The Prevention of Positioning Injuries during Gynecologic Operations. Guideline of DGGG (S1-Level, AWMF Registry No. 015/077, February 2015).

Purpose: Official guideline published and coordinated by the German Society of Gynecology and Obstetrics (DGGG). Positioning injuries after lengthy gynecological procedures are rare, but the associated complications can be potentially serious for patients. Moreover, such injuries often lead to claims of malpractice and negligence requiring detailed medical investigation. To date, there are no binding evidence-based recommendations for the prevention of such injuries. Methods: This S1-guideline is the work of an interdisciplinary group of experts from a range of different professions who were commissioned by DGGG to carry out a systematic literature search of positioning injuries. Members of the participating scientific societies develop a consensus in an informal procedure. Afterwards the directorate of the scientific society approves the consensus. The recommendations cover.

[Evaluation of the Glamorgan Scale in a paediatric intensive care unit: agreement and reliability]. / Evaluation der Glamorgan-Skala in einer pädiatrischen Intensivstation: Übereinstimmungen und Reliabilität.

The development of the Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale was based on empirical data. This instrument was translated into German for application in a hospital in Berlin. Psychometric properties of scale scores of the German version in a paediatric intensive care setting are unknown. In the current study, 24 nurses rated the pressure ulcer risk of 20 children based on the Glamorgan Scale and on a visual analogue scale (VAS) independently from each other. Interrater reliability was assessed using kappa and intraclass correlation (ICC) coefficients. The kappa values for item scores ranged from 0.21 to 0.69. Interrater reliability of the Devices item score was zero. The ICC of the Glamorgan scale sum score was 0.43 (95%-CI: 0.16 - 0.69) and 0.34 (95%-CI: 0.01 - 0.67) for the VAS score. The correlation between Glamorgan Scale sum scores and VAS scores was 0.78. Results indicate high relative errors in sum and item scores in this paediatric intensive care setting. Glamorgan scale sum and item score seem to be of minor value in supporting individual clinical decision making. It is highly probable that this was caused by the homogeneity of the investigated sample of children.

The relationship between malnutrition parameters and pressure ulcers in hospitals and nursing homes.

OBJECTIVES: Pressure ulcers (PU) remain a major health care problem throughout the world. Although malnutrition is considered to be one of the intrinsic risk factors for PU, more evidence is needed to identify the exact relation between PU and malnutrition. This study aims to identify whether there exists a relationship between PU and malnutrition in hospitals and nursing homes. METHODS: A cross-sectional study was performed in April 2007 in hospitals and nursing homes in Germany. PU were assessed using the Braden scale. Malnutrition was assessed by low body mass index (BMI), undesired weight loss, and insufficient nutritional intake. RESULTS: Two thousand three hundred ninety-three patients from 29 nursing homes and 4067 patients from 22 hospitals participated in the study. PU in both hospital and nursing home patients were significantly (P < 0.01) related to undesired weight loss (5%-10%). Moreover low nutritional intake and low BMI (<18.5) were also significantly related to PU in hospitals and nursing homes. CONCLUSION: There is a significant relationship between malnutrition parameters like undesired weight loss, BMI < 18.5, and low nutritional intake and PU.

[Pressure ulcer prevalence in German nursing homes and hospitals: what role does the National Nursing Expert Standard Prevention of Pressure Ulcer play?]. / Dekubitusprävalenzen in deutschen Pflegeheimen und Kliniken--Welche Rolle spielt der Nationale Expertenstandard Dekubitusprophylaxe in der Pflege?

AIM OF THE STUDY: The aim of this study was to investigate the relationship between the use of the National Nursing Expert Standard Pressure Ulcer Prevention and the pressure ulcer prevalence in German nursing homes and hospitals. METHODS: Data were collected within two nationwide surveys conducted by the Department of Nursing Science of the Charité, Berlin, Germany. The surveys, designed as cross-sectional prevalence studies, serve as an investigation of the amount of clinically relevant nursing phenomena, i. e., pressure ulcers. Prevalence per facility in the at-risk group was explored by a ranking procedure of the 95 nursing homes and hospitals. The facilities were divided into two groups according to whether they used the German Expert Standard to develop the local protocol or not. RESULTS: The pressure ulcer prevalence of the at-risk group ranged from 0% to 24.6% in nursing homes and from 7% to 40% in hospitals. In about 40% of the hospitals and nursing homes the local protocol of pressure ulcer prevention was based on the German Expert Standard. The ranking figure indicates that there is no statistically significant relation between Expert Standard-based local protocols and the pressure ulcer prevalence in the at-risk group. CONCLUSION: A clear advantage to use the German Expert Standard compared with other sources cannot be shown with these data. However, a uniform pressure ulcer prevention is an essential quality feature of nursing care. The degree of implementation and the consequent transfer of the recommendations to daily practice should be evaluated regularly.