Pressure ulcers’ incidence, preventive measures, and risk factors in neonatal intensive care and intermediate care units

Epidemiological studies on pressure ulcers (PUs) in hospitalised infants are scarce. Spain lacks comprehensive research studies providing data on the prevalence or incidence in this population. This work was developed to determine the incidence of PUs in hospitalised infants admitted to intensive and intermediate care units, along with relevant risk factors and preventive measures. A prospective study appraising the incidence of PUs in infants was performed. The risk factors and preventive measures were evaluated using a multivariate logistic regression model. A sample of 268 infants was included. The cumulative incidence of PUs was 12.70% (95% confidence interval, CI(95%) = [8.95%‐17.28%])…

Study of different surfaces for neonates in hospital

Evidence of risk of pressure ulcers in neonates pro is related to the type of bearing surface on which the neonate lays. To prevent pressure ulcers is necessary to know which of the available commercial surfaces is the most convenient. The goal of this work is to evaluate the interface and redistribution pressure of five constant low pressure devices (special surfaces for pressure management [SEMP] both static and mixed) for neonates. Next step will be the study of the properties of the new support surface with healthy subjects under clinical conditions.

Towards an international language for incontinence-associated dermatitis (IAD): design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool (GLOBIAD) in 30 countries.

Background Incontinence-associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different levels of severity. An internationally accepted instrument to assess the severity of IAD in adults with established diagnostic accuracy, agreement, and reliability is needed to support clinical practice and research.Objectives To design and psychometrically evaluate the Ghent Global IAD Categorisation Tool (GLOBIAD).Methods The design was based on expert consultation using a three-round Delphi procedure with 34 experts from 13 countries. The instrument was tested using IAD photographs reflecting different severity levels in a sample of 823 health professionals in 30 countries…

Prevention of pressure injuries in critically ill children: A preliminary evaluation

Abstract Aims To evaluate a prevention strategy implemented to reduce incidence and severity of positioning related pressure injuries affecting pediatric patients in a pediatric critical care unit. Secondary objective was to evaluate compliance with preventive recommendations. Background The skin in infants or children has important physiological and anatomical differences compared with adults. Further, factors such as the immaturity of the skin and limited activity and mobility in pediatric critical care unit, along with the pressure exerted by medical devices, increases the risk of pressure ulcers in infants and children. The most effective preventive measures specific to this intensive c…

Clinical Simulation in pediatrics and neonatology using EDISON: an educational innovation project

Introduction: Clinical simulation is a tool that allows creating controlled and safe spaces that mimic reality, where students can acquire skills and abilities prior to facing real situations. Methodology: This is a study with two phases. The first quasi-experimental phase where 3 questionnaires were used; two of them to assess knowledge (pretest - posttest) and the other one to assess the satisfaction of the training action. And the second phase was analytical, where the effectiveness of a training intervention in a confinement context based on the use of audiovisual materials created through EDISON was evaluated. Results: In 2019 the average satisfaction of the students was 9.22 (SD 0.72)…

Psychological Impact on the Nursing Professionals of the Rioja Health Service (Spain) Due to the SARS-CoV-2 Virus

Background: The COVID-19 pandemic is a public health emergency that has affected health professionals around the world, causing physical and mental exhaustion with a greater probability of developing mental disorders in professionals who provide healthcare. Objective: The objective of this study was to know the psychological impact of the SARS-CoV-2 virus on the nursing professionals working for the Rioja Health Service. Methods: We conducted an observational and descriptive cross-sectional study. The nursing staff at the Rioja Health Service were invited to respond to a self-administered questionnaire between June and August 2020. Results: A total of 605 health professionals participated i…

Use of physical restraint in nursing homes in Spain and relation with resident characteristics: a retrospective multi-centre cohort study with a self-organised maps approach

AbstractThis is a retrospective cohort study based on data from five nursing homes which aims to appraise how physical and cognitive characteristics of nursing home residents were associated with the use of restraints, and to provide information on their prevalence in Spain. The goal was to assess, in a visual way, the possible interactions between the nursing homes residents’ characteristics and their association with the use of restraints. Motivation, risk factors, characteristics of the residents analysed by validated rating systems that assess mobility, level of dependence, cognitive condition and nutritional status, and their association with the use of restraints, were described by me…

Las tecnologías de la información y comunicación como herramienta de análisis, evaluación y clasificación de heridas crónicas y neoplásicas. Una revisión sistemática

RESUMEN: Objetivo: Analizar el tipo de información aportada por las diferentes tecnologías de la información y comunicación (TIC) disponibles para el análisis, gestión o evaluación de heridas crónicas y lesiones de origen neoplásico, así como su impacto en los cuidados de las mismas, en términos de valoración y resolución de las lesiones. Metodología: Se realizó una revisión sistemática usando las recomendaciones de la Cochrane Collaboration. Se utilizaron las bases de datos MEDLINE (a través de PubMed), Web Of Science y SCOPUS. La estrategia de búsqueda para …

Shared learning process among students of the Health Sciences and Electronic Engineering Department and students of professional training in the area of Technology and Health. A proposal for educational innovation.

