Research Information System
Thesis Type: Doctorate
Institution Of The Thesis: Gazi Üniversitesi, Sağlık Bilimleri Enstitüsü, Turkey
Approval Date: 2017
Student: TUBA YILMAZER
Supervisor: HÜLYA BULUT
Abstract:Pressure injury prolong the duration of hospitalisation, increase the costs of additional treatment, morbidity and mortality. Especially in intensive care units, pressure injury is more common due to major surgery, restricted physical activity, inadequate tissue perfusion due to hemodynamic changes, skin damage due to moisture/incontinence, deterioration in nutritional status, anemia. This study aimed to evaluate the effect on the pressure injury prevention of the care given in the guideline of the pressure injury prevention algorithm. The study was conducted between 14.11.2016 and 30.04.2017 as a pretest-posttest intervention study in an Anesthesiology and Reanimation Intensive Care Unit of a university hospital. The study was performed in four stages. The first stage, the pressure injury incidence was evaluated in the intensive care unit between 01.04.2016 - 30.09.2016. At the same time, a pressure injury prevention algorithm was developed. In the second stage, nurses working in intensive care unit were trained to prevent pressure injury and to use pressure injury prevention algorithm.In the third stage, the nurses provide care under the guidance of the pressure injury prevention algorithm. In the fourth stage, the incidence of the pressure injury in the 6 month period using the pressure injury prevention algorithm was compared with the incidence of pressure injury in the 6 month period before the study started and the effectiveness of the algorithm was evaluated. The data were analyzed by the frequency, percentage, Shapiro-Wilk test, mean ± standard deviation (mean±SD), median (minimum-maximum), Friedman analysis, Wilcoxon test, Mann-Whitney U test, Logistic regression analysis, Spearman correlation analysis, Chi-square tests, Bonferroni Corrected z-ratio test and Cochran Q test. Incidence rates before and after administration were compared with specific z test for incidence rate. The pressure injury incidence was 46.1 for 1000 patient-days before the maintenance of the pressure injury prevention algorithm (01.04.2016 30.09.2016), and the pressure injury incidence was calculated to be 9.21 (1000 patient-days) after care under the guideline of the pressure injury prevention algorithm (01.11.2016 - 30.04.2017). The difference between the incidences was statistically significant (Z = 9.590, p <0.001). As a result, it has been seen that the application of the training and pressure injury prevention algorithm in the direction of the evidence-based guidelines has reduced the pressure injury rates. It is recommended that intensive care units should be planned under the guidance of pressure injury prevention algorithms and repetition in the wider population for care of pressure injury.