing protocol and use of homemade remedies/substitutions. Recent Advances: There is a developing interest in understanding how the social determinants of health impact the QoL and outcomes of wound care patients. Furthermore, addressing wound care in the light of the COVID-19 pandemic has highlighted the importance of telemedicine options in the continuum of care. Future Directions: The economic, clinical, and social impact of wounds continues to rise and requires appropriate investment and a structured approach to wound care, education, and related research.


Subject(s)
Leg Ulcer/epidemiology , Pressure Ulcer/epidemiology , Wound Infection/epidemiology , Wounds and Injuries/epidemiology , Acute Disease , Bandages , COVID-19 , Chronic Disease , Delivery of Health Care , Diabetes Mellitus/epidemiology , Diabetic Foot/economics , Diabetic Foot/epidemiology , Diabetic Foot/therapy , Education, Medical , Education, Nursing , Foot Ulcer/economics , Foot Ulcer/epidemiology , Foot Ulcer/therapy , Humans , Leg Ulcer/economics , Leg Ulcer/therapy , Obesity/epidemiology , Overweight/epidemiology , Patient Education as Topic , Pressure Ulcer/economics , Pressure Ulcer/therapy , SARS-CoV-2 , Self Care , Social Determinants of Health , Telemedicine , United States/epidemiology , Varicose Ulcer/economics , Varicose Ulcer/epidemiology , Varicose Ulcer/therapy , Wound Infection/economics , Wound Infection/microbiology , Wound Infection/therapy , Wounds and Injuries/economics , Wounds and Injuries/therapy
15.
J Plast Reconstr Aesthet Surg ; 74(9): 2141-2148, 2021 09.
Article in English | MEDLINE | ID: covidwho-987177

ABSTRACT

BACKGROUND: In the context of the COVID-19 pandemic, prone position (PP) has been frequently used in the intensive care units to improve the prognosis in patients with respiratory distress. However, turning patients to prone imply important complications such as pressure ulcers. The aim of this paper is to describe the prevalence and characteristics of prone-positioning pressure sores (PPPS) and analyze the related risk factors. METHODS: A case-control study was performed in Gregorio Maranon hospital in Madrid during the COVID-19 pandemic between April and May 2020. We enrolled 74 confirmed COVID-19 patients in critical care units with invasive mechanical ventilation who were treated with pronation therapy. There were 57 cases and 17 controls. Demographic data, pronation maneuver characteristics and PPPS features were analyzed. RESULTS: In the case group, a total number of 136 PPPS were recorded. The face was the most affected region (69%). Regarding the severity, stage II was the most frequent. The main variables associated with an increased risk of PPPS were the total number of days under pronation cycles, and PP maintained for more than 24 h. The prealbumin level at admission was significantly lower in the case group. All of the ulcers were treated with dressings. The most frequent acute complication was bleeding (5%). CONCLUSIONS: According to our study, PPPS are related to the characteristics of the maneuver and the previous nutritional state. The implementation of improved positioning protocols may enhance results in critical patient caring, to avoid the scars and social stigma that these injuries entail.


Subject(s)
COVID-19/therapy , Critical Care/methods , Patient Positioning/adverse effects , Pressure Ulcer/etiology , Adult , Aged , COVID-19/complications , Case-Control Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Positioning/methods , Pressure Ulcer/diagnosis , Pressure Ulcer/epidemiology , Prevalence , Prone Position , Respiration, Artificial , Risk Factors , Severity of Illness Index , Spain
17.
Int Wound J ; 17(5): 1135-1141, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-693683

ABSTRACT

A tertiary public hospital in Saudi Arabia set out in 2015 to establish a team focused on reducing hospital-acquired pressure ulcers (HAPUs). The pressure ulcer prevention program (PUPP) had a multifaceted approach and data were collected for a period of 5 years. The results showed a definite reduction in the incidences of HAPUs. Many such programs show similar positive results and echo many of the same considerations of risk, prevention strategies, and the need for early intervention. However, none of the other studies either replicate the hospital's PUPP nor the extent of the positive and lasting effect of the program. Eager to determine the contributing factor(s) in order that the project success could be continued and possibly replicated in other quality improvement projects, it was decided that an examination and comparison of other similar programs and their results would be necessary in order to uncover the answer. It was determined that the in-person in-home discharge follow-up portion of the program most likely had the largest effect on the outcomes. Outcomes that were supported by the pre-work completed during the hospital portion of the PUPP towards reducing HAPUs and readmissions.


Subject(s)
Pressure Ulcer , Caregivers , Follow-Up Studies , Hospitals , Humans , Patient Discharge , Pressure Ulcer/epidemiology , Pressure Ulcer/prevention & control , Saudi Arabia/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL