Over 60,000 hospital patients die each year from complications associated with hospital-acquired pressure injuries (HAPIs). Pressure-injury rates have increased by 2% within the past decade as life expectancy has also increased due to high cost in Medicare. Evidence shows that the incidence of pressure injuries (PIs) in healthcare facilities is increasing, with high rates of occurrence in intensive care units (ICUs). At the clinical site for which this project was developed, multiple in-services had been provided to staff regarding PIs, but uncertainty persisted about how knowledgeable the nurses were. This project, using the Academic Center for Evidence Star Model of Knowledge Transformation improved the nurses' knowledge and their practice related to PI prevention in the ICU, as well as to translate evidence into nursing practice. A literature review was conducted on PI prevention to inform the project. The project provided an educational program for intensive care nurses on PI prevention and determined, based on participants' pre- and posttest responses, that nurses' knowledge improved as a result of participation. This project, involving 55 nurses, includes information on the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) measuring pressure knowledge which resulted in an 85% improvement on injury prevention, 76% in wound description, as well as, 62% in the Braden Scale. Improvements in knowledge and practice resulting from nurses' participation in an evidence-based education session on PI prevention may bring positive social change to the organization at which this project was conducted.

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Introduktion: Trycksår räknas som en vårdskada, som drabbar mest individer som är sängbundna och rullstolsburna.Trycksår är associerade med många olika medicinska tillstånd. Vårdskadan kan leda till förlängd vårdtid hos individer samt krävar mer kostnad. Personer med mörkt hudpigment löper större risk att utveckla trycksår. Detta pga. att det är svårt att identifiera kategori 1 trycksår hos de personerna. Syfte: Syftet med studien är att undersöka hur sjukvårdspersonal kan identifiera tryckskador i hudkostymen hos individer med mörk hudpigmentering samt att ta reda på orsaken till brist på vägledningen.  Metod: Deskriptiv litteraturstudie med utgångspunkt från kvantitativa studier. Tio kvantitativa artiklar har använts, varav fem artiklar hittades vid primär sökning medan resten hittades vid sekundär och tredje sökning. Databaser pubmed och Cinahl använts vid artikelsökningar. Resultat: Det finns några metoder som är relevanta för kliniska bedömningar av trycksår hos individer med mörk hudpigmentering. Trycksår kan identifieras hos personen med mörk hudpigment med hjälp av ultraljud, munsell färgtabeller och bildtekniker. Brist på vägledning om hur trycksår identifieras hos individer med mörk hudfärg syns redan under sjuksköterskeutbildningen, vilket tydliggör att högskolor och universitetet inte bidrar mer undervisning om trycksår riktad mot personer med mörkt hudpigment. Slutsats: Det går inte att dra slutsatser pga att studier med låg kvalitet inkuluderades till studien. Det finns metoder som kan användas vid kliniska bedömningar av trycksår hos personer med mörk hudpigmentering bland annat med hjälp av ultraljud och bildtekniker. Dock syns fortfarande brist på vägledning och därför skulle vidare forskning inom området vara nödvändigt. / Background : Pressure ulcer is considered a medical injury, which affects mostly people who are bedridden and wheelchair bound. Pressure ulcer is associated with many different medical conditions. The care injury can lead to extended care time for individuals and is more costly. People with dark skin pigments are at greater risk of developing pressure ulcers. This is due to that it is difficult to identify category 1 pressure ulcer in those individuals. Aim: The aim of the study is to investigate how healthcare professionals can identify pressure injuries in the skin suit of individuals with dark skin pigmentation and to find out the reason for the lack of guidance. Metod: Descriptive literature study based on quantitative studies. Ten quantitative articles have been used. Of which five of them were found in primary search while the rest were found in secondary and third search. Databases pubmed and Cinahl used in article searches. Resultat: There are some methods that are relevant for clinical assessment of pressure ulcers in individuals with dark skin pigmentation. Pressure ulcers can be identified in the person with dark skin pigmentation using ultrasound, munsell color charts and imaging techniques. Lack of guidance on how to identify pressure ulcers in individuals with dark skin tones can already be seen during nursing education, that colleges and universities do not contribute more teaching about pressure ulcers aimed at people with dark skin pigments. Slutsats: It is not possible to draw conclusions due to the fact that low-quality studies were included in the study. There are methods that can be used in clinical assessments of pressure ulcers in people with dark skin pigmentation, among other things with the help of ultrasound and imaging techniques. However, there is still a lack of guidance and therefore further research in this area would be necessary.

Los pacientes quirúrgicos durante el periodo intraoperatorio puede verse afectados por diversos eventos adversos debido a la posición intraoperatoria, de las más frecuentes las lesiones por presión. La siguiente revisión crítica, tiene como objetivo: describir las evidencias del uso de superficies de apoyo para evitar complicaciones por posicionamiento quirúrgico en pacientes sometidos a cirugía. Se realiza debido a la demanda de pacientes quirúrgicos, en el uso constante de las superficies de apoyo durante los procedimientos quirúrgicos, respecto a estos nos formulamos la siguiente pregunta clínica ¿Cuáles son las evidencias del uso de superficies de apoyo para evitar complicaciones por posicionamiento quirúrgico en pacientes sometidos a cirugía?, guiándose de la metodología EBE, se realizaron diferencies estrategias de búsqueda en las siguientes bases de datos; Pubmed, Epistemonikos, Cochrane Central Register of Controlled Trials. Seleccionándose 11 artículos que fueron tamizados mediante la Guía de Validez y Utilidad aparente de Gálvez Toro, siendo apartados 04 artículos, en éstos últimos se aplicó la lista de PRISMA y así determinar su calidad metodológica. Como respuesta a la pregunta clínica, si existe suficiente evidencia en el uso de superficies de apoyo para evitar complicaciones por posicionamiento quirúrgico en pacientes sometidos a cirugía, por lo que esta revisión crítica presenta a las enfermeras de centro quirúrgico los beneficios del uso de las superficies de apoyo adecuadas, para evitar complicaciones por posicionamiento quirúrgico intraoperatorio y por ende brindar una buena calidad de atención. De acuerdo con la clasificación SIGN, debido a la exigua información en el estudio sobre los sesgos, la revisión tuvo un nivel de evidencia 1+ y, de acuerdo con el sistema de clasificación GRADE, una A de recomendación. / Surgical patients during the intraoperative period may be affected by various adverse events due to intraoperative positioning, the most frequent being pressure injuries. The following critical review aims to describe the evidence of the use of support surfaces to avoid complications due to surgical positioning in patients undergoing surgery. It is carried out due to the demand of surgical patients in the constant use of support surfaces during surgical procedures, with respect to these we formulated the following clinical question: What is the evidence of the use of support surfaces to avoid complications due to surgical positioning in patients undergoing surgery? Guided by the EBE methodology, different search strategies were carried out in the following databases; Pubmed, Epistemonikos, Cochrane Central Register of Controlled Trials. Eleven articles were selected and screened by means of Gálvez Toro's Validity and Apparent Usefulness Guide, 04 articles were set aside, and the PRISMA list was applied to the latter to determine their methodological quality. As an answer to the clinical question, if there is enough evidence on the use of support surfaces to avoid complications due to surgical positioning in patients submitted to surgery, this critical review presents to the surgical center nurses the benefits of the use of adequate support surfaces to avoid complications due to intraoperative surgical positioning and therefore provide a good quality of care. According to the SIGN classification, due to the scarce information in the study on biases, the review had a level of evidence 1+ and, according to the GRADE grading system, an A for recommendation.