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.

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.

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.

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. .

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.

Bakgrund: Trycksår uppstår när hudens syre- och näringstillförsel är otillräcklig på grund avlokalt nedsatt blodcirkulation. Detta orsakar smärta och lidande för den drabbade. Tidigareforskning visar att trycksårsprevalensen är fortsatt hög idag trots medvetenhet om riskfaktorer som bidrar till utvecklandet av trycksår. Samt att sjuksköterskor helst förlitar sig på sina tidigare kunskaper och erfarenheter vad gäller bedömning och beslut kring trycksår. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskans omvårdnadsåtgärder för attförebygga och behandla trycksår. Samt beskriva de inkluderade artiklarnasdatainsamlingsmetoder. Metod: Beskrivande litteraturstudie. Artiklar publicerade mellan 2010.01.01-2015.01.30 söktes i databaserna Cinahl och PubMed. Resultatet baseras på 15 artiklar. Huvudresultat: Resultatet visade att den mest effektiva behandlingen mot trycksår ärförebyggande åtgärder, däribland tryckavlastande åtgärder och hudvård. I bedömning och beslutsfattande gällande trycksårsproblematik har sjuksköterskor riskbedömningsinstrument och beslutsstöd till hjälp. Av de ingående artiklarna i denna litteraturstudie beskrivs datainsamlingsmetoden tydligt i nio av 15 artiklar. Fyra av artiklarna beskriver både validiteten och reliabiliteten för sina datainsamlingsmetoder. En artikel beskriver enbart validiteten och två av artiklarna beskriver enbart reliabiliteten för sina datainsamlingsmetoder. En artikel hade multimetod som ansats och det fanns ingen beskrivning av hur intervjuerna hade gått till. Slutsats: Sjuksköterskans viktigaste omvårdnadsåtgärder för att förebygga och behandla trycksår enligt denna litteraturstudie är riskbedömningar, hudvård, tryckavlasta utsatta hudområden samt att ta hjälp av beslutsstöd. / Background: Pressure ulcers occur when the skin's oxygen and nutrient supply is insufficientdue to local poor blood circulation. This causes pain and suffering to the patient. Previous research shows that pressure ulcer prevalence remains high today despite awareness of the risk factors that contribute to the development of pressure ulcers. Nurses in general rely ontheir previous knowledge and experience in the assessment and decision making regarding pressure ulcers. Aim: The aim of this study was to describe nursing interventions to prevent and treat pressure ulcers. Also to describe the articles included data collection methods.Method: Descriptive literature review. Articles published between 2010.01.01-2015.01.30 were searched in the databases Cinahl and PubMed. The result is based on 15 articles. Main result: The result showed that the most effective treatment of pressure ulcers arepreventive methods, including pressure-relieving mattresses and skin care. Nurses can also use risk assessment tools and decision support regarding pressure ulcer problems. Of the included articles in this study the data collection method is clearly described in nine of 15 items. Four of the articles describe both the validity and reliability of their data collection methods. One article only describes the validity and two of the articles describe only there liability of their data collection methods. One article had a multi-method approach and there was no description of how the interviews were performed. Conclusion: According to this study the main nursing interventions to prevent and treat pressure ulcers is to use risk assessment tools, provide skin care, pressure relieve exposed skin areas and to use decision support regarding pressure ulcer care.

