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Patienters upplevelse av delaktighet vid vård av trycksårGardell, Fanny, Dahlström, Emma January 2023 (has links)
Bakgrund: Trycksår är en skada på hud eller vävnad som uppstår genom tryck och/eller skjuv. Det finns många faktorer som ökar risken för trycksår. Såren kan skapa lidande för patienter både fysiskt och psykiskt vilket förlänger återhämtning och vårdtid. Sjuksköterskan ansvarar för att bjuda in patienter och anhöriga till delaktighet för att utföra en god och säker omvårdnad. Syfte: Att undersöka patienters upplevelse av delaktighet i sin egen trycksårsbehandling och/eller trycksårsprevention. Metod: Allmän litteraturöversikt användes som design där 10 kvalitativa originalstudier hittades i databaserna PubMed, Psycinfo och CINAHL. Kvalitetsgranskningen genomfördes med hjälp av SBU:s granskningsmall och analyserades enligt Fribergs fyra-stegs analysmetod. Teoretisk referensram som valdes till arbetet är Katie Erikssons omsorgsteori. Resultat: Fyra huvudkategorier samt fem underkategorier identifierades. Både positiva och negativa upplevelser om delaktighet framkom. Positiva upplevelser av delaktighet förekom vid personcentrerad vård där utbytet av information och kunskap var ömsesidigt. Det som påverkade patienternas delaktighet negativt var smärta och bristande kunskap hos både patienter och vårdpersonal. Faktorer som ansågs lindra lidandet och hade positiv inverkan på delaktighet var ett gott bemötande från personalen, med fokus på personcentrering och tillgång till adekvat information. Slutsats: Patienter har olika upplevelser av delaktighet i sin egen trycksårsbehandling. Delaktigheten är beroende av att patienten förses med efterfrågad information och kunskap samt att vården personcentrerad. Personalen måste besitta specifik kunskap för att möjliggöra patientens delaktighet i vården. I framtiden bör fler studier genomföras för att få en bredare kunskap om området. / Background: A pressure ulcer is an injury to skin or tissue that occurs through pressure and/or shear. There are many factors that increase the risk of pressure ulcers. The wounds can create suffering for patients both physically and psychologically, which prolongs recovery and treatment time. The nurse is responsible for inviting patients and relatives to participate in order to perform good and safe nursing care. Aim: To examine patients' experience of participation in their own pressure ulcer treatment and/or pressure ulcer prevention. Method: General literature review was used as design where ten qualitative original studies were found in the databases PubMed, Psycinfo and CINAHL. The quality review was carried out using SBU's review template and then analyzed according to Friberg's four-step analysis method. The theoretical frame of reference chosen for the work is Katie Eriksson's theory of care. Result: Four main categories and five subcategories were identified. Both positive and negative experiences of participation emerged. Positive experiences of participation occurred in person-centred care where the exchange of information and knowledge was mutual. What negatively affected patients' participation was pain and a lack of knowledge on the part of both patients and healthcare staff. Factors considered to alleviate suffering and have a positive impact on participation were good treatment from staff, focusing on person-centredness and access to adequate information. Conclusion: Patients have different experiences of participation in their own pressure ulcer treatment. Participation is dependent on the patient being provided with the requested information and knowledge and the care being person-centred. The staff must possess specific knowledge to enable the patient's participation in care. In the future, more studies should be carried out to gain a broader knowledge of the area.
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Minimizing Home Health Care-Acquired Pressure Injuries through Effective Nursing TeamworkBaah, Juliana 01 January 2018 (has links)
Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain the etiology and progression of PI while Lewin's Change Theory was used to promote behavioral change in the nursing team. The practice-focused questions for closing the gap between nursing knowledge and practice were what percentage of nurses complied with standard PI prevention guidelines and what was the level of nursing staff teamwork in the agency per the Nursing Teamwork Survey [NTS]. This PI prevention initiative used a cross-sectional design. Data collection involved review of nursing documentation and electronic surveying of all nursing staff using the MISSCARE survey, the NTS, and the AHRQ assessment checklists, which were completed via SurveyMonkey, an online survey software. The impact of the PI prevention initiative was assessed by comparing the results of the documentation review and surveys pretest to the posttest results. There was significant improvement in nursing compliance with PI prevention and treatment. Pressure injury incidence rate fell from 13.6% to 5.1%. The positive social impact includes improving patient care and safety, minimizing PI incidence and producing an efficient team.
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Aplicabilidade de curativos a base de hidrogel com nanopartículas de prata em lesão por pressão / Applicability of hydrogel based curatives with silver nanoparticles in pressure injuryCardoso, Talita Rocha 03 March 2017 (has links)
Cuidar de feridas é um processo dinâmico e complexo que requer atenção especial principalmente quando se refere a uma lesão crônica. A lesão por pressão (LPP) é uma ferida crônica localizada na pele ou no tecido subjacente, geralmente sobre uma proeminência óssea, resultante de pressão isolada ou pressão combinada com fricção ou cisalhamento. O objetivo foi avaliar a aplicabilidade das membranas de hidrogel com nanopartículas de prata no tratamento de lesões por pressão (LPPs) em usuários do SUS, por meio de protocolo clínico. O projeto da pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da UFT/TO sob nº 161/2013, e foram seguidos todos os preceitos éticos conforme Resolução 466/12 do CNS do Ministério da Saúde. Trata-se de um estudo de intervenção terapêutica, do tipo ensaio clínico não controlado, sobre a avaliação do uso da membrana de hidrogel com nanopartículas de prata (NPAg) produzida pelo Instituto de Pesquisa em Energia Nuclear (IPEN). A população do estudo foi composta por 19 pacientes, que por critérios de inclusão e exclusão foi constituída por uma amostra de 6 (seis) pacientes de ambos os gêneros, internados no Hospital de Referência de Porto Nacional, no período de janeiro de 2014 a dezembro de 2015, acometidos por lesões por pressão categoria 3, 4 e não classificável. O estudo apresentou como limitações o restrito número de pacientes por amostra, por se tratar de pesquisa clínica experimental, com um grupo investigado altamente selecionado pelos critérios de exclusão e inclusão. Os hidogéis com NPAg, produzidos pelo IPEN, mostraram-se eficazes no tratamento das LPPs, pois proporcionaram a ferida condições para a epitelização. Houve diminuição do odor, dos tecidos desvitalizados e da dor, itens estes que quando presentes retardam a cicatrização. Porém são necessários novos estudos, envolvendo estes curativos com um número maior de pacientes. / Wound\'s care is a dynamic and complex process that requires special attention especially when referring to a chronic injury. Pressure injury (PI) is a chronic wound located on the skin or underlying tissue, usually on a prominent bone, resulting from isolated pressure or pressure combined with friction or shear. The objective of this work is to evaluate the applicability of hydrogel membranes with silver nanoparticles in the treatment of pressure lesions in SUS users, through a clinical protocol. The research project was approved by the Research Ethics Committee of UFT / TO under No. 161/2013, and all ethical precepts were followed according to Resolution 466/12 of the CNS of the Ministry of Health. It is a therapeutic intervention\'s study, an uncontrolled clinical trial on the evaluation of the use of hydrogel membrane with silver nanoparticles produced by the Nuclear Energy Research Institute (IPEN). The study population consisted of 19 patients, who, by inclusion and exclusion criteria, consisted of a sample of 6 (six) patients of both genders admitted to the National Reference Hospital of Porto Nacional from January 2014 to December of 2015, affected by category 3, 4 and non-classifiable injuries. The study presented as limitation the restricted number of patients per sample, since it was an experimental clinical research, with a highly selected by the exclusion and inclusion criteria investigated group. The hydrogels with NPAg, produced by IPEN, were effective in the treatment of PI, as they provided the wound conditions for epithelization. There was a decrease in odor, devitalized tissues and pain, which, when present, delays healing. However, new studies are necessary, involving these dressings with a larger number of patients.
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Aplicabilidade de curativos a base de hidrogel com nanopartículas de prata em lesão por pressão / Applicability of hydrogel based curatives with silver nanoparticles in pressure injuryTalita Rocha Cardoso 03 March 2017 (has links)
Cuidar de feridas é um processo dinâmico e complexo que requer atenção especial principalmente quando se refere a uma lesão crônica. A lesão por pressão (LPP) é uma ferida crônica localizada na pele ou no tecido subjacente, geralmente sobre uma proeminência óssea, resultante de pressão isolada ou pressão combinada com fricção ou cisalhamento. O objetivo foi avaliar a aplicabilidade das membranas de hidrogel com nanopartículas de prata no tratamento de lesões por pressão (LPPs) em usuários do SUS, por meio de protocolo clínico. O projeto da pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da UFT/TO sob nº 161/2013, e foram seguidos todos os preceitos éticos conforme Resolução 466/12 do CNS do Ministério da Saúde. Trata-se de um estudo de intervenção terapêutica, do tipo ensaio clínico não controlado, sobre a avaliação do uso da membrana de hidrogel com nanopartículas de prata (NPAg) produzida pelo Instituto de Pesquisa em Energia Nuclear (IPEN). A população do estudo foi composta por 19 pacientes, que por critérios de inclusão e exclusão foi constituída por uma amostra de 6 (seis) pacientes de ambos os gêneros, internados no Hospital de Referência de Porto Nacional, no período de janeiro de 2014 a dezembro de 2015, acometidos por lesões por pressão categoria 3, 4 e não classificável. O estudo apresentou como limitações o restrito número de pacientes por amostra, por se tratar de pesquisa clínica experimental, com um grupo investigado altamente selecionado pelos critérios de exclusão e inclusão. Os hidogéis com NPAg, produzidos pelo IPEN, mostraram-se eficazes no tratamento das LPPs, pois proporcionaram a ferida condições para a epitelização. Houve diminuição do odor, dos tecidos desvitalizados e da dor, itens estes que quando presentes retardam a cicatrização. Porém são necessários novos estudos, envolvendo estes curativos com um número maior de pacientes. / Wound\'s care is a dynamic and complex process that requires special attention especially when referring to a chronic injury. Pressure injury (PI) is a chronic wound located on the skin or underlying tissue, usually on a prominent bone, resulting from isolated pressure or pressure combined with friction or shear. The objective of this work is to evaluate the applicability of hydrogel membranes with silver nanoparticles in the treatment of pressure lesions in SUS users, through a clinical protocol. The research project was approved by the Research Ethics Committee of UFT / TO under No. 161/2013, and all ethical precepts were followed according to Resolution 466/12 of the CNS of the Ministry of Health. It is a therapeutic intervention\'s study, an uncontrolled clinical trial on the evaluation of the use of hydrogel membrane with silver nanoparticles produced by the Nuclear Energy Research Institute (IPEN). The study population consisted of 19 patients, who, by inclusion and exclusion criteria, consisted of a sample of 6 (six) patients of both genders admitted to the National Reference Hospital of Porto Nacional from January 2014 to December of 2015, affected by category 3, 4 and non-classifiable injuries. The study presented as limitation the restricted number of patients per sample, since it was an experimental clinical research, with a highly selected by the exclusion and inclusion criteria investigated group. The hydrogels with NPAg, produced by IPEN, were effective in the treatment of PI, as they provided the wound conditions for epithelization. There was a decrease in odor, devitalized tissues and pain, which, when present, delays healing. However, new studies are necessary, involving these dressings with a larger number of patients.
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Effects of Education on Pressure Ulcer Prevention in Developmentally Disabled IndividualsJames, Jasneth M. 01 January 2016 (has links)
Pressure ulcers were a continuing concern among the nonverbal developmentally disabled population of a state institution. The lengthy use of wheelchairs, the inability to body shift, and physical and mental impairment were attributes of the target population that have been cited in the literature as contributing to pressure ulcer. The purpose of this quasi-experimental pretest/posttest project was to evaluate the effectiveness of an education intervention for direct care staff on the prevention treatment, and eradication of pressure ulcers among patients with developmental disabilities. Orem's self-care deficit theory, particularly the emphasis on the need for nursing staff to perform self-care activities for persons who are unable to manage the activities themselves, was the theoretical basis of the project. The Iowa model of evidence-based practice provided the evidence translation direction for the project. All licensed practical nurses and healthcare technicians employed by the institution were invited to participate in the education. Participants completed a pretest on pressure ulcer prevention and management knowledge before the education was presented, and after the educational component of the project concluded. Statistical significance of the differences in pretest to posttest scores was not calculated because the sample size was small (n = 37); however, all participants achieved 100% correct answers on the posttest up from a 50% mean score among licensed practical nurses and a mean score of 30% among health care technicians. Social change was evaluated within the institution by a decrease in new pressure ulcer cases to zero in the week following the education, and a commitment from the director of nursing to provide pressure ulcer education to all new direct care employees and refresher courses for continuing employees.
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Vårdpersonalens tankar och handlande kring trycksår : en litteraturöversiktOhlsson, Josefin, Linnarsson, Ann-Louise January 2010 (has links)
Background: Pressure ulcers have during a long time ages caused great suffering for the patients. The factors affecting the occurrence of pressure ulcers can be both internal and external, such as immobility and malnutrition. Nurses´ role is to assess risks and thus pay attention to prevent and treat pressure ulcers. The nurse may use various assessment tools to highlight and document patients at risk for developing pressure ulcers. Aim: This study was to describe health professionals´ thoughts and actions about the pressure ulcers. Method: A literature review was used to study the selected study area. The review was based on nine quantitative and three qualitative articles. The writers looked for similarities and differences in performance of articles. Results: The results showed that knowledge was good among health professionals´ staff but was not used in practical nursing. Health professionals were using methods which were not evidence based for example massage. The staff felt that lack of time and materials was a barrier to care about pressure ulcers. The documentation carried out by nurses was inadequate. Resulted showed five themes, having knowledge of the risks of pressure ulcers, believing or knowing, applying knowledge, recording, managing and developing. Conclusion: There was good knowledge of pressure ulcer prevention and treatment by health workers and the nurses were able to identify the risk of developing pressure ulcers. The knowledge was not used in practice. Non recommended methods are still used by nursing staff in nursing care. .
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Sjuksköterskans trycksårspreventiva omvårdnadsåtgärder - En litteraturstudieEriksson, Maria, Björklund, Mattias January 2013 (has links)
Syfte: Syftet med föreliggande litteraturstudie var att beskriva vilka omvårdnadsåtgärder sjuksköterskan kan använda sig av i det trycksårspreventiva arbetet. Syftet var även att granska urvalsmetoden som de inkluderade artiklarna har använt sig av. Metod: Artiklar publicerade mellan 2007 och 2013 söktes i databaserna CINAHL och PubMed. Resultatet baserades på tretton artiklar. Resultat: Resultatet utmynnade i fyra kategorier: 1) Riskbedömning; med användandet av ett riskbedömningsinstrument i det dagliga omvårdnadsarbetet minskade förekomsten av trycksår. Det framkom att sjuksköterskans kliniska blick var viktig för att upptäcka patienter med risk för att utveckla trycksår. 2) Tryckavlastande underlag; användande av tryckavlastande underlag var en viktig åtgärd för att förebygga uppkomst av trycksår. Växelvis tryckavlastande madrasser förebyggde uppkomst av trycksår bäst. 3) Lägesändring; 30 graders vinkling i liggande position avlastade riskområden för utveckling av trycksår bäst. När ansvar för lägesändringar tydliggjordes minskade förekomsten av trycksår. 4) Nutrition; ett ökat kaloriintag minskade risken markant för utveckling av trycksår. Metodologisk aspekt; urvalsmetoden beskrevs tydligt i 8 artiklar och mindre tydligt i 5 artiklar. Slutsats: Föreliggande litteraturstudie visade att sjuksköterskan kan använda sig av omvårdnadsåtgärderna riskbedömning, tryckavlastande underlag, lägesändring samt nutrition för att minska risk för uppkomst av trycksår. / Aim: The aim of this literature study was to describe preemptive measures that can be performed by the nurse in order to prevent the development of pressure ulcers. The aim was also to study the sampling methods used in the reviewed studies. Method: The articles for this literature study were gathered from the CINAHL and PubMed databases. Only publications from the years 2007 to 2013 were considered. In total 13 articles were included. Results: The results were divided into four categories: 1) Risk assessment; the use of risk assessment tools was effective in identifying patients at risk for pressure ulcer development. However, it is evident that the nurse experience is an important contributor to identify patients at risk for pressure ulcer formation. 2) Support surfaces; support surfaces is an important measure for prevention of pressure ulcers. Pressure relief mattresses with periodically changing pressure were shown to be the most effective for prevention of pressure ulcers. 3) Reposition; a change of 30 degrees in supine position was the most effective to unload risk areas of pressure ulcers. When the responsibility for changing patient position was clearly defined the frequency of pressure ulcers decreased. 4) Nutrition; with an increaseed caloric intake the risk of developing pressure ulcers clearly decreased. Methodological aspect: The sampling method was clearly described in eight articles and less clear in five articles. Conclusion: This literature study shows that the nurse can use risk assessment, support surfaces, reposition and nutrition to prevent development of pressure ulcers.
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Uppkomst av trycksår i det postoperativa förloppet : En kvantitativ litteraturstudieHolmqvist, Frida, Antonsson, Therese January 2018 (has links)
ABSTRACT Background: Pressure ulcer is caused by pressure on the same skin area for a certain period of time, which causes a reduced blood circulation in the affected area and causes the tissue to die. Pressure ulcer is a major strain on healthcare, society and a big suffering for the patient. It contributes with high costs, extended care and pain. Aim: The aim was to describe the relationship between postoperative care and the appearance of pressure ulcer. Method: A literature study with 10 quantitative studies was used. Results: The intensive care department has an influence on the onset of pressure ulcers, and most of the pressure ulcers occur postoperatively in patients. The operating time is of no significance, but prolonged surgery may be a risk factor for pressure ulcer postoperatively. The majority of patients developing pressure ulcers in the postoperative process have underlying diseases such as diabetes, heart failure and renal failure. Other risk factors are patients who are older, underweight and have low Bradenpoints. Preventive measures such as air-changing mattresses are of great importance to counteract the onset of pressure ulcers, as well as saving large sums of money. Conclusion: Pressure ulcers are a contributing factor to patients having extended periods of suffering, which at the same time contribute to major costs for society and hospitals. In the postoperative stage, patients are more vulnerable due to reduced mobility and underlying diseases. Preventive measures such as mattresses help reduce the appearance of pressure ulcers and save big sums of money in the end. / SAMMANFATTNING Bakgrund: Trycksår uppkommer av att det blir tryck på samma hudområde under en viss tid, vilket leder till att det blir en nedsatt blodcirkulation i det drabbade området och att vävnaden tillslut dör. Trycksår är en stor belastning för sjukvård, samhälle och skapar ett stort lidande för patienten. Tryckskador bidrar med stora kostnader, förlängda vårdtider, smärta samt ett lidande för patienten. Syfte: Syftet var att beskriva sambandet mellan den postoperativa vården och uppkomsten av trycksår.Metod: En litteraturstudie med 10 kvantitativa artiklar. Resultat: Intensivvårdsavdelningen har en påverkan på uppkomsten av trycksår, och större delen av trycksåren uppkommer postoperativt hos patienter som är inneliggande på intensiven. Operationstiden har ingen signifikant betydelse, men en förlängd operation kan vara en riskfaktor för att trycksår uppkommer postoperativt. Majoriteten av patienterna som utvecklar trycksår i det postoperativa förloppet har bakomliggande sjukdomar som diabetes, hjärtsvikt och njursvikt. Andra riskfaktorer är patienter som är äldre, underviktiga och har låga Bradenpoäng. Förebyggande åtgärder som luftväxlande madrass har en stor betydelse för att motverka uppkomsten av trycksår, samt sparar in stora summor pengar. Slutsats: Trycksår är en bidragande faktor till att patienter får förlängda vårdtider med mycket lidande som samtidigt bidrar med stora kostnader för samhälle och sjukhus. I det postoperativa skedet är patienter extra utsatta på grund av nedsatt rörlighet och bakomliggande sjukdomar. Förebyggande åtgärder som madrasser bidrar till minskad uppkomst av trycksår och sparar stora summor pengar i slutändan
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Cuidar de pessoas com úlcera por pressão no domicílio: preparo recebido pelas famíliasMaciel, Mírian Tereza Cerqueira Brito January 2008 (has links)
