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      The Nursing Diagnosis of risk for pressure ulcer: content validation 1

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          Abstract

          Objective:

          to validate the content of the new nursing diagnosis, termed risk for pressure ulcer.

          Method:

          the content validation with a sample made up of 24 nurses who were specialists in skin care from six different hospitals in the South and Southeast of Brazil. Data collection took place electronically, through an instrument constructed using the SurveyMonkey program, containing a title, definition, and 19 risk factors for the nursing diagnosis. The data were analyzed using Fehring's method and descriptive statistics. The project was approved by a Research Ethics Committee.

          Results:

          title, definition and seven risk factors were validated as "very important": physical immobilization, pressure, surface friction, shearing forces, skin moisture,

          alteration in sensation and malnutrition. Among the other risk factors, 11 were validated as "important": dehydration, obesity, anemia, decrease in serum albumin level, prematurity, aging, smoking, edema, impaired circulation, and decrease in oxygenation and in tissue perfusion. The risk factor of hyperthermia was discarded.

          Conclusion:

          the content validation of these components of the nursing diagnosis corroborated the importance of the same, being able to facilitate the nurse's clinical reasoning and guiding clinical practice in the preventive care for pressure ulcers.

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          Most cited references69

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          Methods to validate nursing diagnoses.

          R Fehring (1987)
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            Results of the 2008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis.

            The National Quality Forum has identified a pressure ulcer as a hospital-acquired condition (HAC) that is high-cost and high-volume and may be preventable with implementation of evidence-based guidelines. The Center for Medicare and Medicaid Services no longer reimburses acute care facilities for the ancillary cost of facility-acquired (FA) ulcers. Benchmarking patient safety indicators, such as FA, may help facilities reduce pressure ulcer rates. The purpose of this observational, cross-sectional cohort study was to report the International Pressure Ulcer Prevalence Survey (IPUP) in the United States in 2008 and 2009. In addition, previously collected data (2006/2007) were used to evaluate and report general and unit-specific prevalence rates in acute care facilities. The overall prevalence and FA pressure ulcer rates were 13.5% and 6% (2008, N = 90,398) and 12.3 and 5% (2009, N = 92,408), respectively. In 2008 and 2009, overall prevalence rates were highest in long-term acute care (22%). FA rates were highest in adult intensive care units (ICUs) and ranged from 9.2% (general cardiac care unit [CCU]) to 12.1% (medical ICU) in 2008 and from 8.8% (general CCU) to 10.3% (surgical ICU) in 2009. In 2009, 3.3% of ICU patients developed severe FA ulcers (Stage III, Stage IV, eschar/unable to stage, or deep tissue injury). In 2009, approximately 10% (n = 1,631) of all ulcers were described as device-related. The most common anatomic locations for device-related ulcers were the ear (20%) and sacral/coccyx region (17%). Both the overall and FA pressure ulcer prevalence rates were lower in 2008 and 2009 than in 2006 and 2007. Results indicate that, although overall prevalence trends are encouraging, there is a stark contrast from the desired state, especially in adult ICUs.
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              Pressure ulcers: Back to the basics

              Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of “prevention is better than cure” suits this condition the most.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                14 June 2016
                2016
                : 24
                : e2693
                Affiliations
                [2 ]RN, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. Profeasor, Centro Universitário Metodista de Porto Alegre, Porto Alegre, RS, Brazil.
                [3 ]PhD, Associate Professor, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
                Author notes
                Corresponding Author: Amália de Fátima Lucena Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 Bairro: Rio Branco CEP: 90620-110, Porto Alegre, RS, Brasil E-mail: afatimalucena@ 123456gmail.com
                Article
                00335
                10.1590/1518-8345.0782.2693
                4916974
                27305182
                40526c7d-f708-4717-9c94-a95704f176d1

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 18 March 2015
                : 02 August 2015
                Page count
                Figures: 0, Tables: 12, Equations: 0, References: 25, Pages: 1
                Categories
                Artigos Originais

                pressure ulcer,nursing diagnosis,nursing process,risk factors,nursing

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