Bakgrund: Trycksår är ett stort problem inom vården. De uppstår lätt bland äldre patienter och medför lidande för dem. En av sjuksköterskans uppgifter är att identifiera patienternas behov av förebyggande omvårdnadsinsatser. Det finns många insatser för trycksårsprevention, som exempelvis riskbedömning, lägesändring och tryckavlastande underlag. Trots det råder osäkerhet kring hur dessa preventionsinsatser bör användas. Denna litteraturstudie fokuserar på att beskriva evidensbaserade trycksårsförebyggande insatser för äldre för att underlätta sjuksköterskans val av hjälpmedel samt minska förekomsten av trycksår bland äldre patienter. Syfte: Att beskriva evidensbaserade trycksårsförebyggande insatser för äldre patienter. Metod: Detta är en litteraturstudie innehållande tio kvantitativa artiklar. Resultat: Trycksårsincidensen kan minskas genom användning av riskbedömningsinstrument i kombination med sjuksköterskans kliniska bedömning. Viskoelastisk madrass, luftalternerande madrass samt överdrag har visats ha bra effekt som tryckavlastande preventionsinsatser. Lägesändring var tredje timme under natten minskar trycksårsincidensen, detta gör även lägesändring var fjärde timme i kombination med tryckavlastande viskoelastisk madrass. Dessutom kan trycksår på hälar undvikas om en kilformad viskoelastisk kudde eller ett avlastande hälskydd används. Tryckavlastande rullstolsdynor har visat sig minska trycksårsincidensen. Slutsats: Riskbedömningsinstrument bör kombineras med sjuksköterskans kliniska bedömning, och utifrån det resultat som erhålls kan trycksårsförebyggande insats väljas, som till exempel luftalternerande alternativt viskoelastisk madrass eller tryckavlastande rullstolsdyna. Lägesändring har visat minskad trycksårsincidens, men det råder osäkerhet om vilket intervall som bör användas och därför behövs mer forskning inom detta område. Det finns tydligt evidens för att en kilformad kudde eller ett hälskydd ger minskad trycksårsincidens. / Background: Pressure ulcers are a major problem in health care. They easily occur among elderly patients, and cause suffering for them. One task of being a nurse is to identify the patients' needs of prevention. Many pressure ulcer preventions exist, such as risk assessment, repositioning and support surfaces. Despite this, there is uncertainty about how these preventive measures should be used. This work focuses on describing evidence-based pressure ulcer prevention for the elderly to facilitate nurses' choices regarding the application of their resources, as well as reduce the incidence of pressure ulcers among elderly patients. Aim: To describe evidence-based pressure ulcer prevention in elderly patients. Method: A literature review containing ten quantitative articles. Results: Pressure ulcer incidence can be reduced by use of assessment instruments in combination with the nurse's clinical judgment. Viscoelastic mattress, air alternating mattress and cover have been shown to be effective as pressure ulcer prevention. Repositioning every three hours during the night reduces the incidence of pressure ulcers, and so does repositioning every four hours in combination with a pressure-relieving viscoelastic mattress. Additionally, pressure ulcers on heels can be avoided if a wedge-shaped viscoelastic cushion or a heel guard is used. Pressure relieving wheelchair cushions have been shown to reduce the incidence of pressure ulcers. Conclusion: Risk assessment instruments should be combined with the nurse's clinical assessment, and based on the results obtained pressure ulcer prevention efforts can be selected, such as air alternating or viscoelastic mattress, or pressure relieving wheelchair cushion. Repositioning have shown reduced pressure ulcer incidence, but there is uncertainty about the interval that should be used, and therefore more research is needed in this area. There is clear evidence that a wedge-shaped pillow or a heel guard provides reduced pressure ulcer incidence.

No description available.

Background Although Pressure ulcer is common in high and middle income countries it is rarely researched in low income countries. Evidence based interventions of pressure ulcer prevention are developed but the gap between the evidence and the clinical practice is wide. Aim Describe the nurses‟ knowledge about pressure ulcer prevention at a provincial hospital in Ghana. Design An empirical qualitative approached was used and semi-structured interviews were made with nurses at the Kwahu Governmental Hospital in Atibie, Ghana. A content analysis and a deductive content analysis were used to analyze the material. The evidence based interventions suggested by the North American Nurses Association (NANDA) was used as a theoretical framework. Result / Conclusion The themes Pressure ulcer prevention and Nurses‟ knowledge were found. Most of the evidence based interventions were mentioned by the participants. However, the participants explained massage as a preventive intervention although the evidence advice against massage. The participants did not mention any interventions considering documentation and nutrition. Further the nurses explained that they achieved their knowledge in school by practical demonstrations and examinations. The nurses‟ opinion was that their knowledge is enough to prevent pressure ulcers. / <p>Röda Korsets sjuksköterskeförening stipendium 2011</p>

Background: Pressure ulcers are related to reduced quality of life for patients and high costs for health care. Guidelines for pressure ulcer prevention have been available for many years but the problem remains. Aim: The overall aim of this thesis was to investigate hospital setting factors that are important to the performance of pressure ulcer prevention and to evaluate an intervention focused on implementing evidence-based pressure ulcer prevention. Methods: Four studies with a qualitative and quantitative approach were conducted.  Registered nurses’ performance of pressure ulcer prevention for patients at risk was investigated. Factors related to pressure ulcer prevention at different levels in hospital organizations were examined (hospital and ward type, workload, and nurse staffing) in two hospitals. A quasi-experimental study evaluated the effects of an intervention focusing on pressure ulcer prevention and a descriptive study with interviews examined nurses and first-line managers’ experiences of this intervention. Results: All of the studies show that quality improvement was needed for patients at risk of pressure ulcer. Registered nurses attention to pressure ulcer prevention was low and the caring culture of the wards ranged from organized work to unorganized work. Factors related to pressure ulcer prevention were patients’ age (risk and skin assessment) and patients’ risk (skin assessment, pressure reducing mattresses and planned repositioning), type of hospital (university and general), and ward (geriatric, medical, and surgical). Nurse staffing and workload played a minor role. Significantly more patients received pressure ulcer prevention after the intervention. Important factors for improvement were the support nurses and managers received by external and internal facilitators. Another important factor was interpersonal communication on the care provided by the nurses and first-line managers. Conclusion: Quality improvement regarding evidence-based pressure ulcer prevention was needed. Factors associated with pressure ulcer prevention were related to all levels in the hospital settings. A comprehensive intervention showed statistically significant improvement in the care. Interpersonal communication among the staff based on quality measurements was the key factor. Managers from the micro- to the macro-level have to know the conditions for pressure ulcer prevention and, given their position, ensure that the necessary prerequisites are in place.