The pressure ulcers in patients with comorbid neurological disorders

Czech version

Authors: J. Němcová ¹; E. Hlinková ¹; M. Slačková ²; M. Balková ¹
Authors‘ workplace: Ústav ošetrovateľstva, Jesseniova LF v Martine, UK v Bratislave, Slovensko ¹; Ortopedická klinika, UN Martin, Slovensko ²
Published in: Cesk Slov Neurol N 2018; 81(Suplementum 1): 19-22
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2018S19

Overview

Aim:

The aim of the retrospective cross-sectional study was to analyze the occurrence of pressure ulcers in patients at the Orthopedic Clinic (OC) of the University Hospital Martin (UHM), in the years 2016 and 2017.

Patients and methods:

We retrospectively analyzed documentation of patients with pressure ulcers with respect to age, gender, presence and degree/ category of pressure ulcers and confirmation of comorbid neurological diagnoses. We used the nursing documentation of the systematic management of the occurrence of pressure ulcers at OC UHM. For the evaluation of the data, descriptive statistics with absolute and relative frequency was used.

Results:

The UHM admitted 1,869 patients in 2016 of which 2.35% had pressure ulcer, the average age of the patients with pressure ulcers was 77.47 SD ± 15.25, and the women with the pressure ulcers were 70.45%. In 2017, 1,879 patients were hospitalized at OC UHM, the occurrence of pressure ulcers increased to 4.57%, the mean age was 78.42 years SD ± 14.05; women with pressure ulcers were 67.19%. Patients at OC UHM were also those who were already admitted with pressure ulcers, 0.96% (2016) and 1.86% (2017). The most of all pressure ulcers were the I. and II. category. The most serious III. and IV. pressure ulcer category did not occur at OC UHM, except one in category III., but patients with pressure ulcers were admitted to the department. Comorbid neurological diseases were represented in patients with pressure ulcer category I– IV by 56.08% in 2016 and in 2017 it was 27.89%.

Conclusion:

Patients on traumatology and orthopedics are exposed to higher risk of development of pressure ulcers due to older age and with the occurrence of neurological comorbid diseases. It is important to monitor the occurrence of pressure ulcers when patients are admitted at the department. The mistake can be avoided, where patients with pre-existing pressure ulcers (formatted before admission) should be excluded from this assessment, when assessing the quality of care provided at the workplace.

Key words:

patient – pressure ulcer – traumatology – orthopedics – comorbid neurological diseases

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Sources

1. Haesler E (ed). National Pressure Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers: clinical practice guideline. Osborne Park: Cambridge Media 2014.

2. Pokorná A, Mrázová R. Kompendium hojení ran pro sestry. Praha: Grada 2012.

3. Lyder CH. Pressure ulcer prevention and management. JAMA 2003; 289(2): 223– 226.

4. Šáteková L, Žiaková K, Zeleníková R. Predictive validity of the Braden scale, Norton scale and Waterlow scale in Slovak republic. Centr Eur J Nurs Midw 2015; 6(3): 283– 290. doi: 10.15452/ CEJNM.2015.06.0017.

5. Poledníková Ľ, Slamková A. At risk of pressure ulcers – a nursing diagnosis. Cent Eur J Nurs Midw 2016; 7(2): 428– 436. doi: 10.15452/ CEJNM.2016.07.0011.

6. Haesler E (ed). National Pressure Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressre ulcers: clinical practice guideline. Perth: Cambridge Media 2009.

7. Vanderwee K, Clark M, Dealey C et al. Pressure ulcer prevalence in Europe: a pilot study. J Eval Clin Pract 2007; 13: 227– 235. doi: 10.1111/ j.1365-2753.2006.00684.x.

8. Krajčík Š, Bajanová E. Dekubity: prevencia a liečba v praxi. Bratislava: Herba 2012.

9. Pokorná A, Benešová K, Jarkovský J et al. Pressure injuries in patient care facilities in the Czech republic. J Wound Ostomy Continence Nurs 2017; 44(4): 1– 5.

10. Sving E, Idvall E, Hőrberg H et al. Factors contributing to evidence - based pressure ulcer prevention. A cross- -sectional study. Int J Nurs Stud 2014; 51(5): 717– 725. doi: 10.1016/ j.ijnurstu.2013.09.007.

11. Pokorná A, Benešová K, Mužík J et al. The pressure ulcers monitoring in patients with neurological diseases-analyse of the national register of hospitalized patients. Cesk Slov Neurol N 2016; 79/ 112 (Suppl 1): S8– S14. doi: 10.14735/ amcsnn2016S8.

12. Pokorná A, Benešová K, Mužík J et al. Data sources for monitoring of non healing wounds in a national health information systém – epidemiology of non-healing wounds – analysis of the national register of hospitalized patients in 2007– 2015. Cesk Slov Neurol N 2017; 80/ 113 (Suppl 1): S8– S17. doi: 10.14735/ amcsnn2017S8.

13. Baumgarten M, Margolis DJ, Orwig DL et al. Pressure ulcers in elderly patients with hip fracture across the continuum of care. J Am Geriatr Soc 2009; 57(5): 863– 870.

14. Sterner E, Lindholm C, Berg E, Stark A, Fossum B. Category I pressure ulcers how reliable is clinical assessment? Orthop Nurs 2011; 30(3): 194– 205. doi: 10.1097/ NOR. 0b013e318219ae77.

15. Lindholm C, Sterner E, Romanelli M et al. Hip fractureand pressure ulcers-the Pan – Euroean Pressure Ulcer Study-intrinsic and extrinsic risk factors. Int Wound J 2008; 5(2): 315– 328. doi: 10.1111/ j.1742-481X.2008.00452.x.

16. Bóriková I, Žiaková K, Tomagová M et al. The risk of falling among older adults in long-term care: screening by Morse Fall Scale. Kontakt 2018; 20(2): e111– e119. doi: 10.1016/ j.kontakt.2017.11.006.

17. Herdman TH, Kamitsuru S (eds). Nursing Diagnoses Definitions & Classification 2018-2020. 11th ed. New York: Thieme 2017.

18. Van Hout MC, Norman I. Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies. Int J Drug Policy 2016; 27: 17– 22. doi: 10.1016/ j.drugpo.2015.09.007.

19. Graves N, Birrell F, Whitby M. Effect of pressure ulcers on lenght of hospital stay. Infect Cont Hosp Epidemiol 2005; 26(3): 293– 297. doi: 10.1086/ 502542.

20. Zhou Q, Yu T, Liu Y et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs 2018; 27: 694– 704. doi: 10.1111/ jocn.14019.

21. Bóriková I. Manažment prevencie dekubitov v systéme kvality starostlivosti. In: Ošetrovateľstvo 21. storočia v procese zmien 3. Nitra: Univerzita Konštantina Filozofa 2009: 121– 127.