Impact of a multifactorial intervention to prevent pressure ulcers in specialised care
Section: Cover story
How to quote
García Sánchez AM et ál. Impacto de una intervención multifactorial para prevenir úlceras por presión en atención especializada. Metas de Enferm may 2011; 14(4): 27-32
Authors
1Mª Milagros Prieto Guerrero, 2Ana Mª García Sánchez, 3Mª Jesús Albar Marín, 4Antonio Erasto Villar Rojas, 5Concepción Romero Brioso, 6Mª Lourdes Castilla Moro, 7Enrique García Bernal
Position
1Directora de Enfermería. Centro de Salud El Alamillo, Sevilla. 2Enfermera. Becaria de Investigación de la Fundación Pública Andaluza para la Investigación Sanitaria, Sevilla.3Diplomada en Enfermería. Doctora en Psicología. Área Hospitalaria Virgen Macarena, Sevilla. Profesora del Departamento de Enfermería de la Universidad de Sevilla. Grupo Coalición para el Estudio de la Salud, el Poder y la Diversidad.4Responsable de la Unidad Integral de Úlceras Por Presión (UPP). Hospital Universitario Virgen Macarena. 5Profesora del departamento de enfermería en la Universidad de Sevilla. Grupo Estudio de Enfermedades Infecciosas en la Práctica Clínica.6Enfermera. Coordinadora de Farmacia del HUVM.7Enfermero. Supervisor de Enfermería de Medicina Interna del HUVM.
Contact address
Ana Mª García Sánchez. C/ Pedrera, 48. 41600 Arahal, Sevilla.
Contact email: anamari_arahal@hotmail.com
Abstract
Material and method: before and after intervention study performed in three internal medicine units and one intensive care unit of the Virgen Macarena University Hospital of Sevilla, on 81 patients in pre-intervention phase and 81 in post-intervention phase. Variables: multifactorial intervention (primary independent variable): a) awareness raising and training of professionals on prevention and treatment of pressure ulcers; b) implementation of a new wound care registry, monitoring of the preventive process and incidence of pressure ulcers; c) dissemination of the Integral Unit of Telecare of Pressure Ulcers and Chronic Wounds. Outcome variable: pressure ulcer incidence. Control variables: age, sex, stay duration in days and degree of risk of presenting pressure ulcers according to the EMINA scale. A descriptive analysis of the studied variables was performed and the pre- and post-intervention incidences were calculated and compared using the Chi square test.
Results: 162 patients were studied, 52,2% and mean age 72,11 years. 48,14% had a moderate risk of pressure ulcers and 51,85% had a high risk. With regard to the impact of a multifactorial intervention, there was a higher incidence in the pre-intervention phase (9,9% versus 2,5%; p = 0,049). In the post-intervention phase the use of protections increased significantly (from 46,9% to 75.3%; p = 0,000). In Intensive Care alternating air surfaces (82,2% versus 14,4%; p = 0,000) and hyperoxygenated fatty acids (87,5% versus 69,2%; p = 0,005) are used more frequently and postural changes less (32,8% versus 72,1% p = 0,000).
Conclusions: a multifactorial intervention has been proven to be effective in the prevention of pressure ulcers. The awareness of nursing professionals regarding this issue is the first step to address it.
Keywords:
EMINA Scale; hospitalisation; intensive care; Pressure ulcer; preventiontraining
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