The Effectiveness Of Prophylactic Dressing For Prevention Of Onset Of Pressure Ulcer, Compared With No Dressing In High Risk Critical Care Unit Patients: A Randomized Controlled Trial

Background:

The onset of pressure ulcers (PU) is produced by pressure exerted upon over a bony prominence.

Pressure ulcers are considered adverse events that further complicate the critical state of patients hospitalized with high-complexity problems, causing deaths associated to infection and sepsis.

Pressure injuries have a varying incidence rate of 1% to 40 % and a global prevalence of nearly 20%, with the highest incidence rates observed in intensive care units (ICUs) .

The physical characteristics of hydrocolloid and foam dressings aid in the prevention of pressure injuries.

Studies of PU prevalence in hospitals in Colombia reveal a variation between 2.2% and 10%. Data indicate that 60% of ulcers are developed in intensive and chronic care units during the first two weeks of hospitalization and their risk increases by 74% along with other comorbidities.

Current management strategies target protective dressings to prevent pressure injuries. Dressings are accessible and easily implemented devices.

Purpose:

In our Hospital (175 bedded) on 2017 Hospital Acquired Pressure Ulcer (HAPU) was quite high. As pressure ulcer is a core Nursing Quality Indicator, we had reinforced skin assessment, back care and position changing or repositioning. We came to a decision in our Monthly Nursing Quality Meeting (MNQM) to apply Hydrocolloid dressing patches prophylactically on pressure points and change the same after 72 hours along with other standard HAPU preventive measures. We had started applying the same from 2018 and there was a steady reduction of occurrence HAPU among our oncology patients. But this issue of this application always remain debatable among other disciplines, as they are concerned about the cost of the dressing materials and   the sole efficacy of the dressing material.And the application of prophylactic dressing could not be generalized among all the high risk patients of our hospital.

The objectives for the following research are as follows:

1.To assess whether prophylactic dressings reduce onset of PU in high risk CCU patients compared with no dressings in high risk CCU patients.

2.To evaluate whether no dressing alone reduces the onset of PU in high risk CCU patients.

3.To find out the association between the onset of PU and the selective demographic variables of the high risk CCU patients.