Results of collaboration between case managers and staff nurses.
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Biomedical subjects
Publications and source records attributed to J Maklebust.
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The number of support surfaces marketed as pressure relieving devices has escalated during recent years and objective measures are needed to evaluate those that are effective. The purpose of this study was to compare the pressure relief capabilities of a special three-layered plastic air mattress (Sof.Care Bed Cushion--Gaymar), an air-fluidized bed (Clinitron--Support Systems International) and a standard hospital mattress. Sixty-four volunteers served as their own control as they were rotated onto the three sleep surfaces. Tissue interface pressure measurements were taken over bony prominences where pressure ulcers are most likely to occur: the sacrum, the greater trochanter of the femur and the heels. A one-way analysis of variance was computed for interface measurement scores by type of surface and a statistically significant difference was found among the three surfaces. A Newman-Keuls test was employed to compare the mean scores between two groups at a time. Both the Sof.Care Cushion and the Clinitron Bed differed significantly from the hospital mattress in the ability to relieve pressure. There was no statistical difference between the Sof.Care Cushion and the Clinitron Bed in the ability to relieve pressure over the sacrum, trochanter, or heels. However tissue pressure readings under the heels were greater than 32 mm Hg on both the Clinitron and Sof.Care surfaces. The data from this study, by looking at a larger sample supports our prior findings.
Pressure ulcers are a major health care problem that nurses can directly impact by identifying contributing factors and taking measures to determine patients at risk. Prevention of pressure ulcers is based on an understanding of their origin. The purpose of this article is to review the etiology of pressure ulceration and to explore recent advances toward prevention of this clinically significant problem.
Pressure ulcers are common among the frail elderly. Reducing the incidence of pressure ulcers requires vigilance on the part of an entire interdisciplinary team; however, gerontology nurses in particular must know how to intervene and assist in maintaining tissue integrity for older adults who are at risk. This article discusses various factors that place individuals at risk for pressure ulceration. Ways to address factors that place patients at particularly high risk for pressure damage are also suggested.
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Debridement of nonviable tissue is crucial to optimal wound healing, which can be impaired unless all necrotic tissue, exudate, and metabolic wastes have been removed from the wound. Debridement methods are classified as sharp, mechanical, chemical, and autolytic. This article describes methods of debridement and their outcomes.
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