Self-management in the prevention of skin injuries in adults hospitalized in an emergency department
DOI:
https://doi.org/10.22579/27448592.1027Keywords:
Self-Management, Skin Care, Patient Safety, Pressure Ulcer, AdultAbstract
Introduction. Worldwide, the incidence of pressure skin injuries or pressure ulcers (PU) is 5.4% per 10,000 patients and the prevalence is 8.4%. These can increase the risk of dying by five times. The objective of this project was to generate behaviors and knowledge in people for the self-management of this condition. Materials and methods. A self-management intervention was applied in the prevention of skin lesions in hospitalized adults. This was selected from a systematic search of the literature. To measure the change before and after applying the intervention, two instruments were used: Nursing Outcomes Classification (NOC) "Risk control" of 13 indicators and the KPUP instrument of attitudes towards the prevention of PU of 5 constructs in 13 items: competence; priority; impact; responsibility and efficiency. In addition, student-patient interaction was measured with the Jean Watson Caring Nurse-Patient Interactions scale. Results. The NOC: "Risk control" before and after the intervention for each applied session went from 1.5 (SD= ±0.8) to 3.1 (SD=± 0.1) in session 1; in session 2 it went from 2.2 (SD= ±1.0) to 3.7 (SD ±0.7); for session 3 from 3.1 (SD ±1.7), to 4.6 (SD ±1.1) and finally for sessions 4 and 5 it went from 2.8 (SD ±1.0) to 4, 4 (SD ±0.6). Regarding the results of the attitudes towards the prevention of PUs according to the KPUP constructs, the "Priority" construct was the one that obtained the highest compliance in the role of the caregiver, whose items ranged from 95 to 100%, which indicates that the participants perceive that it is important to prevent pressure ulcers, while the "Competition" construct was the one with the lowest compliance, which means that they still do not feel capable of carrying out their own activities. In relation to the student-patient interaction, the item that the participants valued the most was allowing time for questions to be asked in response to concerns.Conclusions. It was possible to promote self-management and attitudes of the participants in the prevention of PU, evidenced in the results of the NOC and attitudes. In addition, the nurse-patient interaction was recognized.
References
Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. Int J Nurs Stud. 1 de mayo de 2020;105:103546.
Bauer K, Rock K, Nazzal M, Jones O, Qu W. Pressure Ulcers in the United States’ Inpatient Population From 2008 to 2012: Results of a Retrospective Nationwide Study. Ostomy Wound Manage. noviembre de 2016;62(11):30-8.
Sardo PMG, Teixeira JPF, Machado AMSF, Oliveira BF, Alves IM. A systematic review of prevalence and incidence of pressure ulcers/injuries in hospital emergency services. J Tissue Viability. mayo de 2023;32(2):179-87.
Chacón-Mejía JP, Del Carpio-Alosilla AE. Indicadores clínico-epidemiológicos asociados a úlceras por presión en un hospital de Lima. Rev Fac Med Humana. abril de 2019;19(2):66-74.
González-Consuegra RV, Cardona-Mazo DM, Murcia-Trujillo PA, Matiz-Vera GD. Prevalencia de úlceras por presión en Colombia: informe preliminar. Rev Fac Med. julio de 2014;62(3):1-32.
Ministerio de Salud, Colombia. Seguridad del paciente [Internet]. [citado 16 de septiembre de 2023]. Disponible en: https://www.minsalud.gov.co/salud/CAS/Paginas/seguridad-del-paciente.aspx
Charalambous C, Vassilopoulos A, Koulouri A, Eleni S, Popi S, Antonis F, et al. The Impact of Stress on Pressure Ulcer Wound Healing Process and on the Psychophysiological Environment of the Individual Suffering from them. Med Arch Sarajevo Bosnia Herzeg. noviembre de 2018;72(5):362-6.
Zhang C, Zhang S, Wu B, Zou K, Chen H. Efficacy of different types of dressings on pressure injuries: Systematic review and network meta-analysis. Nurs Open. septiembre de 2023;10(9):5857-67.
