Journal of Korean Academy of Nursing

Original Articles

Development and Evaluation of Electronic Health Record Data-Driven Predictive Models for Pressure Ulcers: Seul Ki Park, Hyeoun-Ae Park, Hee Hwang; J Korean Acad Nurs 2019;49(5):575-585. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.575

Abstract Purpose

The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital.

Methods

A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale.

Results

The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model.

Conclusion

Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

Citations

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Development of a Pressure Injury Machine Learning Prediction Model and Integration into Clinical Practice: A Prediction Model Development and Validation Study
Ju Hee Lee, Jae Yong Yu, So Yun Shim, Kyung Mi Yeom, Hyun A Ha, Se Yong Jekal, Ki Tae Moon, Joo Hee Park, Sook Hyun Park, Jeong Hee Hong, Mi Ra Song, Won Chul Cha
Korean Journal of Adult Nursing.2024; 36(3): 191. CrossRef
Could we prove the nursing outcomes utilising clinical data warehouse? Effectiveness of pressure ulcer intervention in Korean tertiary hospital
Moonsook Kim, Se Yeon Park, Meihua Piao, Earom Lim, Soon Hwa Yoo, Minju Ryu, Hyo Yeon Lee, Hyejin Won
International Wound Journal.2023; 20(1): 201. CrossRef
Data‐driven approach to predicting the risk of pressure injury: A retrospective analysis based on changes in patient conditions
Yinji Jin, Ji‐Sun Back, Sun Ho Im, Jong Hyo Oh, Sun‐Mi Lee
Journal of Clinical Nursing.2023; 32(19-20): 7273. CrossRef
Factors Associated with Pressure Injury Among Critically Ill Patients in a Coronary Care Unit
Eunji Ko, Seunghye Choi
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Data-Driven Learning Teaching Model of College English Based on Mega Data Analysis
Jie Zhang, Tongguang Ni
Scientific Programming.2022; 2022: 1. CrossRef

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Risk Factors of Medical Device-Related Pressure Ulcer in Intensive Care Units: MiJee Koo, YoungA Sim, InSoon Kang; J Korean Acad Nurs 2019;49(1):36-45. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.36

Abstract PDF

Abstract Purpose

The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units.

Methods

A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, χ ²-test, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program.

Results

Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19).

Conclusion

On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

Citations

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Factors Influencing the Development of Pressure Ulcers in Surgical Patients: Hyoung Sook Park, Kyung Yeon Park, Sung Mi Yu; Journal of Korean Academy of Nursing 2005;35(1):125-134. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.1.125

Abstract PDF

Purpose

The purpose of this study was to identify the influencing factors on the development of pressure ulcers in patients undergoing surgery which lasted more than two hours.

Method

One hundred nineteen surgical adult patients were included in the study. Data was measured on each participant from December 2003 to February 2004. It was collected using a structured researcher-administered sheet and analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis.

Result

The prevalence of a perioperative pressure ulcer was 26.1%. The level of moisture, friction and shear, length of surgery, and perioperative irrigation were significantly higher in the pressure ulcer group than those in the non-pressure ulcer group. The level of activity and level of consciousness were significantly lower in the pressure ulcer group than those in the non-pressure ulcer group. Significant influencing factors on the development of pressure ulcer were ‘ moisture’ and 'irrigation' and those variables explained 23.1% of varience in the development of a pressure ulcer during surgery.

Conclusion

It is necessary to develop a strategy to prevent pressure ulcer by taking ‘ moisture' and 'irrigation' into account during the preoperative, perioperative and postoperative period.

