PURPOSE: The purpose of this study was to identify the influencing factors on the development of pressure ulcers in patients undergoing surgery which lasted more than two hours. METHOD: One hundred nineteen surgical adult patients were included in the study. Data was measured on each participant from December 2003 to February 2004. It was collected using a structured researcher-administered sheet and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. RESULT: The prevalence of a perioperative pressure ulcer was 26.1%. The level of moisture, friction and shear, length of surgery, and perioperative irrigation were significantly higher in the pressure ulcer group than those in the non-pressure ulcer group. The level of activity and level of consciousness were significantly lower in the pressure ulcer group than those in the non-pressure ulcer group. Significant influencing factors on the development of pressure ulcer were 'moisture' and 'irrigation' and those variables explained 23.1% of varience in the development of a pressure ulcer during surgery. CONCLUSION: It is necessary to develop a strategy to prevent pressure ulcer by taking 'moisture' and 'irrigation' into account during the preoperative, perioperative and postoperative period.
Risk Factors ; Pressure Ulcer/*etiology/nursing/prevention & control ; Middle Aged ; Male ; Humans ; Female ; Aged ; Adult

As a new respiratory support technique, high-flow nasal cannula oxygen therapy (HFNC) has been widely used in clinical practice in recent years. During HFNC treatment, due to the long time and continuous wearing of nasal stopper and fasteners on the patient face, it is easy to cause medical device-related pressure injury on multiple facial skin. Moreover, when the patient's position changes greatly, because there is no good fixed design at the HFNC nasal stopper, it is easy to shift or turn the nasal stopper outward, causing abnormal ventilation and failure to achieve the purpose of clinical oxygen therapy. To overcome above problems, medical staff in the intensive care unit of department of infectious diseases, Tongji Hospital Tongji Medical College of HUST designed a new type of decompression fixator to prevent HFNC face pressure injury, and obtained national utility model patent (ZL 2022 2 0754626.1). The integrated design structure of the device has the functions of decompression of facial skin and fixation of nasal stopper, which can ensure the effect of oxygen therapy and improve the oxygen therapy experience and patient comfort, which is suitable for clinical promotion.
Humans ; Cannula ; Pressure Ulcer/prevention & control* ; Oxygen Inhalation Therapy/methods* ; Oxygen ; Decompression ; Respiratory Insufficiency/therapy* ; Noninvasive Ventilation

Stroke ranks as one of the leading causes of death and the most common cause of permanent disability in adults in Korea. Timely recognition and treatment is imperative to reduce stroke-related morbidity and mortality. Patients with acute ischemic stroke should be evaluated for intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA); antiplatelet drugs can be administered to those who do not qualify for rt-PA therapy. Adequate hydration and correction of possible hypoxia are necessary, and hyperglycemia and fever should be treated aggressively. Blood pressure management should be individualized on the basis of stroke pathophysiology. It is important to prevent and manage complications of acute stroke, such as pneumonia, urinary tract infection, bed sore, deep vein thrombosis, and joint contracture. Meticulous evaluation of etiology of ischemic stroke can determine the most appropriate acute management and would guide the secondary prevention of stroke.
Adult ; Anoxia ; Blood Pressure ; Cause of Death ; Contracture ; Fever ; Humans ; Hyperglycemia ; Joints ; Korea ; Mortality ; Platelet Aggregation Inhibitors ; Pneumonia ; Pressure Ulcer ; Secondary Prevention ; Stroke* ; Urinary Tract Infections ; Venous Thrombosis

We have developed a new rotating bed for the old and the paralised people. This rotating bed is composed of two bed heads at front and at end, bed boards, guardrails, an electric motor, a reducer, an induction locator and a set of electronic controls. With the preestablished program, the angle between the left/right bed board and the middle board is changed by rotating the left/right board around the rotation axis, and the gravity direction between the human body and the ground is changed by the rotation of the middle board as a whole, so that the middle bed board and the left and right ones will act respectively as supporters of weight of the person who is lying on his back or on his side. In this way, a person can turn over automatically, comfortably and naturally when he/she is asleep. This rotating bed meets the physiological needs of a sleeping person, and people with turning over problems can turn over in a comfortable and natural way by means of biotechnology. It can also improve the quality of sleep and help avoid decubitus. In addition, it can be used to promote the rehabilitation of those who are paralysed by reason of its passive exercising function.
Automation ; Bed Rest ; adverse effects ; nursing ; Beds ; Equipment Design ; Humans ; Motion Therapy, Continuous Passive ; economics ; instrumentation ; Pressure Ulcer ; etiology ; prevention & control ; Rotation

PURPOSE: The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers. METHODS: Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and -II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method. RESULTS: Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR. CONCLUSION: Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.
Adult ; Aged ; Area Under Curve ; Bayes Theorem ; Cohort Studies ; Female ; Humans ; Logistic Models ; Male ; Medical Records ; Middle Aged ; *Predictive Value of Tests ; Pressure Ulcer/epidemiology/*prevention & control ; Retrospective Studies ; Risk Assessment

PURPOSE: This study was done to develop an evidence-based incontinence care protocol through an adaptation process and to evaluate the effects of the protocol. METHODS: The protocol was developed according to the guideline of adaptation. A non-randomized controlled trial was used for testing the effects of the new Incontinence Care Protocol. A total of 120 patients having bowel incontinence with Bristol stool type 5, 6, and 7 and admitted to intensive care units were recruited to this study. The newly developed incontinence care protocol was used with patients in the experimental group and conventional skin care was given to patients in the control group. Outcome variables were incontinence-associated dermatitis (IAD) severity, pressure ulcer occurrence and severity. RESULTS: The experimental group had significantly less severe IAD (t=6.69, p<.001), lower occurrence of pressure ulcers (chi2=7.35, p=.007), and less severity of pressure ulcers (Mann-Whitney=86.00, p=.009) than the control group. CONCLUSION: Use of this incontinence care protocol has the effects of preventing pressure ulcers and inhibiting worsening of IAD and pressure ulcers. Therefore, this incontinence care protocol is expected to contribute to managing IAD and pressure ulcers.
Aged ; Aged, 80 and over ; Dermatitis/pathology ; Evidence-Based Nursing/*standards ; Fecal Incontinence/pathology/*prevention & control ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pressure Ulcer/epidemiology/pathology ; Program Development ; *Program Evaluation ; Severity of Illness Index ; Skin Care ; Urinary Incontinence/pathology/*prevention & control