[EN] The objective of this proposal for educational innovation is to facilitate the learning of complex concepts and their relationship with reality, through peer-to-peer training, in where two scenarios will be shared: university and professional training. We propose an experience in which University students in the area of Electronic Technology and Health, specifically from the degrees of Industrial Electronics Engineering, Physiotherapy and Nursing, previously trained in the concepts of radiation and its types, infrared radiation, its use in health in both treatment and diagnosis, thermoregulation and thermography with the visual thinking tool, can transversally share a teaching scenario…

Shared learning between health sciences university students. Teaching-learning process of hand hygiene

El objetivo principal del proyecto ha sido el uso de metodologías de enseñanza activa para crear conciencia sobre la importancia de la higiene de manos en la atención médica. Metodología: El proyecto de innovación docente ha puesto en práctica el aprendizaje compartido de conocimientos y habilidades entre iguales. 11 estudiantes de Grado de Enfermería, con un trabajo cooperativo e individual previo, participan en un proceso de enseñanza-aprendizaje sobre higiene de manos con 82 estudiantes de Grado de Fisioterapia, utilizando Tics, talleres sobre desinfección de manos con autoevaluación, evaluación de conocimiento previo y posterior y evaluación de La satisfacción con la actividad. Resultad…

Educational innovation in basic and advanced cardiopulmonary resuscitation in pediatrics and neonatology in a realistic context

Introducción: El profesor universitario debe transmitir las habilidades técnicas y cognitivas sobre reanimación cardiopulmonar (RCP) en Pediatría con el método más efectivo. Metodología: 17 clases prácticas de Resucitación Cardiopulmonar de 2 horas para 225 alumnos. Se impartió el 2º curso de Enfermería Pediátrica de la Universidad de Valencia. Cada clase consistió en 3 casos clínicos en los que participaron 15 estudiantes y 3 monitores. El conocimiento de los estudiantes se evaluó con prueba-repetición de 11 preguntas y la satisfacción después de la simulación (cuestionario de 20 preguntas). Resultados: la media de satisfacción de los alumnos fue de 8,62 sobre 10 puntos. La evaluación de l…

Cross-cultural adaptation, reliability and validity of the Spanish version of the Neonatal Skin Risk Assessment Scale.

Aim: To adapt the Neonatal Skin Risk Assessment Scale to the Spanish context and to test its validity and reliability. Background: Currently, in Spain there are no validated scales to evaluate the risk of pressure ulcers in infants. Method: The research was performed in 10 neonatal units. Overall, we use an observational study design, but divided it in to three stages. In the first stage, the transcultural adaptation of the scale and its content validation was performed. For the second stage, the inter‐rater/intra‐rater agreement and construct validity were evaluated using a cross‐sectional design. Finally, in the third stage, a cohort study to analyse pressure ulcers’ incidence, diagnostic…

The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial.

Objective: To assess the effects of preoperative balance training on the early postoperative balance and functional outcomes after total knee replacement surgery and to test whether an outpatient intervention may be as effective as a domiciliary intervention. Design: This is a three-arm randomized controlled trial. Setting: University hospital. Subjects: Eighty-six individuals were recruited. Seventy-seven were analysed, aged 72.1 (SD 7.6) years, of which 68% were women. Outcome measures: Overall state of balance, as measured with the Berg Balance Scale, and patient-perceived functionality, as measured with the Knee Injury and Osteoarthritis Outcome Score Function in Activities in Daily Liv…

Clinical simulation: innovative educational project in basic cardiopulmonary resuscitation and advanced in pediatrics and neonatology

[EN] Introduction: Nowadays, clinical simulation could be a key link in the teaching and learning of different procedures. Methodology: It is a quasi-experimental study, using three evaluation questionnaires as a method to collect the respective information to the acquisition of competences and satisfaction of the students regarding a theoretical-practical training on pediatric and neonatal CPR for students of 2nd year Nursing the University of Valencia. To this end, 17 RCP laboratories formed by 228 students were carried out. Results: The students gave a great reception to this project, giving it a score of 8.82 (SD 0.42) out of 10. The most valued item (by the students) was that in which …

Evaluation of interface pressure and temperature management in five wheelchair seat cushions and their effects on user satisfaction