Citations

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Risk Factors Associated With Pressure Injuries in Surgical Patients
Jung Yoon Kim, Hyun Hee Lee
Journal of Wound, Ostomy & Continence Nursing.2022; 49(6): 511. CrossRef
Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission
Hye Ran Kwak, Jiyeon Kang
Korean Journal of Adult Nursing.2015; 27(3): 347. CrossRef
Factors Affecting Attitudes and Preventive Practice of Pressure Ulcer among Nurses
Seungmi Park, Nam Young Yang, Jeong Sil Choi
Journal of muscle and joint health.2013; 20(1): 43. CrossRef
Predictive Bayesian Network Model Using Electronic Patient Records for Prevention of Hospital-Acquired Pressure Ulcers
In Sook Cho, Eunja Chung
Journal of Korean Academy of Nursing.2011; 41(3): 423. CrossRef

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A Comparative Study on the Predictive Validity among Pressure Ulcer Risk Assessment Scales: Young Hee Lee, Ihn Sook Jeong, Seong Sook Jeon; Journal of Korean Academy of Nursing 2003;33(2):162-169. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.2.162

Abstract PDF

Purpose

This study was to compare the predictive validity of Norton Scale(1962), Cubbin & Jackson Scale(1991), and Song & Choi Scale(1991).

Method

Data were collected three times per week from 48-72hours after admission based on the four pressure sore risk assessment scales and a skin assessment tool for pressure sore on 112 intensive care unit(ICU) patients in a educational hospital Ulsan during Dec, 11, 2000 to Feb, 10, 2001. Four indices of validity and area under the curve(AUC) of receiver operating characteristic(ROC) were calculated.

Result

Based on the cut off point presented by the developer, sensitivity, specificity, positive predictive value, negative predictive value were as follows : Norton Scale : 97%, 18%, 35%, 93% respectively; Cubbin & Jackson Scale : 89%, 61%, 51%, 92%, respectively; and Song & Choi Scale : 100%, 18%, 36%, 100% respectively. Area under the curves(AUC) of receiver operating characteristic(ROC) were Norton Scale .737, Cubbin & Jackson Scale .826, Song & Choi Scale .683.

Conclusion

The Cubbin & Jackson Scale was found to be the most valid pressure sore risk assessment tool. Further studies on patients with chronic conditions may be helpful to validate this finding.

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Patient-Level Fall Risk Prediction Using the Observational Medical Outcomes Partnership’s Common Data Model: Pilot Feasibility Study
Hyesil Jung, Sooyoung Yoo, Seok Kim, Eunjeong Heo, Borham Kim, Ho-Young Lee, Hee Hwang
JMIR Medical Informatics.2022; 10(3): e35104. CrossRef
Predictive Validity of the Braden Scale for Pressure Ulcer Risk in Critical Care: A Meta‐Analysis
Min Wei, Ling Wu, Yan Chen, Qiaomei Fu, Wenyue Chen, Dongliang Yang
Nursing in Critical Care.2020; 25(3): 165. CrossRef
Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit
Ja Eun Choi, Sun-Kyung Hwang
Journal of Korean Critical Care Nursing.2019; 12(2): 26. CrossRef
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Hyesil Jung, Hyeoun-Ae Park
Western Journal of Nursing Research.2018; 40(12): 1785. CrossRef
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Yinji Jin, Taixian Jin, Sun-Mi Lee
Nursing Research.2017; 66(6): 462. CrossRef
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Eun Young Hur, Yinji Jin, Taixian Jin, Sun-Mi Lee
Journal of Nursing Care Quality.2017; 32(3): 242. CrossRef
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Seong-Hi Park, Young-Shin Lee, Young-Mi Kwon
Western Journal of Nursing Research.2016; 38(4): 459. CrossRef
A Meta-analysis of the Timed Up and Go test for Predicting Falls
Seong-Hi Park, On-Seok Lee
Quality Improvement in Health Care.2016; 22(2): 27. CrossRef
Predictive validity of the Braden Scale for pressure ulcer risk in hospitalized patients
Seong-Hi Park, Yun-Kyoung Choi, Chang-Bum Kang
Journal of Tissue Viability.2015; 24(3): 102. CrossRef
Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis
Young Ok Kang, Rhayun Song
Korean Journal of Adult Nursing.2015; 27(1): 29. CrossRef
Validity of the Morse Fall Scale implemented in an electronic medical record system
Seonhyeon Baek, Jinshi Piao, Yinji Jin, Sun‐Mi Lee
Journal of Clinical Nursing.2014; 23(17-18): 2434. CrossRef
Incidence and Associated Factors of Pressure Ulcers in Newborns
Won-Young Choi, Hyeon-Ok Ju
Journal of Korean Academy of Child Health Nursing.2012; 18(4): 177. CrossRef
Predictive Bayesian Network Model Using Electronic Patient Records for Prevention of Hospital-Acquired Pressure Ulcers
In Sook Cho, Eunja Chung
Journal of Korean Academy of Nursing.2011; 41(3): 423. CrossRef
Braden Scale: evaluation of clinical usefulness in an intensive care unit
InSook Cho, Maengseok Noh
Journal of Advanced Nursing.2010; 66(2): 293. CrossRef

