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From Journal of the American Geriatrics Society
For full article:
http://www.medscape.com/viewarticle/514261?src=mp
Access is free, but requires a one-time subscription.
The National Pressure Ulcer Long-Term Care Study: Outcomes of Pressure
Ulcer Treatments in Long-Term Care
Posted 10/27/2005
Nancy Bergstrom, PhD, RN; Susan D. Horn, PhD; Randall J. Smout, MS;
Stacy A. Bender, MS, RD; Maree L. Ferguson, PhD, RD; George Taler, MD;
Abby C. Sauer, MPH, RD; Siohban S. Sharkey, MBA; Anne Coble Voss, PhD, RD
Abstract and Introduction
Abstract
Objectives: To identify resident, wound, and treatment characteristics
associated with pressure ulcer (PrU) healing in long-term care residents.
Design: Retrospective cohort study with convenience sampling.
Setting: Ninety-five long-term care facilities participating in the
National Pressure Ulcer Long-Term Care Study throughout the United States.
Participants: Eight hundred eighty-two residents, aged 18 and older,
with length of stay of 14 days or longer, who had at least one Stage II
to IV PrU.
Measurements: Data collected for each resident over a 12-week period
included resident characteristics, treatment characteristics, and change
in PrU area. Data were obtained from medical records, Minimum Data Set,
and other records.
Results: Two multiple regression models, one for each stage grouping
(Stage II, Stage III and IV), were completed. The area of Stage II PrU
was reduced more with moist (F = 21.91, P < .001) than with dry (F =
13.41, P < .001) dressings. PrUs cleaned with saline or soap showed less
decrease in area (F = 12.34, P < .001) than PrUs cleaned with other
cleansers such as antiseptic, antibiotic, or commercial cleansers.
Change in area of Stage III and IV PrUs was related to sufficient
enteral feeding (F = 5.23, P = .02), enteral feeding without higher
acuity levels (F = 3.94, P = .048), size of PrU (very large (F = 120.89,
P = .001) and large (F = 27.82, P = .001)), and type of dressing (moist
(F = 14.70, P < 001) and dry (F = 5.88, P = .02)). Stage III and IV PrUs
increased in area when debrided (F = 5.97, P = .02). The overall models
were significant (Stage III and IV, F = 20.30, coefficient of
determination (R2) = 0.06, P < 001; Stage II, F = 40.28, R2 = 0.13, P <
001) but explained little of the variation in change in PrU area.
Conclusion: In this sample of nursing facility residents, use of moist
dressings (Stage II, Stage III and IV) and adequate nutritional support
(Stage III and IV) are strong predictors of PrU healing.
--
Kathrynne Holden, MS, RD < [log in to unmask] >
"Ask the Parkinson Dietitian" http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
http://www.nutritionucanlivewith.com/
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