Document Detail

The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers.
MedLine Citation:
PMID:  19732245     Owner:  NLM     Status:  MEDLINE    
AIMS AND OBJECTIVE: The objective of this study was to identify prognostic factors associated with the development of pressure ulcer lesions (grade 2-4) in nursing home patients with non-blanchable erythema. BACKGROUND: No studies could be found that identify risk factors for further development of pressure ulcer in patients with non-blanchable erythema. For some patients with non-blanchable erythema, standard preventive measures do not suffice to prevent pressure ulcers from deterioration. Identifying these patients beforehand can considerably contribute to the efficiency of pressure ulcer prevention. DESIGN: Secondary data analyses of a previously conducted randomised controlled trial were performed. METHODS: Eighty-four wards of 16 Belgian nursing homes participated in the study. In total, 235 nursing home residents with a grade 1 pressure ulcer (non-blanchable erythema) were included. All the residents received standard preventive care. Potential prognostic factors were collected using a standardised form. The incidence of pressure ulcers was recorded according to the European pressure ulcer classification system. RESULTS: The cumulative pressure ulcer incidence was 18.7% (44/235). Hypotension (relative risk = 3.42, 95% CI = 1.56-7.49), a history of a cerebral vascular accident (relative risk = 1.94, 95% CI = 1.10-3.70) and contractures (relative risk = 2.02, 95% CI 1.03-3.95) were identified as independent predictive factors for developing pressure ulcers. Remarkably, being urinary incontinent decreased the risk of developing a pressure ulcer by 76%. CONCLUSIONS: In nursing home residents with non-blanchable erythema, hypotension, contractures, and a history of cerebral vascular accident were independent risk factors for the development of pressure ulcer lesions. RELEVANCE TO CLINICAL PRACTICE: Patients with non-blanchable erythema who have hypotension, contractures or a history of cerebral vascular accident are in need of more intensive preventive measures. Identifying these patients can contribute considerably to a more efficient pressure ulcer prevention policy, resulting in a lower pressure ulcer lesion incidence and in lower costs.
Katrien Vanderwee; Maria Grypdonck; Dirk De Bacquer; Tom Defloor
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-09-03
Journal Detail:
Title:  Journal of clinical nursing     Volume:  18     ISSN:  1365-2702     ISO Abbreviation:  J Clin Nurs     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-13     Completed Date:  2009-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207302     Medline TA:  J Clin Nurs     Country:  England    
Other Details:
Languages:  eng     Pagination:  3050-8     Citation Subset:  N    
Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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MeSH Terms
Aged, 80 and over
Belgium / epidemiology
Nursing Homes*
Pressure Ulcer / epidemiology*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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