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Resumo(s)
Background: Pressure ulcers (PU) are considered to an adverse event and constitute a constant challenge for all health professionals and institutions. Aim: Study the prevalence and incidence of PU in a intensive care unit (ICU) and the difficulties of classification and characterization of the lesions in critical ill patients. .Materials and methods: Retrospective cohort analysis of electronic health record database from adult patients admitted to a ICU during 2012/1013. Barriers/difficulty's to classification of PUs 'were also studied in the nursing staff. Results: Epidemiologic sample study included 600 participants, and differential diagnoses study 27 nurses. The episodes in the study period (n = 600), 98 'were identified with at least one PU present during hospitalization period, corresponding to a prevalence rate of 16.3%. The remaining 502 had no PU recording at entry or during hospitalization, 98 patients who were identified with PU, 40.8% presented it upon admission, and 59.2% developed ulceration in the service after 24 hours of admission (n = 58), which resulted in an incidence rate of 11.4%. The categorization of the PU ulcers identified in the present study, the most prevalent was category II (36,1%), followed by IV (35,4%), then I (13.1%) and III (10.8%). Regarding barriers of the differential diagnosis, 77.7% reported difficulty in evaluating PU in patients with peripheral arterial disease; 92.5% referred difficulty in evaluating Category I in dark skin; 81.5% referred subjectivity in the characterization in the mucosa; 40.7% reported difficulty PU associated to medical devices; 96.3% considered essential training as a way to reduce subjectivity. Conclusion: Extra attention needs to be taken to prevent PU in ICU. The incidence of PU is higher if associated with a medical device, Staff must adopt multiple strategies to prevent it. More education and sharing experiences is needed to reduce the subjectivity of differential diagnosis in PU.
Descrição
Palavras-chave
Incidence Prevalence Nursing assessment Intensive care Portugal Pressure ulcer Risk assessment
Contexto Educativo
Citação
Alves, P., Eberhardt, T., Soares, R., Pinto, M., Pinto, C., Vales, L., Morais, J., Oliveira, I. (2017). Differential diagnosis in pressure ulcers and medical devices. Ceska a Slovenska Neurologie a Neurochirurgie, 80(Supp.1), S29-S35
Editora
Czech Medical Association