Mäki-Turja-Rostedt S, Stolt M, Leino-Kilpi H, Haavisto E. Preventive interventions for pressure ulcers in long-term older people care facilities: A systematic review. J Clin Nurs. julio de 2019;28(13-14):2420-42.
Huang L, Yan Y, Huang Y, Liao Y, Li W, Gu C, et al. Summary of best evidence for prevention and control of pressure ulcer on support surfaces. Int Wound J. agosto de 2023;20(6):2276-85.
Engelen M, van Dulmen S, Vermeulen H, de Laat E, van Gaal B. The content and effectiveness of self-management support interventions for people at risk of pressure ulcers: A systematic review. Int J Nurs Stud. octubre de 2021;122:104014.
JBI Critical Appraisal Tools | JBI [Internet]. [citado 3 de octubre de 2023]. Disponible en: https://jbi.global/critical-appraisal-tools
GRADE handbook [Internet]. [citado 16 de septiembre de 2023]. Disponible en: https://gdt.gradepro.org/app/handbook/handbook.html
Johnson M, Maas M. The Nursing Outcomes Classification. J Nurs Care Qual. junio de 1998;12(5):9-20; quiz 85-7.
Shanley E, Patton D, Avsar P, O’Connor T, Nugent L, Moore Z. The impact of the Shanley Pressure Ulcer Prevention Programme on older persons’ knowledge of, and attitudes and behaviours towards, pressure ulcer prevention. Int Wound J. mayo de 2022;19(4):754-64.
Vujanić J, Mikšić Š, Barać I, Včev A, Lovrić R. Patients’ and Nurses’ Perceptions of Importance of Caring Nurse–Patient Interactions: Do They Differ? Healthcare. 16 de marzo de 2022;10(3):554.
Chaboyer W, Bucknall T, Webster J, McInnes E, Gillespie BM, Banks M, et al. The effect of a patient centred care bundle intervention on pressure ulcer incidence (INTACT): A cluster randomised trial. Int J Nurs Stud. diciembre de 2016;64:63-71.
Kim JY, Cho E. Evaluation of a self-efficacy enhancement program to prevent pressure ulcers in patients with a spinal cord injury. Jpn J Nurs Sci JJNS. enero de 2017;14(1):76-86.
O’Connor T, Moore ZE, Patton D. Patient and lay carer education for preventing pressure ulceration in at-risk populations. Cochrane Database Syst Rev. 24 de febrero de 2021;2(2):CD012006.
Farzan R, Yarali M, Mollaei A, Ghaderi A, Takasi P, Sarafi M, et al. A systematic review of caregivers’ knowledge and related factors towards pressure ulcer prevention. Int Wound J. octubre de 2023;20(8):3362-70.
Dias TKC, Evangelista CB, Zaccara AAL, Dias KCC de O, Costa BHS, França JRF de S. Reflexão crítica da teoría de Jean Watson: estudo fundamentado no modelo de Chinn E Kramer. Arq Ciênc Saúde UNIPAR. 3 de agosto de 2023;27(8):4203-13.
Monje V. P, Miranda C. P, Oyarzün G. J, Seguel P. F, Flores G. E, Monje V. P, et al. Percepción de cuidado humanizado de enfermería desde la perspectiva de usuarios hospitalizados. Cienc Enferm [Internet]. 2018 [citado 3 de octubre de 2023];24. Disponible en: http://www.scielo.cl/scielo.php?script=sci_abstract&pid=S0717-95532018000100205&lng=es&nrm=iso&tlng=es
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Paula Daniela Rivera-Sepúlveda, María Fernanda Herrera-Ardila, María Camila Quintero-Palencia, Johan Esteban Hernández-Méndez, Daniela Isabel Tovar-Ospino, Dora Inés Parra

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Esta revista y sus artículos se publican bajo la licencia Creative Commons (CC BY-NC-ND 4.0), que permite el uso, distribución y reproducción sin restricciones en cualquier medio o formato, siempre que se acredite el autor y la fuente originales; no usar bajo propósitos comerciales.