Advanced search
1 file | 116.96 KB

The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers

Katrien Vanderwee (UGent) , Maria Grypdonck (UGent) , Dirk De Bacquer (UGent) and Tom Defloor (UGent)
(2009) JOURNAL OF CLINICAL NURSING. 18(21). p.3050-3058
Author
Organization
Abstract
Aims and objective. The objective of this study was to identify prognostic factors associated with the development of pressure ulcer lesions (grade 2-4) in nursing home patients with non-blanchable erythema. Background. No studies could be found that identify risk factors for further development of pressure ulcer in patients with non-blanchable erythema. For some patients with non-blanchable erythema, standard preventive measures do not suffice to prevent pressure ulcers from deterioration. Identifying these patients beforehand can considerably contribute to the efficiency of pressure ulcer prevention. Design. Secondary data analyses of a previously conducted randomised controlled trial were performed. Methods. Eighty-four wards of 16 Belgian nursing homes participated in the study. In total, 235 nursing home residents with a grade 1 pressure ulcer (non-blanchable erythema) were included. All the residents received standard preventive care. Potential prognostic factors were collected using a standardised form. The incidence of pressure ulcers was recorded according to the European pressure ulcer classification system. Results. The cumulative pressure ulcer incidence was 18.7% (44/235). Hypotension (relative risk = 3.42, 95% CI = 1.56-7.49), a history of a cerebral vascular accident (relative risk = 1.94, 95% CI = 1.10-3.70) and contractures (relative risk = 2.02, 95% CI 1.03-3.95) were identified as independent predictive factors for developing pressure ulcers. Remarkably, being urinary incontinent decreased the risk of developing a pressure ulcer by 76%. Conclusions. In nursing home residents with non-blanchable erythema, hypotension, contractures, and a history of cerebral vascular accident were independent risk factors for the development of pressure ulcer lesions. Relevance to clinical practice. Patients with non-blanchable erythema who have hypotension, contractures or a history of cerebral vascular accident are in need of more intensive preventive measures. Identifying these patients can contribute considerably to a more efficient pressure ulcer prevention policy, resulting in a lower pressure ulcer lesion incidence and in lower costs.

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 116.96 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Vanderwee, Katrien, Maria Grypdonck, Dirk De Bacquer, and Tom Defloor. 2009. “The Identification of Older Nursing Home Residents Vulnerable for Deterioration of Grade 1 Pressure Ulcers.” Journal of Clinical Nursing 18 (21): 3050–3058.
APA
Vanderwee, K., Grypdonck, M., De Bacquer, D., & Defloor, T. (2009). The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers. JOURNAL OF CLINICAL NURSING, 18(21), 3050–3058.
Vancouver
1.
Vanderwee K, Grypdonck M, De Bacquer D, Defloor T. The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers. JOURNAL OF CLINICAL NURSING. 2009;18(21):3050–8.
MLA
Vanderwee, Katrien, Maria Grypdonck, Dirk De Bacquer, et al. “The Identification of Older Nursing Home Residents Vulnerable for Deterioration of Grade 1 Pressure Ulcers.” JOURNAL OF CLINICAL NURSING 18.21 (2009): 3050–3058. Print.
@article{805833,
  abstract     = {Aims and objective. The objective of this study was to identify prognostic factors associated with the development of pressure ulcer lesions (grade 2-4) in nursing home patients with non-blanchable erythema.

Background. No studies could be found that identify risk factors for further development of pressure ulcer in patients with non-blanchable erythema. For some patients with non-blanchable erythema, standard preventive measures do not suffice to prevent pressure ulcers from deterioration. Identifying these patients beforehand can considerably contribute to the efficiency of pressure ulcer prevention.

Design. Secondary data analyses of a previously conducted randomised controlled trial were performed.

Methods. Eighty-four wards of 16 Belgian nursing homes participated in the study. In total, 235 nursing home residents with a grade 1 pressure ulcer (non-blanchable erythema) were included. All the residents received standard preventive care. Potential prognostic factors were collected using a standardised form. The incidence of pressure ulcers was recorded according to the European pressure ulcer classification system.

Results. The cumulative pressure ulcer incidence was 18.7\% (44/235). Hypotension (relative risk = 3.42, 95\% CI = 1.56-7.49), a history of a cerebral vascular accident (relative risk = 1.94, 95\% CI = 1.10-3.70) and contractures (relative risk = 2.02, 95\% CI 1.03-3.95) were identified as independent predictive factors for developing pressure ulcers. Remarkably, being urinary incontinent decreased the risk of developing a pressure ulcer by 76\%.

Conclusions. In nursing home residents with non-blanchable erythema, hypotension, contractures, and a history of cerebral vascular accident were independent risk factors for the development of pressure ulcer lesions.

Relevance to clinical practice. Patients with non-blanchable erythema who have hypotension, contractures or a history of cerebral vascular accident are in need of more intensive preventive measures. Identifying these patients can contribute considerably to a more efficient pressure ulcer prevention policy, resulting in a lower pressure ulcer lesion incidence and in lower costs.},
  author       = {Vanderwee, Katrien and Grypdonck, Maria and De Bacquer, Dirk and Defloor, Tom},
  issn         = {0962-1067},
  journal      = {JOURNAL OF CLINICAL NURSING},
  language     = {eng},
  number       = {21},
  pages        = {3050--3058},
  title        = {The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers},
  url          = {http://dx.doi.org/10.1111/j.1365-2702.2009.02860.x},
  volume       = {18},
  year         = {2009},
}

Altmetric
View in Altmetric
Web of Science
Times cited: