Pressure ulcer incidence and progression in critically ill subjects: influence of low air loss mattress versus a powered air pressure redistribution mattress.

PURPOSE: The primary objective of this study was to compare facility-acquired pressure ulcer incidence and progression of pressure ulcers present on admission in critically ill patients, using 2 different support surfaces. DESIGN: We completed a comparison cohort study in a surgical intensive care u...

Descripción completa

Detalles Bibliográficos
Publicado en:Journal of Wound, Ostomy & Continence Nursing Vol. 39; no. 3; pp. 267 - 274
Autores principales: Black, Joyce, Berke, Christine, Urzendowski, Gail
Formato: pictorial research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins 2012 May-Jun
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=108134489&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 108134489
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        10715754
        4CQ
      jtl: Journal of Wound, Ostomy & Continence Nursing
      issn: 10715754
      maglogo: N
    pubinfo:
      dt: 2012 May-Jun
      vid: 39
      iid: 3
      pid: 433
      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
    artinfo:
      ui:
        108134489
        108134489
        2011617160
        10.1097/won.0b013e3182514c50
        NLM22552108
        108134489
      ppf: 267
      ppct: 7
      formats:
      tig:
        atl: Pressure ulcer incidence and progression in critically ill subjects: influence of low air loss mattress versus a powered air pressure redistribution mattress.
      aug:
        au:
          Black, Joyce
          Berke, Christine
          Urzendowski, Gail
        affil: College of Nursing, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE 68198, USA. cberke@nebraskamed.com
      sug:
        subj:
          Disease Progression
          Pressure Ulcer Epidemiology
          Critically Ill Patients
          Human
          Intensive Care Units
          Nonexperimental Studies
          Prospective Studies
          Protocols
      ab: PURPOSE: The primary objective of this study was to compare facility-acquired pressure ulcer incidence and progression of pressure ulcers present on admission in critically ill patients, using 2 different support surfaces. DESIGN: We completed a comparison cohort study in a surgical intensive care unit (ICU). SUBJECTS AND SETTING: The study setting was a 12-bed cardiovascular ICU in a university-based hospital in the Midwestern United States. The sample comprised 52 critically ill patients; 31 were placed on low air loss weight-based pressure redistribution-microclimate management system beds and 21 were placed on integrated powered air pressure redistribution beds. METHODS: Prior to the start of the study, 5 low airloss beds were placed in open rooms in the cardiovascular surgical ICU. Inclusion criteria were anticipated ICU stay of 3 days, and patients did not receive a speciality bed for pulmonary or wound issues. Initial assessment of the patients included risk assessment and prior events that would increase risk for pressure ulcer development such as extended time in operating room, along with skin assessment for existing pressure ulcers. Subjects in both groups had ongoing skin assessment every 3 to 4 days and a subjective evaluation of heel elevation and turning or repositioning by the researcher. Data were collected until the subjects were dismissed from the ICU. Patients admitted to the unit were assigned to open rooms following the usual protocols. RESULTS: The mean length of stay was 7.0 days, with an 8.1-day length of stay for subjects on 'low air loss with microclimate management' beds (LAL-MCM) and 6.6 days on the integrated power pressure air redistribution (IP-AR) beds (P = NS). The incidence of pressure ulcers on the buttocks, sacrum, or coccyx was 0% (0/31) on the low air loss bed and 18% (4/21) on the IP-AR bed (P = .046). Five subjects had 6 pressure ulcers on admission. Two pressure ulcers on 2 patients worsened on the integrated power air redistribution beds, which required specialty bed rental costing the facility $4116. No subjects on the low air loss beds experienced worsening of existing pressure ulcer. One patient with a deep tissue injury present on admission improved on the LAL-MCM bed. The IP-AR beds were approximately 7 years old, and the LAL-MCM beds were new. CONCLUSIONS: Critically ill subjects placed on low air loss beds with microclimate management in surgical ICUs had a lower pressure ulcer incidence than those placed on integrated powered air pressure redistribution beds. The clinical performance of the IP-AR surfaces may have been influenced by their age.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N