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Previous issue date: 2008 / Este estudo buscou analisar o preparo recebido pelas famílias para cuidar de pessoas com úlcera por pressão no domicilio. Foi realizado nas clinicas médica (neurológica) e cirúrgica de um hospital público da cidade de Feira de Santana-Ba. Procedeu-se uma pesquisa com abordagem qualitativa utilizando a entrevista sem-estruturada e a observação não participante, no período de junho a agosto de 2008. Os sujeitos constituiriam-se de nove familiares cuidadoras dos pacientes que apresentavam úlcera por pressão. Para análise dos dados, foi usado a análise de conteúdo temático de Bardin, à luz dos pressupostos de Collière, e demais autores que abordam sobre o cuidar/cuidado.Os resultados mostraram que, a maioria dos sujeitos são preparados de forma inadequada, para dar continuidade aos cuidados após a alta hospitalar, e os que se consideram preparados, não se sentiam seguros para realizá-los em casa. Identificamos, também, que o cuidar/educar, como processo de trabalho acontece de forma precária nas unidades estudadas. Às famílias, são delegadas responsabilidades pelos cuidados, sem o devido preparo e/ou supervisão, o que acarreta o aparecimento de úlceras por pressão, ou aprofundamento das lesões, já existentes. Concluímos que o distanciamento da enfermeira e a delegação de cuidados, têm impedido que ações educativas, possam garantir aos familiares condições para realizarem, adequadamente, os cuidados de seu parente em casa. / Salvador
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A Escala de Waterlow na Ãlcera por pressÃo em pessoas com lesÃo medular: uma tecnologia assistencial de enfermagem / Waterlowâs Scale on pressure ulcers on spinal cord injured persons: an assistance technology of nursingRita MÃnica Borges Studart 12 February 2009 (has links)
STUDART, Rita MÃnica Borges. A escala de Waterlow na Ãlcera por pressÃo em pessoas com lesÃo medular: uma tecnologia assistencial de enfermagem 2009.124f. DissertaÃÃo de Mestrado. Programa de PÃs-GraduaÃÃo de Enfermagem. Faculdade de FarmÃcia, Odontologia e Enfermagem. Universidade Federal do CearÃ.Fortaleza- Ce, 2009.
A aplicaÃÃo da tecnologia assistencial na prÃtica profissional do enfermeiro para avaliar Ãlcera por pressÃo em pacientes com lesÃo medular deve ter uma abordagem holÃstica envolvendo a equipe multiprofissional. Este estudo teve como objetivo avaliar os fatores de risco para Ãlceras por pressÃo em pessoas hospitalizadas por lesÃo medular, utilizando a escala de Waterlow. Estudo transversal, com 60 pacientes internados em um hospital pÃblico municipal de emergÃncia de Fortaleza, cuja coleta de dados ocorreu no perÃodo de maio de 2008 a outubro de 2008. A populaÃÃo foi constituÃda pelos pacientes internados nas Unidades de InternaÃÃes: Neurocirurgia, UTI, Traumatologia e Cirurgia Geral, com o diagnÃstico mÃdico de lesÃo medular. Para a coleta de dados, utilizou-se dois instrumento, contendo dados de identificaÃÃo e fatores de risco, elaborado por meio de levantamento bibliogrÃfico utilizando a escala de Waterlow. Os dados foram coletados em duas etapas: no primeiro momento no mÃximo com 96 horas de internaÃÃo e no segundo momento foram coletados com dez dias de internaÃÃo. Os dados foram compilados no software Excel, em forma de planilhas e a anÃlise estatÃstica foi feita no programa SPSS versÃo 13.0. Para a anÃlise de associaÃÃo dos dados foram utilizados: Teste de KolmogorovâSmirnov, Coeficiente de correlaÃÃo de Pearson e Coeficiente de correlaÃÃo de Spearman. Todas as recomendaÃÃes Ãticas foram seguidas durante as etapas da pesquisa. No estudo, os pacientes afetados pela Ãlcera por pressÃo, em sua maioria, foram do sexo masculino, com faixa etÃria entre 18 a 33 anos com uma mÃdia de 37,12 anos procedentes da capital, com mÃdia salarial e nÃvel de escolaridade baixos. A aplicaÃÃo da escala de Waterlow, implementada neste estudo, revelou-se eficaz e sensÃvel para avaliar os fatores de risco para Ãlceras por pressÃo em pessoas hospitalizadas por lesÃo medular. Com base nos resultados obtidos, acredita-se que no primeiro momento da avaliaÃÃo pela escala de Waterlow pode ser dispensada a mensuraÃÃo do