Effectiveness of a pressure ulcer prevention package (pupp) for patients admitted in intensive care units: An experimental study
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Many critically ill patients admitted in ICUs are sedated, on mechanical ventilation and unable to change the position themselves. Therefore, these patients are at high risk of impaired skin integrity and leads to development of pressure ulcers.
This study was done to assess the effectiveness of pressure ulcer prevention package in reducing the incidences of pressure ulcers among patients admitted in intensive care units (ICUs).
Experimental design (Pre test post test control group).
Seventy patients from different ICUs of Dr. R. M. L. Hospital, Delhi were randomly allocated into two groups i.e. experimental and control groups. Experimental group received the intervention of pressure ulcer prevention package and the control group received routine skin care. Demographic and clinical data were collected by using demographic profile tool; standardised skin assessment tool and pressure ulcer staging tool. All the subjects were followed every third day from admission to discharge, death and up to a maximum 20 days. Data were analyzed using STATA 11.1 with the level of significance at p < 0.05. Descriptive and inferential statistics were used.
The total seventy numbers of patients were recruited: 35 in experimental group and 35 in control group. Findings show that the sacrum and then heels were the most common areas of pressure ulcers among ICU patients. Pressure ulcer prevention package was significantly (p< 0.001) effective to delay the pressure ulcers related adverse events among patients of experimental group. Pressure ulcers related adverse events were developed earlier in control group i.e. 14% in experimental and 41% in control group. Number of pressure ulcers development were significantly (p<0.001) lower in experimental group (08/35) compared to control group (20/35). The experimental group had significantly less Stage I and Stage II pressure ulcers development compared to control group (p<0.001).
Pressure ulcers prevention package was found to be significantly effective to reduce incidences, severity and total number of pressure ulcers among patients admitted in ICUs.
Pressure ulcers, Pressure ulcer prevention package, ICU patients, Skin integrity.