Avaliação de risco e de fatores preditores para desenvolvimento de úlcera por pressão em pacientes críticos

• Autor(a) principal: Borghardt, Andressa Tomazini
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/5257
• topic: Úlcera de decúbito - Desenvolvimento; Avaliação de riscos de saúde - Pacientes; Enfermagem - Cuidados; Enfermagem; 61

Introduction: Pressure ulcers in critically ill patients have been constituted as a serious management and care, creating major challenges to nursing. Objectives: Estimate the incidence of pressure ulcers in critically ill patients, identify factors associated with its development and. evaluate the accuracy of risk assessment scales of Braden and Waterlow Method: This is a cohort study conducted from March to June 2013, with 77 patients admitted to the intensive care units, which consisted of an initial assessment of variables associated with intrinsic and extrinsic factors, among which: the metabolic profile of patients, daily application of risk assessment scales (Braden and Waterlow) on admission and every 48 hours, and assessment and classification of ulcers into categories Results: The incidence was found to be 22 %, 17 patients developed 32 pressure ulcers, predominantly located in the sacral region (47%) and in class I (72%). Regarding the metabolic profile, the bearer of ulcer, showed albumin, transferrin and low lymphocyte count. In bivariate analysis the variables found were: hospitalization for longer than 10 days (71%), type of surgical hospitalization (53%), congestive heart failure (24%), norepinephrine (29%) and high risk Scale Braden. Braden and Waterlow Scale, presented, respectively, high sensibility (41% and 71%) and low specificity (21% and 47%) in the three assessments. The cutoff scores found in the first, second and third evaluation were 12, 12 and 11 for the Braden Scale and 16, 15 and 14 for the Waterlow scale. Conclusion: The study showed a high incidence of pressure ulcers, identified associated factors with it and evaluated the Braden Scale to be a good screening tool and the Waterlow a better predictive power tool and emphasizing the importance of the systematization of nursing actions and the use of appropriate technology in the prevention of injury.