IMC, dada a dificuldade de aferir o mesmo. Ademais foi constatado que o paciente com lesÃo medular tem altÃssimo risco para desenvolver Ãlcera por pressÃo independente do IMC. O fator de risco mais significante para o desenvolvimento de Ãlcera por pressÃo no paciente com lesÃo medular foi à mobilidade fÃsica prejudicada associada ao longo tempo de internaÃÃo. A presenÃa de acompanhante foi outro achado importante, pois dos 19 pacientes que nÃo desenvolveram Ãlcera por pressÃo todos tinham acompanhantes. Foi constatado tambÃm que 90% dos pacientes nÃo receberam nenhum tipo de orientaÃÃo antes do advento da Ãlcera por pressÃo e que apenas 31% receberam orientaÃÃes depois do aparecimento da Ãlcera. Este estudo permitiu conhecer de forma aprofundada os riscos mais importantes para desenvolver Ãlcera por pressÃo nos pacientes com lesÃo medular com a utilizaÃÃo da escala de Waterlow / STUDART, Rita MÃnica Borges. Waterlowâs Scale on pressure ulcers on spinal cord injured persons: an assistance technology of nursing 2009. 122f. Masterâs Degree Dissertation. Program of Post Graduation on Nursing. Pharmacy, Odontology and Nursing College. Federal University of CearÃ. Fortaleza-Ce, 2009.
The application of assistant technology in nursing professional practice to evaluate pressure ulcers in spinal cord injured patients must be an holistic approach, involving a multiprofessional team. This study purposed to evaluate the risk factors linked to pressure ulcers in persons hospitalized due to spinal cord injury, using the Waterlow scale. Transversal study, with 60 patients from a municipal public emergency hospital of Fortaleza, in which data were collected between May 2008 and October 2008. The population was constituted by patients interned in Infirmaries: Neurosurgery, UTI, Traumatology and General Surgery with spinal cord injury diagnosis. Two instruments were used for collecting the data, containing identification data and risk factors, elaborated by bibliographical consulting using the Waterlow scale. Data were collected at two stages: the first one the interview and physical exam in patients at the primary 72h of incoming, in the second one at 10 days of incoming. Data were summarized by the software Excel, based on plans, and the statistical analysis was made by SPSS program 13.0 version. Statistical test were performed to data association analysis: Kolmogorov-Smirnov Test, Pearsonâs Correlation Coefficient and Spearmenâs Correlation Coefficient. All ethical recommendations were followed during the research stages. In this study, most of all patients affected by pressure ulcers were male, between 18 and 33 years old, with an age average of 37,12 years, coming from the capital urban area, with salary average and scholar status low. The application of the Waterlow scale, performed in this study, demonstrated efficacy and sensibility to evaluate risk factors to pressure ulcers in spinal cord injured hospitalized persons. Supported by the results, it is believed that in the first moment of the evaluation using the Waterlow scale the Body Mass Index should be dismissed, due to the difficulty of measuring it. Besides, it was revealed that spinal cord injured patient has a great risk to developing pressure ulcers, not depending on Body Mass Index. The most significant risk factor to pressure ulcers in that patient was the physical mobility damaged linked to the time of hospitalization. The presence of a companion was other important evidence, so that all of the 19 patients that not developed pressure ulcers were accompanied. It was also showed that 90% of the patients did not receive any kind of information before pressure ulcer occurrence and that only 31% received information after the pressure ulcer occurrence. This study permitted to know deeply the most important risks to pressure ulcers in spinal cord injured patients using the Waterlow scale
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