• Title/Summary/Keyword: bed sore

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A Study on Prevalence and Nursing Intervention of Bed Sore Patients who Received Regional Home Care Services (가정간호 대상자의 욕창발생 및 간호중재에 관한 조사연구)

  • Kim Keum-Soon;Cho Nam-Ok;Park Young-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.1
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    • pp.43-60
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    • 1997
  • This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.

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Case Report of Korean Medicine Treatment and Dressing Therapy for Grade III Trochanteric Pressure Sore (한의 치료와 드레싱 요법을 병행한 뇌졸중 환자의 대퇴골 대전자부 3단계 욕창 치험 1례)

  • Kim, Kwangho;Lee, Young-ung;Kim, Cheol-hyun;Lim, Hyeon-seo;Kang, Geonhui;Lee, Sangkwan
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.122-130
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    • 2021
  • The purpose of this study is to report the effect of Korean medicine treatment on a pressure sore in a stroke patient. An 86-year-old female patient diagnosed with spontaneous intracerebral hemorrhage in the right basal ganglia had symptoms of left hemiparesis, dysphagia, and a 4.5-cm-by-2.5-cm left trochanteric pressure sore. Clinical outcomes were measured using the National Pressure Ulcer Advisory Panel (NPUAP) pressure injury stages, the Agency for Health Care Policy and Research (AHCPR) pressure ulcer stages, and the Braden scales. Treatment with Korean medicine, including acupuncture, herbal medicine, and dressing therapy, significantly improved the trochanteric pressure sore, as reflected by a NPUAP stage change from III to I, an AHCPR stage change from III to I, and a Braden scale change from 13 to 18. These findings suggest that Korean medicine treatment may be effective to treat pressure sores in stroke patients.

CQI Action Team Approach to Prevent Pressure Sores in Intensive Care Unit of an Acute Hospital Korea (중환자의 욕창 예방 연구 : 욕창 예방 QI팀을 중심으로)

  • Kang, So Young;Choi, Eun-Kyung;Kim, Jin-Ju;Ju, Mi-Jung
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.50-63
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    • 1997
  • Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

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Clinical Experience of Pulmonary Embolism after Coverage of Pressure Sore (압박 궤양 수술 후 발생된 페색전증 치험례)

  • Seo, Sang Woo;Lee, Won Jai;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.543-546
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    • 2005
  • Pulmonary embolism is a one of the major cause of postoperative death. Surgery predisposes patients to pulmonary embolism, even as late as one month after the operation. The accurate detection of pulmonary embolism remains difficult, and the differential diagnosis is extensive. The prevention of pulmonary embolism is thus of paramount importance. We report a case of pulmonary embolism after coverage of pressure sore on the left ischium on the 8th day after operation. The patient was 60 years old, a severe smoker, in the high quantity of body mass index and had hypertension. The risk factors are 60 years of age or older who were in the highest quantity of body mass index. Heavy cigarette smoking and high blood pressure are also identified as risk factors. Plastic surgeons should keep the probability of pulmonary embolism development after operation in mind. When taking history, the risk factors should be checked certainly. The immobilization may explain the probability of pulmonary embolism development. Therefore absolute bed rest or positional maintenance should be avoided. Until recently, low molecular weight heparin has been used for preoperative prophylaxis. Plastic surgeons should be concerned in low molecular weight heparin for prophylaxis of the pulmonary embolism and study the indications and effectiveness in liposuction or abdominoplasty.

Capstone Design Trail in Nursing Education and Its Outcome (간호학에 적용한 캡스톤 디자인의 적용사례 및 결과)

  • Moon, Kyoung-Ja
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.194-202
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    • 2017
  • This study is a methodological study analyzing the results of applying capstone design to nursing education. Among the nursing college students who completed the fundamental nursing subject, the students who agreed to participate in the research were composed of the project team and proceeded as team activities. It was conducted through knowledge - team composition - topic selection / analysis - design / development - simulation - evaluation / feedback process starting from knowledge learned through fundamental nursing class. The research period was from January 1, 2015 to October 30, 2015 for 6 months. BBS (Bed Sore Socks) was developed for the prevention of pressure ulcers, and BBS was applied for seven days to randomly selected patients in the long term care facility. The incidence and pressure ulcer risk scores were assessed. The results of the pilot study showed that the intervention group had an effect on the incidence of pressure ulcer ($x^2=.40$, p = .500) and the pressure ulcer risk score (z = -.45, p = .690), but it was not statistically significant. Capstone design was trailed in the field of nursing education and produced the bed sore socks. In the nursing education, not many capstone design trails appeared yet, this study might be the first trail in the field of nursing, and it could be challenging for expanding of nursing education.

Cognitive Function and Activity of Daily Living of Older Adults Using Long-term Care Service (장기요양 이용 재가노인의 인지기능과 일상생활 능력)

  • Chang, Hyun-Sook;Lee, Hung Sa
    • Health Policy and Management
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    • v.22 no.4
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    • pp.522-537
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    • 2012
  • The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.

A Case Report of Stage 4 Pressure Ulcer Patient Treated with Acupuncture and the Herbal Medicine Gamisipjeon-tang (침구 치료와 가미십전탕을 병행하여 호전된 4도 욕창 환자 치험 1례)

  • Ryu, Hae-rang;Kang, Eun-jin;Kim, Young-kyun;Kim, Kyoung-min
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.619-627
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    • 2017
  • Objectives: The purpose of this case study is to report the effect of oriental medicine on pressure ulcers. Methods: We treated a patient with a pressure ulcer with acupuncture, Jaungo, and Gamisipjeon-tang. We started with herbal medicine only, and then added the acupuncture treatment after one month. We treated the sore for a total of 4 months. We measured the size and depth of the ulcer and graded it with a National Pressure Ulcer Advisory Panel (NPUAP) score once every two weeks. Results & Conclusions: Even though the wound was not cured completely, the total size of the pressure ulcer was reduced and the NPUAP stage was improved from 4 to 3. Therefore, Korean medicine could be an effective treatment for improving pressure ulcers.

A Study of the Evaluation of the Spinal Cord Injuries (척수 손상 환자에 관한 실태 조사)

  • Kim, Myung-Hoon
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.1011-1019
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    • 1996
  • The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

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Development of medical bed system equipped with body pressure sensors (체압센서를 장착한 의료용 침대 시스템의 개발)

  • Seon, Minju;Lee, Youngdae
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.1
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    • pp.646-653
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    • 2021
  • The medical bed developed in this study consists of N keys and each is driven vertically by an actuator. Since M sensors are mounted on each keyboard to measure body pressure, the resolution of the body pressure map is determined by the MN. A sensor controller is mounted on each keyboard, and the body pressure values measured from M sensors are transmitted to the main controller through a serial communication network such as CAN (Car Area Network). Each keyboard is equipped with a servo driver that drives a motor, and it is connected to the main controller via CAN to control the height of the keyboard according to the displacement value indicated by the main controller. In addition, the maximum body pressure value and body pressure ratio applied to each part of the keyboard are calculated and used as the basic data for controlling bed comfort by artificial intelligence. As a result, the proposed system can be a foundation that can be used for the control of body comfort and pressure sore prevention by artificial intelligence to be developed in the future.