ABSTRACT
This study aimed to determine the predictive accuracy and factors deteriorating blanchable erythema. A prospective cohort study was conducted in a 832-bed university hospital in Japan. Skin condition, risk factors, care plans and practices were measured everyday for 4 weeks by direct assessments and chart review by research staff. Blanchable erythema developed in 62 (24.9%) and a pressure ulcer in 8 (3.2%) patients. Six of the 62 blanchable erythema patients worsened to pressure ulcer of either stage I or II. Calculating the accuracy of blanchable erythema for predicting pressure ulcer development, sensitivity was 75%, specificity 77% and positive likelihood ratio 3.26. The factors found to deteriorate blanchable erythema were K-scale 'pressure' and inadequate support surface management to a patient whose condition was deteriorating. These results suggested that the value of positive likelihood ratio means small effect to the clinical use. However, if adequate support surface management were implemented to blanchable erythema patients, the incidence of pressure ulcer would probably fall to 0.8%.
Subject(s)
Erythema/diagnosis , Nursing Assessment/methods , Physical Examination/methods , Pressure Ulcer/etiology , Risk Assessment/methods , Adolescent , Adult , Aged , Child , Disease Progression , Early Diagnosis , Erythema/complications , Female , Hospitals, University , Humans , Incidence , Japan/epidemiology , Likelihood Functions , Male , Middle Aged , Nursing Evaluation Research , Physical Examination/nursing , Predictive Value of Tests , Pressure Ulcer/epidemiology , Pressure Ulcer/prevention & control , Prospective Studies , Risk Factors , Severity of Illness Index , Statistics, NonparametricABSTRACT
A procedure for the simultaneous determination of bromine and iodine by inductively coupled plasma (ICP) mass spectrometry was investigated. In order to prevent the decrease in the ionization efficiencies of bromine and iodine atoms caused by the introduction of water mist, electrothermal vaporization was used for sample introduction into the ICP mass spectrometer. To prevent loss of analytes during the drying process, a small amount of tetramethylammonium hydroxide solution was placed as a chemical modifier into the tungsten boat furnace. After evaporation of the solvent, the analytes instantly vaporized and were then introduced into the ICP ion source to detect the (79)Br(+), (81)Br(+), and (127)I(+) ions. By using this system, detection limits of 0.77 pg and 0.086 pg were achieved for bromine and iodine, respectively. These values correspond to 8.1 pg mL(-1) and 0.91 pg mL(-1) of the aqueous bromide and iodide ion concentrations, respectively, for a sampling volume of 95 microL. The relative standard deviations for eight replicate measurements were 2.2% and 2.8% for 20 pg of bromine and 2 pg of iodine, respectively. Approximately 25 batches were vaporizable per hour. The method was successfully applied to the analysis of various certified reference materials and practical situations as biological and aqueous samples. There is further potential for the simultaneous determination of fluorine and chlorine.
