Biomedical subjects
J Maklebust
Publications and source records attributed to J Maklebust.
Risk factors associated with having a pressure ulcer: a secondary data analysis.
Data obtained through five hospital-wide pressure ulcer audits were pooled for exploratory analysis. The purpose of this secondary data analysis was (1) to delineate the association of various risk factors and the presence of pressure ulcers and (2) to generate specific, testable hypotheses. Risk factors studied included fecal incontinence, urinary incontinence, malnutrition, impaired mobility, decreased mental status, diabetes mellitus, peripheral vascular disease, spinal cord injury, multiple sclerosis, and metastatic carcinoma. Stepwise logistic regression resulted in a best-fitting model that included fecal incontinence, impaired mobility, malnutrition, decreased mental status, and an interaction effect between fecal incontinence and impaired mobility. This model suggested that the odds of having a pressure ulcer were 22 times greater for hospitalized adult patients with fecal incontinence compared to hospitalized adult patients without fecal incontinence.
Approaches to patient and family education for pressure ulcer management.
The Agency for Health Care Policy and Research (AHCPR) guidelines for pain management, urinary incontinence, and pressure ulcers emphasize the importance of patient and family education. Patient teaching strategies are discussed by using the example of pressure ulcer management. The family is invited into an educational partnership through needs assessment and mutual goal setting. Teaching strategies that involve the learner and are adapted for the home setting are most effective. Evaluation of teaching should be in terms of patient outcomes.
Impact of AHCPR pressure ulcer guidelines on nursing practice.
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Results of collaboration between case managers and staff nurses.
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Case-managed care: capitalizing on the CNS.
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Pressure ulcer incidence in high-risk patients managed on a special three-layered air cushion.
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Pressure relief capabilities of the Sof.Care bed and the Clinitron bed.
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: etiology and prevention.
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.
United Ostomy Association visits and adjustment following ostomy surgery.
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Pressure ulcer staging systems.
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Pressure ulcers: definition and assessment parameters.
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