Predicting pressure ulcer sore risk.
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Biomedical subjects
Publications and source records attributed to E A Ayello.
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The importance of education in preventing and treating patients with pressure ulcers is evident by the inclusion of recommendations for educational objectives in the clinical guidelines by the Agency for Health Care Policy and Research. Both caregiver and client should be assessed for knowledge of pressure ulcers. Physical changes in vision, hearing, and cognition that might affect educating older clients are described. Strategies suitable for teaching older clients about the prevention and treatment of pressure ulcers are given.
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The National Pressure Ulcer Advisory Panel appointed a task force to review the definition of Stage I pressure ulcers, specifically to assess its adequacy in people with darkly pigmented skin. The process used by the task force to draft a new definition is described in this preliminary report of their work. The proposed definition and initial critique of it are given.
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Preventing Pressure Ulcers--A patient's guide was released by the Agency for Health Care Policy and Research (AHCPR) in May 1992. Using criteria suggested by Falvo (1985), Redman (1988), Ruzicki (1989), and others, the guide was critiqued to determine how it compared to existing criteria for evaluating written tools. The AHCPR guidelines does not meet all the criteria; suggestions for improvement are provided.
The Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) Agenda for Change has refocused and redefined quality monitoring in health care. The JCAHO has operationalized these new concepts of quality monitoring and evaluation by means of a 10-step process that includes the development of clinical indicators. Theoretical frameworks for the 10-step process were drawn from the work of theorists whose applications of quality-monitoring methods occurred in business and industry. An enhanced understanding of the current JCAHO definitions of quality and processes for quality measurement will help practitioners prepare for future accreditation surveys. A review of quality monitoring and evaluation activities in nutrition support has demonstrated a need for more published accounts to document these important activities.
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Proper nutrition is essential to prevent the development of pressure ulcers and to support adequate and timely wound healing. Additionally, research and clinical observation suggest nutrients play a major role in wound healing. How the nutrients Vitamin A, Vitamin C, zinc, calories, protein, and fluids are used in wound healing and recommendations regarding use of supplements are discussed in this article.
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The consumer version of the clinical practice guidelines entitled "Treating Pressure Sores" was released by the Agency for Health Care Policy and Research (AHCPR) in December 1994. This review of the patient teaching booklet compares it to existing criteria-evaluating written tools. The AHCPR 1994 Consumer Guide meets almost all the criteria; one area that still needs improvement is the reading level.
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On the last day of the 12th Annual Clinical Symposium on Wound Management, a panel of clinicians from various disciplines, and with diverse experience in wound management, discussed the challenges and rewards of being part of a multidisciplinary team caring for patients with wounds. Panelists included Sharon Baranoski, MSN, RN, CETN; C. Andrew Salzberg, MD; Marlys J. Staley, MS, PT; and David R. Thomas, MD, FACP. Elizabeth A. Ayello, PhD, RN, CS, CETN, was the moderator. An excerpt from this session is published here.