Abstract Background Factors such as the manufacturing materials, shape or even the mechanical and thermal response of sitting Pressure Redistribution Support Surfaces (PRSS) can be potential contributors to pressure ulcers. However, few studies have compared a number of characteristics of the most frequently used devices. Objective To compare three potential contributors to pressure ulcers in five commercial PRSS: pressure redistribution, temperature and perceived comfort. Method: Study with a cross-over randomized design in healthy volunteer participants. Data was collected in a temperature and relative humidity controlled environment. To assess thermal response, the temperature (Flir-E60)…

Adaptación transcultural al español y validez de contenido de 3 escalas de riesgo nutricional

Introduction: There are various scales designed to determine the risk of malnutrition at hospital admission in children. However, most of these instruments are developed and published in English. Their cross-cultural adaptation and validation being mandatory in order to be used in our country. Objectives: Cross-culturally adapt three scales designed to determine the risk of malnutrition linked to the disease and determine the validity of their content. Material and methods: Cross-cultural adaptation using the translation-back-translation met-hod in accordance with the recommendations of the International Test Commission Guidelines for Translating and Adapting Tests. Content validity was mea…

Prevalence of pressure ulcers in the paediatric population and in primary health care: An epidemiological study conducted in Spain.

Abstract Aim The primary goal of this study was to estimate the prevalence of pressure ulcers in the paediatric population cared for in primary health care. Materials The data of this epidemiological study were extracted from the records of the 24 departments that attended to an approximate population of 1 million inhabitants between 0 and 18 years old from 2012 to 2015. The study included children requiring assistance to reduce pressure ulcer incidence. The paediatric population was categorised into neonates and infants (0–2 years), young child (3–6 years), child (7–12 years) and adolescents (13–18 years). The primary outcome was information on the prevalence of pressure ulcers. Secondary …

Training, management, and quality of nursing care of vascular access in adult patients: The INCATIV project

Background:More than one billion of peripheral venous catheters are inserted into hospitalized patients every year. This study sought to identify the status of nursing care in vascular accesses in different hospitals and to evaluate the impact of a series of informative and formative interventions aimed at their care.Methods:Quasi-experimental, multicenter study. A total of 54 nursing professionals of 19 hospitals participated. The intervention consisted of informative talk and three training sessions related to the care and maintenance of vascular accesses and intravenous therapy in the hospital-admitted adult population. This was delivered in four years, with eight periodic cross-sectiona…

In search of health evidence. Proposal for self-learning

Las fuentes de información son una herramienta clave en la evolución social y tecnológica actual. Si bien es cierto que no todos son beneficios. Del mismo modo, la sobreinformación es evidente y puede conducir a la extracción de conclusiones que, en muchos casos, se vuelven confusas, difusas o incluso erróneas. En este contexto, el uso de la pirámide 6S puede ayudar a encontrar la mejor evidencia de investigación con la menor cantidad de tiempo y esfuerzo. Esta propuesta de trabajo expone los métodos y el desarrollo de un programa de apoyo y capacitación para la búsqueda en la salud. Para hacerlo, los recursos de aprendizaje se han convertido a través de un servidor de acceso libre, del Cen…

Mitigando el dolor durante la punción venosa en una población pediátrica: un estudio factorial aleatorizado

The Risk Assessment Scales are an Efficient Tool in the Prevention of Pressure Ulcers in Hospitalized Neonates.

In the last decade, the increase of new health technologies in Neonatal Intensive Care Units (NICU) -adapted from technological advances in adults- has led a significant increase in survival and prognosis of some neonates diseases with high-risk situations (premature) and critical conditions (respiratory distress). Some health technologies (mechanical ventilation, hemodiafiltration, Extracorporeal Membrane Oxygenation-ECMO) require that the infant remains sedated and maintain prolonged immobility. This situation favouring the occurrence of Pressure Ulcers (PU) in hospitalized neonates. In Spain in neonatal units the prevalence rates are from 50% in NICU, and 12.5% in hospitalization [1-3]. …

Effectiveness of mechanical diagnosis and therapy in patients with non-specific chronic low back pain: a literature review with meta-analysis

Abstract Objective To determine the effectiveness of mechanical diagnosis and therapy (MDT) in patients with chronic low back pain (CLBP) compared to other traditional physical therapy interventions. Methods Randomized controlled trials investigating the effect of MDT compared to other traditional physical therapy interventions in individuals with CLBP were considered eligible. For the purpose of this review, MDT was compared to active and passive physical therapy interventions. Independent reviewers assessed the eligibility of studies, extracted data, and assessed the risk of bias. The primary outcomes investigated were pain and disability. Results Fourteen studies were included in the rev…