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Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers
BACKGROUND: Hospital-acquired pressure ulcers (HAPUs) are largely preventable yet still common occurrences in hospitals. The purpose of the current study is to determine how data from the electronic medical record can be used to better understand and predict HAPU formation over the course of a hospi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6554149/ https://www.ncbi.nlm.nih.gov/pubmed/31321159 http://dx.doi.org/10.1097/GOX.0000000000002099 |
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author | Cabrejo, Raysa Ndon, Sifon Saberski, Ean Chuang, Carolyn Hsia, Henry C. |
author_facet | Cabrejo, Raysa Ndon, Sifon Saberski, Ean Chuang, Carolyn Hsia, Henry C. |
author_sort | Cabrejo, Raysa |
collection | PubMed |
description | BACKGROUND: Hospital-acquired pressure ulcers (HAPUs) are largely preventable yet still common occurrences in hospitals. The purpose of the current study is to determine how data from the electronic medical record can be used to better understand and predict HAPU formation over the course of a hospital admission. METHODS: A case-control study on HAPUs was performed over an 8-month period at Yale New Haven Hospital. A Cox regression analysis model analyzed the impact of multiple factors on HAPU development including friction and shear, among other Braden score components. A receiver operating characteristic curve was calculated to determine the sensitivity and specificity of changes in these factors in predicting HAPU development. RESULTS: On a sample of 8,790 admissions, HAPU incidence was 4.2% over the study period (6.3% per annum). The average hospital day for HAPU development was day 15.6 (± 19.3). The Cox regression analysis demonstrated that the volatility of the friction and shear component of Braden scores had a risk ratio of 28.6 (P < 0.01; CI, 14.5–56.4). Volatility in the friction and shear component was the most predictive factor with a high receiver operating characteristic curve area of 0.865 (CI, 0.847–0.882). CONCLUSIONS: Volatility of the friction and shear component of Braden scores appears to be the most significant factor preceding HAPU development at Yale New Haven Hospital. Efforts to place more focus on identifying and reducing volatility of this factor may help decrease HAPU risk for future patients. |
format | Online Article Text |
id | pubmed-6554149 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-65541492019-07-18 Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers Cabrejo, Raysa Ndon, Sifon Saberski, Ean Chuang, Carolyn Hsia, Henry C. Plast Reconstr Surg Glob Open Original Article BACKGROUND: Hospital-acquired pressure ulcers (HAPUs) are largely preventable yet still common occurrences in hospitals. The purpose of the current study is to determine how data from the electronic medical record can be used to better understand and predict HAPU formation over the course of a hospital admission. METHODS: A case-control study on HAPUs was performed over an 8-month period at Yale New Haven Hospital. A Cox regression analysis model analyzed the impact of multiple factors on HAPU development including friction and shear, among other Braden score components. A receiver operating characteristic curve was calculated to determine the sensitivity and specificity of changes in these factors in predicting HAPU development. RESULTS: On a sample of 8,790 admissions, HAPU incidence was 4.2% over the study period (6.3% per annum). The average hospital day for HAPU development was day 15.6 (± 19.3). The Cox regression analysis demonstrated that the volatility of the friction and shear component of Braden scores had a risk ratio of 28.6 (P < 0.01; CI, 14.5–56.4). Volatility in the friction and shear component was the most predictive factor with a high receiver operating characteristic curve area of 0.865 (CI, 0.847–0.882). CONCLUSIONS: Volatility of the friction and shear component of Braden scores appears to be the most significant factor preceding HAPU development at Yale New Haven Hospital. Efforts to place more focus on identifying and reducing volatility of this factor may help decrease HAPU risk for future patients. Wolters Kluwer Health 2019-04-11 /pmc/articles/PMC6554149/ /pubmed/31321159 http://dx.doi.org/10.1097/GOX.0000000000002099 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Article Cabrejo, Raysa Ndon, Sifon Saberski, Ean Chuang, Carolyn Hsia, Henry C. Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers |
title | Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers |
title_full | Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers |
title_fullStr | Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers |
title_full_unstemmed | Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers |
title_short | Significance of Friction and Shear in the Prevention of Contemporary Hospital-acquired Pressure Ulcers |
title_sort | significance of friction and shear in the prevention of contemporary hospital-acquired pressure ulcers |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6554149/ https://www.ncbi.nlm.nih.gov/pubmed/31321159 http://dx.doi.org/10.1097/GOX.0000000000002099 |
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