Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
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J Wound Ostomy Continence Nurs · Jul 1999
Clinical practice guidelines for pressure ulcer prevention can prevent malpractice lawsuits in older patients.
To evaluate the impact of implementation of and compliance with practice guidelines for pressure ulcer (PU) prevention using medical malpractice litigation data. ⋯ Use of clinical pathways in these settings can benefit both caregivers and patients by favorably modifying preventive practice patterns while decreasing vulnerability to litigation. Conversely, the continuing threat of fault-based litigation against substandard practitioners and facilities provides an ongoing safeguard of patient rights and reduces the risk of subsequent disability.
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J Wound Ostomy Continence Nurs · May 1999
Intraoperatively acquired pressure ulcer prevalence: a national study.
This study was completed to determine the prevalence and identify comorbid conditions for intraoperatively acquired pressure ulcers. ⋯ The risk of intraoperative ulcerations increases as surgical time increases. Although patients with comorbid conditions known to affect the risk of ulceration under normal circumstances experienced pressure ulcers in this investigation, no significant relationship was found to link the presence of these conditions to an increased risk of intraoperatively acquired ulcers. Therefore all surgical patients undergoing prolonged procedures should be considered at risk for intraoperative ulceration.
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The diabetic foot ulcer is one of the most common and devastating complications of diabetes mellitus. These ulcers account for most of the hospital admissions for patients with diabetes, and they represent a common precursor for amputation. When a diabetic foot ulcer becomes infected, gangrene and amputation can follow in rapid succession. ⋯ This management is complicated, and typically requires radical débridement, appropriate antibiotics, non-weight-bearing, and vascular surgery when indicated. A variety of adjunctive therapy can be helpful, including hyperbaric oxygen and topical growth factors. The most important step in preventing ulceration of the foot is patient education in foot care.
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J Wound Ostomy Continence Nurs · Jan 1998
Pressure ulcer prevalence and incidence and a modification of the Braden Scale for a rehabilitation unit.
We examined pressure ulcer incidence and prevalence, the cutoff score for risk for skin breakdown, and the contribution of each of the subscale risk factors of the Braden pressure ulcer risk-assessment tool in an inpatient rehabilitation unit. ⋯ The mean prevalence rate of 12% was comparable, and the incidence rate of 6% for this unit was lower, compared with other skilled care and rehabilitation settings reported in the literature. The proactive, interdisciplinary approach to skin integrity on this unit likely contributed to the lower incidence rate. Risk factors most predictive of pressure ulcer development in this sample were moisture, nutrition, and friction and shear. Predicting risk for skin breakdown with use of a consistent risk-assessment tool is essential for all rehabilitation patients. Assessing risk with the Braden Scale merits further research.