EFFECT OF SAFETY SKIN PROTOCOL ON PRESSURE ULCER OCCURRENCE AMONG IMMOBILIZED PATIENTS

Document Type : Original Article

Authors

1 critical care and emergency - mansoura university- faculty of nursing

2 medical surgical nursing faculty of nursing alexanria university

3 medical surgical nursing faculty of nursing Alexandria university

4 medical surgical nursing technical institute alexandria university

5 medical surgical nursing -faculty of nursing- port saied university

Abstract

Background: Immobilized patients are vulnerable to pressure ulcer development due to severity of illness, increased length of stay, poor tissue perfusion due to hemodynamic instability, immobility, and poor nutritional status Pressures sores are areas of localized damage to the skin and underlying tissue friction. This type of damage can also be known as pressure ulcers, bedsores, or decubitus ulcers. Aim: Evaluate the effect of safety Skin protocol on pressure ulcer occurrence among immobilized patients. Subjects and method: Design: A quasi-experimental research design was utilized. Subjects: convenience sample  of 70 adult patient, assigned into two groups (study and control) each group consisted of 35 patients. Setting: The study was conducted in the Mansoura University Hospital at Neurological departments and Neurological ICU. Tools: Two tools were utilized tool one pressure ulcer status, tool 2 skin safety observational chick list, and it was done at the time of admission until six days. Results: data revealed that 70% of patients maintained their skin integrity all over the study period, 30% develop the first stage of the ulcer.The effect of safety skin protocol was significant statistically. Conclusion: Immobility, increase pressure, Immobilized patients more susceptible to pressure ulcers Recommendations: It is important to enhance the awareness level among the public, patients, and also the health care providers regarding the importance of applying safety skin protocol for immobilized patients from admission regular educational programs to continuously update the nurse's knowledge with the advanced and effective practice of skin care and early detection of pressure ulcers.
   

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Barbara J. Braden J. (2005). Preventing Pressure Ulcers with the
Braden Scale. An update on this easy-to-use tool that assesses a
patient’s risk;  AJN The American Journal of Nursing, 105 (671).
 Bethell E. (2018). Incidence and prevalence data: can we ensure greater accuracy? J Wound Care, (8):285–311.
 Black J, Hawks J. (2019). Neurological Surgical Nursing: Clinical Management for positive outcomes 6thed.Philadelphia: W.B. Saunders company; 1295-1301.
Coleman S,Gorecki C,Nelson A, Closs J, Defloor T, Halfens R, Farrin A, Brown J, Shoon HOVEN L, Nixon J,(2013); Patient risk factors for pressure ulcer development: systematic review . International Jouranl of Nursing Studies, 50(7), July, pages 974-1003.
FLETCHER, J. (2017). An overview of pressure ulcer risk assessment tools. Wounds UK, 13(1), p18-26.
Taylor C, Mulligan K, Mcgraw C (2021); Barriers and enablers to the implementation of evidence –based practice in pressure ulcer prevention and management in an integrated community care setting: a qualitative study informed by theoretical domains framework. http://doi.org/10.1111/hsc.13332.
Rao.D.Aditi,Preston.M.Ave ,Robyn, Strauss, Rebecca Stamm, Demetro C zalman, (2016). Risk Factors Associated With Pressure Ulcer Formationin Critically Ill Cardiac Surgery Patients Wound ostomy ,Conlinence nurse, 43(3):242-247.
Salcido R. (2017) Pressure ulcers and wound care. Rehabilitation Med; 9:1-15.
Jaul, E., Barron, J., Rosenzweig, J.P. MenczelJ, (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr 18, 305 https://doi.org/10.1186/s12877-018-0997-7.
Truong B, Grigson E, Patel M, LiuX (2005); pressure ulcer prevention in the hospital setting using silicone foam dressings, CUREUS 8(8):e 730.
OzyurekP, Yavuz M, Yild (2016); investigation of risk factors of pressure ulcers in intensive care unit pateints: according to barden scale. Estern journal of medicine 2(c1):1-9.
MallahZ, Nassar N, Badr L (2014). The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: controlled before and after study. Applied nursing research. 28(2)
Mendez M, Serrano M, Castano C (2017); Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. https:doi.org/10.1111/jocn.14091.
Niezgoda J& Mendez S. (2006); "The effective management of
pressure ulcers. Adv Skin Wound Care; 19(1):3-15.
Xinjuan Wu, Zhen Li, Jing Cao, Jing Jiao, Yingli Wang, Ge Liu, Ying Liu, Fangfang Li, Baoyun Song, Jingfen Jin, Yilan Liu, Xianxiu Wen, Shouzhen Cheng, Xia Wan. (2018), 13(10): e0205729. Published online 2018 Oct 12. doi: 10.1371/journal.pone.0205729.
Sree,V.D., Rausch,M.K., &Tepole, A.B (2019). Linking microvascular collaps to tissue, the Lancet, 304(7872), 81-84.
Smit,I.,Harrison, L.,Letzkus,L., Quatrara, B.,(2016) What Factors are Associated with the Development of Pressure Ulcers in Medical Intensive Care Unites? Dimes Crit Care Nurses, Jan- Feb, 35(1) 37-41.doi:10.1097/Dcc0000000000000/53.

18- Coleman S , Gorecki C, . Nelson  A,  Closs S , Defloor T, Halfens R Farrin  A,  Brown J , Schoonhoven L, Nixon  J .(2013)Patient risk factors for pressure ulcer development: Systematic review,International Journal of Nursing Studies Volume 50, Issue 7, July 2013, Pages 974-1003

 https://doi.org/10.1016/j.ijnurstu.2012.11.019.

19-Jessica H. Beard, M.D., M.P.H., Niels D. Martin, M.D., Patrick M. Reilly, M.D., .(2018)Nighttime Trauma Fellow Care Is Associated with Improved Outcomes after Injury, the American surgeon https://doi.org/10.1177/000313481808400319.

Cai, S,   Rahman, M&  Intrator,O (2013) Obesity and pressure ulcers among nursing home residents, Med Care. 2013 Jun; 51(6): 478–486. doi: 10.1097/MLR.0b013e3182881cb0.

21- Karayurt O,Kyol O,Kilicaslan N, Akgun N, Sargin U, Kondakci M Ekinci H, Sari N (2016) The incidence of pressure ulcer in pateint on mechanical ventilation and effects of selected risk factors on pressure ulcer development Tuk J MED Sci  vol 17 46:1314-1322 https:// doi: 10.3906/sag.1504-139 .

Serrano, M , Méndez, G & Cebollero C , (2017)Risk factors for pressure ulcer development in Intensive Care Units: A systematic review, Medicina Intensiva (English Edition) Volume 41, Issue 6, August–September 2017, Pages 339-346. Volume 41, Issue 6, August–September 2017, Pages 339-346.