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Repercussion
of the incorporation of alternating pressure air mattresses in the
epidemiology and cost of pressure ulcers in an intensive care unit
Juan José Zamora Sánchez.
SUMMARY
Introduction: The
ICU at the Hospital General de Catalunya is the unit having the
greatest risk and proportion of pressure ulcers. After the incorporation
of alternating pressure air mattresses for the prevention of pressure
ulcers, a descriptive study was designed for to epidemiologically
determine the dimension of the problem, to quantify the financial
impact of treatment and to evaluate the effectiveness of the support
surfaces.
Material and methods: A longitudinal study was carried
out into the incidence and prevalence of pressure ulcers in the
ICU between February and July 2002. Treatment for patients with
ulcers was monitored, as was the degree of healing from the lesions
produced, in order to estimate costs.
Results: A total of 19 lesions sere produced in 11 patients,
of a total of 327 studied, over the five months of the study, with
an incidence and prevalence in the period of 4.58 % and 12.79%,
respectively. The figure of prevalence of 12.79 represents a reduction
of more than half with respect to the average prevalence figure
for the 1998-2001 period. 68.42 % of the lesions corresponded to
phases I & II. With respect to the localization of lesions,
of particular importance were those that developed in the occipital
zone (21.06%), which represents the second most frequent area following
that of the gluteal-sacra region (47.34 %). A total of 900 treatment
procedures were undertaken in 351 days of treatment, requiring almost
80 hours of personal care from the nurse. The cost of the treatment
was of 1.500 € throughout the study period.
Conclusions: The systematic use of alternating air surfaces
within the prevention protocol has shown itself to be a basic and
effective measure in reducing the incidence of pressure ulcers in
ICU patients, it also reduces treatment costs. The pressure ulcers
that appeared were mostly in the initial phase, of a small or average
size. This leads us to suppose that the preventive measures taken
favored the fact that the lesions did not develop to a higher phase,
which would lead to complications and increase in costs. The high
percentage of occipital lesions is possibly related to patients
undergoing mechanical ventilation for whom, in spite of being provided
with alternating air mattresses, these surfaces do not act such
a level.
KEY WORDS
Pressure ulcers, bedsores,
alternating pressure air mattresses, epidemiology, prevention, cost,
Intensive Care Unit.
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