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Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients: Ji Seon Shine, Soo Jin Kim, Ji Hyun Lee, Mi Yu; J Korean Acad Nurs 2017;47(6):794-805. Published online January 15, 2017; DOI: https://doi.org/10.4040/jkan.2017.47.6.794

Abstract PDF

Abstract Purpose

Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure.

Methods

A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression.

Results

The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (±14.90), 41.15 (±16.04), 53.44 (±24.67), and 54.33 (±22.80) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ≥70 years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ≥36.5^oC (OR 3.12, 95% CI: 1.17~8.17); age ≥70 years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ≥36.5^oC (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area.

Conclusion

Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

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A Prospective, Randomized, Non-inferiority Trial to Compare the Efficacy of 3% Povidone-Iodine Foam Dressing and Silver Foam Dressing in the Treatment of Pressure Injuries
Kyung Hee Park, Kyuwon Baek, Minkyung Kim, Myoung Jean Ju, Won Hee Jung, Yong Soon Yoon
Journal of Wound Management and Research.2023; 19(1): 13. CrossRef
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Lili Qin, Wenjuan Yun, Cheng Hang
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Yina Han, Yinji Jin, Taixian Jin, Sun-Mi Lee, Ju-Young Lee
Journal of Wound, Ostomy & Continence Nursing.2019; 46(3): 194. CrossRef
The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment
Chul-Gyu Kim, Seungmi Park, Ji Woon Ko, Sungho Jo
Journal of Tissue Viability.2018; 27(3): 130. CrossRef

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A Structural Equation Model of Pressure Ulcer Prevention Action in Clinical Nurses: Sook Ja Lee, Ok Kyoung Park, Mi Yeon Park; J Korean Acad Nurs 2016;46(4):572-582. Published online August 31, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.4.572

Abstract PDF

Purpose

The purpose of this study was to construct and test a structural equation model for pressure ulcer prevention action by clinical nurses. The Health Belief Model and the Theory of Planned Behavior were used as the basis for the study.

Methods

A structured questionnaire was completed by 251 clinical nurses to analyze the relationships between concepts of perceived benefits, perceived barriers, attitude, subjective norm, perceived control, intention to perform action and behavior. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting pressure ulcer prevention action among clinical nurses.

Results

The model fitness statistics of the hypothetical model fitted to the recommended levels. Attitude, subjective norm and perceived control on pressure ulcer prevention action explained 64.2% for intention to perform prevention action.

Conclusion

The major findings of this study indicate that it is essential to recognize improvement in positive attitude for pressure ulcer prevention action and a need for systematic education programs to increase perceived control for prevention action.

