Searched Dynamed, PubMed and Joanna Briggs using search terms skin cream AND pressure ulcer.
Joann Briggs Institute: Pressure Area Care. [Recommended Practices] 2016.
PubMed search results for your review:
Reviewed 4/20/14 AA
Updated link for entry in Joanna Briggs, 10/16/2017
A number of related articles can be found in PubMed using the search strategies listed below. To execute the searches:
1. Go to www.health.library.emory.edu and then click on the PubMed link on right side of page.
2. When PubMed opens, copy/paste this search strategy in the search box (articles):
(“Pressure Ulcer/prevention and control”[MAJR] AND “Patient Positioning”[MeSH]) AND English[lang]
3. For a broader search, copy/paste this: pressure ulcer AND (turning OR patient position) AND (English[lang])
When results appear, click on title to view abstract, then use the “Find It@Emory” button to link to full text, if available.
One article of note:
Still, Mary D, et al. “The turn team: a novel strategy for reducing pressure ulcers in the surgical intensive care unit.” Journal of the American College of Surgeons 216.3 (2013):373-379.
“At baseline, when frequent turning was encouraged but not required, a total of 42 pressure ulcers were identified in 278 patients. After implementation of the turn team, a total of 12 pressure ulcers were identified in 229 patients (p < 0.0001). The preintervention group included 34 stage I and II ulcers and 8 higher stage ulcers. After implementation of the turn team, there were 7 stage I and II ulcers and 5 higher stage ulcers. The average Braden score was 16.5 in the preintervention group and 13.4 in the postintervention group (p = 0.04), suggesting that pressure ulcers were occurring in higher risk patients after implementation of the turn team.”
Overview of latest published evidence: See Prevention and Screening section of Pressure Ulcer topic in: DynaMed Plus.
Also see: Pressure Area Care: Management in Joanna Briggs Institute EBP Database.
Includes appraisals of
DynaMed Plus also reviews evidence specific to patient with spinal cord injury.
Searched CINAHL and PubMed for patient rounds AND (“intensive care” OR “critical care”) with a limit of English.
Six quasi-experimental studies in CINAHL measuring nurse satisfaction, ventilator-associated pneumonia, cental-line associated bloodstream infection, nosocomial infections, healthcare outcomes, family presence, and facilitators and barriers to patient care rounds
Adding intensive care or critical care eliminates many studies that may also be relevant.
(MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort)
These results include several experimental and quasi-experimental studies. If you want to look at specific outcomes, see the following searches for particular topics:
Falls – (MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort) AND falls
Patient satisfaction – (MH “Patient Rounds”) AND (hourly OR intentional OR proactive OR comfort) AND patient satisfaction
Patient centered care – (MH “Patient Rounds”) AND (MH “Patient centered care”)
Papers in PubMed search: (rounds OR rounding) AND (intentional OR hourly OR time factors OR proactive) AND (nurses OR nursing) AND (safety OR quality improvement OR infection OR pneumonia OR pressure ulcers OR falls OR patient satisfaction OR patient outcome assessment OR outcomes assessments) AND (“intensive care” OR “critical care”)
This search retrieves papers examining common outcomes in the intensive care unit. Other outcomes can be included in the search.
Reviewed and updated 5/1/2014 ldt
Bottom line: Practice guidelines recommend having a standard procedure for assessing and documenting skin and training staff who will be making these assessments, but there is no specific recommendation for the number of staff required for assessing skin.
DynaMed topic on Pressure Ulcers includes a section on prevention screening and section on guidelines. Prevention/screening section summarizes data on utility of specific structured assessment tools. There are numerous guidelines, which should document studies on which they base recommendations. One guideline is Institute for Clinical Systems Improvement (ICSI) guideline on pressure ulcer treatment.
JBI+COnNECT – There are several evidence summaries, but the most relevant ones (ex: Pressure Ulcers: Prevention and Management, seem to reference the guidelines included in DynaMed, such as that of the Royal College of Nursing.
No identifed recommendations or mention of using more than one person to assess a patient’s skin in the DynaMed or JBI+ information.
PubMed search: pressure ulcers AND (rater* OR observer*) AND (accura* OR reliabl*)
Yielded studies such as these two that compare use of one nurse to two nurses in documenting skin and found no difference in the number of pressure ulcers documented. These studies did not address assessment for risk.
Kottner J, Tannen A, Dassen T. Hospital pressure ulcer prevalence rates and number of raters. J Clin Nurs. 2009 Jun;18(11):1550-6.
Kottner J, Tannen A, Halfens R, Dassen T. Does the number of raters influence the pressure ulcer prevalence rate? Appl Nurs Res. 2009 Feb;22(1):68-72.
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