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Q: research in pressure area sore ( Answered,   2 Comments )
Question  
Subject: research in pressure area sore
Category: Health
Asked by: rainy-ga
List Price: $10.00
Posted: 07 Oct 2002 05:02 PDT
Expires: 06 Nov 2002 04:02 PST
Question ID: 73506
What sort of research is there to support the question that there are
a lot of patients that are admitted to hospital with pressure sores
where they are care for in a residential or nursing home?
Answer  
Subject: Re: research in pressure area sore
Answered By: synarchy-ga on 07 Oct 2002 19:42 PDT
 
Hi -

There are numerous studies on the incidence of "pressure sores"
(decubitus ulcers) in nursing home residents.  There are also, as
surgeon-ga points out, lots and lots of web-sites for lawyers who like
to litigate such claims.  Pressure sores are commonly found in
individuals who have difficulty ambulating (the highest incidence are
in individuals who are paralyzed) and can be found in patients in
hospitals, nursing homes, and other long-term care situations.

A nice description of pressure sores, the causes and incidence of such
sores in hospitalized patients and patients in long-term care
facilities (incidence given at 2.4 - 23%) is discussed here:
http://www.ccjm.org/pdffiles/Thomas801.pdf

A general description of the management of pressure sores in nursing
home patients was published in the American Family Physician in 1993. 
Moving people at least every two hours while in bed, minimizing
moisture in contact with the skin (good hygeine, controlling
incontinence), and proper wound care for ulcers have all been shown to
prevent and improve existing pressure sores in the nursing home
population.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8465716&dopt=Abstract

One study suggests that the prevalence of pressure sores in nursing
home residents is around 8.5% and that this rate has remained constant
between 1992 and 1998.  The authors of the study were investigating
whether changes in the way that nursing homes were funded had affected
this rate (it does not appear to have).  The article is available
online for a fee, the abstract can be found here:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11982675&dopt=Abstract

Another study contrasting methods of estimating the risk of pressure
sores in nursing home patients (suggests incidence rate of 25%)
http://ageing.oupjournals.org/cgi/content/abstract/29/1/63

A study of Ohio nursing homes suggests that the prevalence of pressure
sores in residents suggests a prevalence of 12% with a prevalence of
serious (requiring medical attention) sores at 8%.  The abstract:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10182418&dopt=Abstract

A 1994 study suggests that there are multiple factors involved in the
prevalence of medically significant pressure sores - the main reasons
in high incidence (20%) nursing homes were: difficulty moving around,
diabetes, and difficulty feeding onself.  In low incidence (6%) homes,
the main factors were: difficulty moving, fecal incontinence and male
gender.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8144823&dopt=Abstract


Please let me know if you wish further information.

synarchy
Comments  
Subject: Re: research in pressure area sore
From: surgeon-ga on 07 Oct 2002 11:26 PDT
 
The medical term for pressure sores is "decubitus ulcer." If you
search the term and include "nursing home incidence" you'll get lots
of hits, especially from malpractice attorney sites. Since, as a
physician, such "fishing" by lawyers offends me, I'll just give you
this site (you can find others easily, as suggested):
http://www.emedicine.com/plastic/byname/pressure-ulcers-surgical-treatment-and-principles.htm
Subject: Re: research in pressure area sore
From: researcher7-ga on 04 Nov 2002 09:51 PST
 
Sometimes, the ulcers are so deep, that surgery is required before
healing can be undertaken by the tissue. Following surgery, the
patient must be put on a high protein diet, to hasten tissue growth
and subsequent healing.

Relative to the nursing home environement, one should add that the NAs
in the homes are not well paid and as a result there is an acute
shortage of professional staff in the homes.  Thus, patients do not
receive either intensive or extensive care, unless of course they're
in an expensive nursing home with well paid employees and no nursing
shortage.


The bottom line:  bed sores are of a great economic importance.  If
not prevented, they may cause the patient and/or society hundreds of
thousands (or even millions) of dollars.

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