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Lia van Rijswijk

Publications and source records attributed to Lia van Rijswijk.

At least 19 recordsLinked to original sources
PubMed2006

Teachers-R-Us.

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Career Choice↗
PubMed2005

Comparison of air-fluidized therapy with other support surfaces used to treat pressure ulcers in nursing home residents.

To provide empirical evidence comparing pressure ulcer healing rates between different support surfaces, data were analyzed from eligible residents with pressure ulcers (N = 664) enrolled in the National Pressure Ulcer Long-Term Care Study, a retrospective pressure ulcer prevention and treatment study. Support surfaces were categorized as: Group 1 (static overlays and replacement mattresses), Group 2 (low-air-loss beds, alternating pressure, and powered/non-powered overlays/mattresses), and Group 3 (air-fluidized beds). Calculation of healing rates, using the largest ulcer from each resident, found mean healing rates greatest for air-fluidized therapy (Group 3) (mean = 5.2 cm(2)/week) versus Group 1 (mean =1.5 cm(2)/week) and Group 2 (mean = 1.8 cm(2)/week) surfaces (P = 0.007). Healing rates also were assessed using 7- to 10-day "episodes"; each ulcer generated separate episode(s) that included all ulcers when residents had multiple ulcers. Mean healing rates were significantly greater for Stage III/IV ulcers on Group 3 surfaces (mean = 3.1 cm(2)/week) versus Group 1 (mean = 0.6 cm(2)/week) and Group 2 (mean = 0.7 cm(2)/week) surfaces (Group 2 versus Group 3: P = 0.0211). This finding persisted for ulcers with comparable initial baseline areas (20 cm(2) to 75 cm(2)) on Group 2 and Group 3 surfaces; healing improved on Group 3 surfaces (+2.3 cm(2)/week) versus Group 2 surfaces (-2.1 cm(2)/week, P = 0.0399). Residents on Group 3 (6 out of 82; 7.3%) and Group 1 (47 out of 461; 10.2%) surfaces had fewer hospitalizations and emergency room visits than those on Group 2 surfaces (23 out of 121; 19.0%, P = 0.01) despite significantly greater illness in residents on Group 2 and 3 versus Group 1 surfaces (P is less than 0.0001). Despite limitations inherent in retrospective studies, ulcers on Group 3 surfaces versus Groups 1 and Group 2 surfaces had statistically significant faster healing rates (particularly for Stage III/IV ulcers) with significantly fewer hospitalizations and emergency room visits (Group 3 versus Group 2), despite significantly more illness in residents on Group 2 or Group 3 versus Group 1 surfaces. Episode analyses -- providing greater power, uniform treatment duration, and comparable baseline sizes -- confirmed these findings. Air-fluidized support surfaces represent great healing potential that justifies further exploration.

Adult↗
PubMed2005

Pressure ulcer prevention and care: preventing and managing pressure ulcers in long-term care: an overview of the revised federal regulation.

Although the Centers for Medicare and Medicaid Service's Federal Regulation as it relates to pressure ulcer prevention and care in long-term care facilities has not changed, the Guidance to Surveyors (F-314) has been expanded significantly. In addition to more clearly defining commonly used terms, the new guidance document emphasizes the use of pressure ulcer risk assessment and prevention strategies, pain assessment and treatment, and monitoring the care outcomes. The Centers for Medicare and Medicaid Service has clearly raised the bar on pressure ulcer care. Based on currently available evidence, the guidance document is clear in its intent to encourage all long-term care facilities to adopt evidence-based pressure ulcer protocols of care. This transition, and the development and implementation of this guidance document, may present considerable challenges to some long-term care facilities. However, the lack of ambiguity in the F-314 document and its consistency with currently available evidence may be helpful to staff and improve outcomes of care.

Humans↗
PubMed2005

Pressure ulcer prevention and care: implementing the revised guidance to surveyors for long-term care facilities.

The revised guidelines for long-term care surveyors by the Centers for Medicare and Medicaid Services link the existing pressure ulcer prevention and treatment evidence base with federal guidelines. The guidance document is detailed and attempts to ensure that residents receive optimal care to help prevent and manage these wounds. Implementation of the guidance document recommendations requires a complete review, and possibly revision, of existing policies and procedures. Understanding the background, rationale, and methods to implement these recommendations will help administrators and clinicians develop protocols of care that are effective, cost efficient, and comply with the new guidelines.

Health Plan Implementation↗
PubMed2003

Déjà vu.

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Evidence-Based Medicine↗
PubMed2003

Black and white.

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Diffusion of Innovation↗
PubMed2002

Experts.

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Clinical Competence↗
PubMed2002

The impact of urinary incontinence in African American women.

Urinary incontinence is a major health problem for many individuals, especially older women. Research on urinary incontinence is common in Caucasians, but scarce in women of diverse cultures. Using data from a previous (parent) descriptive correlational study on risk factors for urinary incontinence in African American women (N = 233), a descriptive study of the impact of urinary incontinence was conducted among 85 college-educated African American women who were members of a prestigious African American organization and reported symptoms of urinary incontinence. Information about frequency and duration of incontinence, activities affected by urinary incontinence, and ratings of how much they were bothered by their urinary incontinence was obtained. Mean age of the study group was 51.94 years (range 20 to 80 years). Fifty-four of the participants (64%) reported one or more vaginal delivery, 33% had undergone a hysterectomy, and symptoms of urinary incontinence had been present from 3 months to 30 years. Stress, urge, and mixed incontinence were reported. Eleven women (13%) had sought treatment for their urinary incontinence, 20% said urinary incontinence bothered them a great deal, 8.5% reported behavioral modifications, and a portion of the women said they had to spend extra money on incontinence supplies. In this group of African American women, urinary incontinence rates were similar to those reported in Caucasian women. Research to increase clinician knowledge base and improve the care of African American women is needed.

Adult↗