RESUMEN
OBJECTIVE: Urinary catheter-related meatal pressure injury (UCR-MPI) is a preventable and serious complication of indwelling urinary catheter use. This prospective study aimed to determine the prevalence and risk factors of UCR-MPI in male critical care patients. METHODS: A total of 138 male patients 18 years and older using an indwelling urinary catheter were included in the study. Participants' perineal areas were assessed daily for the development of MPI. RESULTS: The UCR-MPI prevalence was 26.1% (n = 36/138). Most patients (61.1%) had a grade I UCR-MPI with intact skin and mucosa and nonblanchable erythema. Urinary catheter irrigation (P = .001), lower Braden Scale scores (P = .040), lower Glasgow Coma Scale score (P = .002), higher Itaki Fall Risk Scale score (P = .040), higher dependency level (P = .027), hypoalbuminemia (P = .002), and perineal edema (P = .001) were risk factors for UCR-MPI. CONCLUSIONS: The prevalence of UCR-MPI was high in this sample. Providers should take preventive measures to prevent UCR-MPI in patients with a penis including early and frequent risk assessment.
Asunto(s)
Úlcera por Presión , Cateterismo Urinario , Humanos , Masculino , Estudios Prospectivos , Úlcera por Presión/epidemiología , Úlcera por Presión/prevención & control , Úlcera por Presión/etiología , Persona de Mediana Edad , Factores de Riesgo , Cateterismo Urinario/efectos adversos , Anciano , Adulto , Cuidados Críticos/métodos , Catéteres Urinarios/efectos adversos , Catéteres de Permanencia/efectos adversos , Prevalencia , Medición de Riesgo/métodosRESUMEN
Evaluating the healing status of pressure injuries is important to planning medical and nursing care. PURPOSE: A descriptive, retrospective study was conducted to determine the healing status of pressure injuries among critically ill immobile patients. METHODS: Data were obtained via medical record review of all patients admitted to a Turkish university hospital's anesthesiology intensive care unit (ICU) between January 2008 and December 2015. Demographic (age, gender), medical (comorbidities, diagnosis, length of ICU stay), and pressure injury characteristics (number, location, stage, healing status, length, width, exudate amount, tissue type) were evaluated along with Pressure Ulcer Scale for Healing (PUSH) Tool scores. Data from all patients >18 years of age with an ICU stay >24 hours who had a pressure injury and whose records were complete were included in the study. Data were expressed as number, percentage, and mean and median values. Wilcoxon test, Spearman's correlation analysis, and chi-square test were performed as appropriate. Pressure injuries were considered healed when the PUSH score equaled zero. RESULTS: The study sample comprised 359 patients (60.97 ± 19.31 [range 19-95] years, 217 men, median length of stay 25 [range 1-363] days) with 672 pressure injuries. Most pressure injuries were located on the coccyx (278 [41.4%]), and 153 (22.8%) healed during ICU stay. Older age (r = 0.167; P = .002) and length of ICU stay (r = 0.238; P = .0001) were significantly correlated with having multiple pressure injuries. There was a statistically significant relationship between pressure injury location and stage and healing status (χ2 = 28.993, P = .0001; and χ2 = 60.200, P = .001, respectively). The lowest percentage of injuries healed were on the coccyx and were stage 4 and unstageable. Overall, the mean first PUSH score was significantly higher than the last assessment score (8.99 ± 3.82 to 7.28 ± 5.22, respectively; z = -10.807; P = .0001). CONCLUSION: Many immobile ICU patients had multiple pressure injuries, especially patients who were older and who had a longer length of stay. Healing scores for pressure injuries were better at discharge or transfer and 22% of injuries were healed. Prospective studies comparing all factors that may contribute to pressure injury healing are warranted. .
Asunto(s)
Enfermedad Crítica/rehabilitación , Úlcera por Presión/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Femenino , Humanos , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Úlcera por Presión/fisiopatología , Estudios Prospectivos , Estudios Retrospectivos , TurquíaRESUMEN
PURPOSE: The purpose of this study was to evaluate operating room (OR) experiences of student nurses. DESIGN: The focus group interview from qualitative research methods was used. METHODS: This study was carried out between February and March 2011 in an OR practice at a university school of nursing. The grounded theory method was used to collect and analyze semistructured interview. Interviews were held with a total of 26 students in three focus group interviews. Each interview was tape recorded and was supported by taking notes. The audiotapes were listened and relistened by the researchers and transcribed. FINDINGS: Four themes were determined as a result of this study. These are information, determination of career preference, period of internship and/or rotation, and fear and/or anxiety. CONCLUSIONS: The students stated that the period of OR practice was insufficient, the opportunities for being able to implement were limited, they mostly observed, and they experienced feelings of being alone and fear in the OR. Despite all of these, the students stated that the OR practice provided a major contribution to their education and was effective in the determination of their career preferences after graduation.