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Seungmi Park, Eun Jung Kim, Son Ja Lee, Eun Jeong Kim, Ji Yeon Lee, Jung Eun Hong
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Journal of Korean Academy of Nursing Administration.2019; 25(5): 384. CrossRef
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Journal of Health Informatics and Statistics.2019; 44(3): 227. CrossRef
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Journal of Clinical Nursing.2019; 28(11-12): 2101. CrossRef
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Ji Hye Jeong, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2019; 30(4): 471. CrossRef

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Economic Effect of Home Health Care Services for Community-dwelling Vulnerable Populations: Eunhee Lee, Jinhyun Kim; J Korean Acad Nurs 2016;46(4):562-571. Published online August 31, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.4.562

Abstract PDF

Purpose

In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program.

Methods

The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income.

Results

Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010.

Conclusion

The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.

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Examining Characteristics and Service Utilization of South Korean Home Health Care Patients: Secondary Analysis of 10-Year Data From a Tertiary Hospital
Hana Lee, Aeri Kim, Hyunsook Heo, Jisoo Lee, Kyungmi Woo
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Evolving Changes in the Delivery of Health Services: A Place for Urological Homecare?
Khalid Al Rumaihi, Stephen A. Boorjian, Michael Jewett
European Urology.2019; 75(4): 543. CrossRef

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Adaptation and Evaluation of the Incontinence Care Protocol: Kyung Hee Park, Heejung Choi; J Korean Acad Nurs 2015;45(3):357-366. Published online June 30, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.3.357

Abstract PDF

Purpose

This study was done to develop an evidence-based incontinence care protocol through an adaptation process and to evaluate the effects of the protocol.

Methods

The protocol was developed according to the guideline of adaptation. A non-randomized controlled trial was used for testing the effects of the new Incontinence Care Protocol. A total of 120 patients having bowel incontinence with Bristol stool type 5, 6, and 7 and admitted to intensive care units were recruited to this study. The newly developed incontinence care protocol was used with patients in the experimental group and conventional skin care was given to patients in the control group. Outcome variables were incontinence-associated dermatitis (IAD) severity, pressure ulcer occurrence and severity.

Results

The experimental group had significantly less severe IAD (t=6.69, p<.001), lower occurrence of pressure ulcers (χ²=7.35, p=.007), and less severity of pressure ulcers (Mann-Whitney=86.00, p=.009) than the control group.

Conclusion

Use of this incontinence care protocol has the effects of preventing pressure ulcers and inhibiting worsening of IAD and pressure ulcers. Therefore, this incontinence care protocol is expected to contribute to managing IAD and pressure ulcers.

Citations

Citations to this article as recorded by

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients
Soomi Kim, Chul-Gyu Kim
Journal of Korean Academy of Nursing.2023; 53(3): 275. CrossRef
The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients
Kyung Hee Park, Joohee Park
Journal of Wound, Ostomy & Continence Nursing.2017; 44(5): 440. CrossRef

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Clinical Nurses’ Knowledge and Visual Differentiation Ability in Pressure Ulcer Classification System and Incontinence-associated Dermatitis: Yun Jin Lee, Seungmi Park, Jung Yoon Kim, Chul-Gyu Kim, Sun Kyung Cha; J Korean Acad Nurs 2013;43(4):526-535. Published online August 12, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.4.526

Abstract PDF

Abstract Purpose

This study was done to compare clinical nurses’ knowledge and visual differentiation diagnostic ability for the pressure ulcer classification system (PUCS) and incontinence-associated dermatitis (IAD).

Methods

A convenience sample of 602 nurses took the pressure ulcer classification system and incontinence-associated dermatitis knowledge test (PUCS & IAD KT) and completed the visual differentiation tool (VDT), consisting of 21 photographs with clinical information.

Results

The overall mean score for correct answers was 14.5 (± 3.2) in PUCS & IAD KT and 11.15 (± 4.9) in PUCS & IAD VDT. Incorrect responses were most common for statements related to stage III, IAD for PUCS & IAD KT, and suspected deep tissue injury (SDTI), un-stageable, and stage III for PUCS & IAD VDT. Significant correlations were found between PUCS & IAD KT and VDT (r= .48, p< .001). Factors affecting scores for PUCS & IAD VDT were PUCS & IAD KT, frequency of pressure ulcer, IAD management and participation in wound care education programs.

Conclusion

Results indicate that nurses have an overall understanding of PUCS & IAD, but low visual differentiation ability regarding stage III, SDTI, and unstageable ulcers. Continuing education is needed to further improve knowledge and visual differentiation ability for PUCS & IAD.

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Effectiveness of immersive teaching strategies on pressure injury: Impact on nurses' knowledge, attitudes and self-efficacy – A partially randomized participant preference (PRPP) controlled trial
Wen-Yi Chao, Yu-Lin Wu, Mei-Yu Hsu, Chien-Lun Chu
Nurse Education in Practice.2025; 82: 104237. CrossRef
Senior Baccalaureate Nursing Students’ Knowledge and Visual Differentiation Ability for the Pressure Injury Classification System and Incontinence-associated Dermatitis
Eunyoung Cho, Yune Kyong Kim, Yun Jin Lee, Youn Sun Hwang
Journal of Korean Academy of Fundamentals of Nursing.2024; 31(2): 191. CrossRef
Big Data Analysis on Consumer Perception of Pressure Injuries: Text Mining and Semantic Network Analysis
Kyung Hee Park, Jinho Lee, Soon Chul Kwon, Jaeseung Kim
Journal of Wound Management and Research.2024; 20(3): 251. CrossRef
Knowledge and Visual Differentiation Ability of the Pressure Injury Classification System and Incontinence-Associated Dermatitis among Hospital Nurses: A Descriptive Study
Seungmi Park, Eun Jung Kim, Son Ja Lee, Eun Jeong Kim, Ji Yeon Lee, Jung Eun Hong
Healthcare.2024; 12(2): 145. CrossRef
Investigation of factors associated with pressure ulcer in patients receiving home care services via path analysis
Selma Durmuş Sarıkahya
Journal of Tissue Viability.2024; 33(2): 152. CrossRef
Evaluating Intensive Care Nurses’ Knowledge of Incontinence-Associated Dermatitis: A Multicenter Cross-sectional Study
Meryem Kılıç, Asiye Tuncay, Sümeyra Benan Çakır
Advances in Skin & Wound Care.2024; 37(9): 1. CrossRef
Development and Effectiveness of a Clinical Decision Support System for Pressure Ulcer Prevention Care Using Machine Learning
Myoung Soo Kim, Jung Mi Ryu, Byung Kwan Choi
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The ability of critical care nurses to identify pressure injury and incontinence‐associated dermatitis: A multicentre cross‐sectional survey
Huan Liu, Aiping Du, Yongming Tian, Mingrong Gao, Shuming Ji, Jie Mi, Xiaoping Shao, Debin Huang, Xiaoyi Cao
Nursing Open.2023; 10(3): 1556. CrossRef
Effects of Attitude, Barriers/Facilitators, and Visual Differentiation on Oral Mucosa Pressure Ulcer Prevention Performance Intention
Min Kyeong Kang, Myoung Soo Kim
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Gaeun Kim, Mikyung Park, Kyungwon Kim
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The Interrater Agreement for the Assessment of Pressure Ulcer Risk Using the Braden Scale and the Classification of Pressure Ulcers by Nurses in A Medium-Sized Hospital
Hyung-Ju Na, Sung-Hee Yoo, Young-Ran Kwon, Min-Jeng Ahn
Korean Journal of Adult Nursing.2020; 32(1): 35. CrossRef
Development and Utilization of a Clinical Decision Support System Contents for Pressure Ulcer Prevention Care
Myoung Soo Kim, Jung Mi Ryu
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Myoung Soo Kim, Jung Mi Ryu
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Seungmi Park, Chul-Gyu Kim, Ji Woon Ko
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Hyo Jung Lee, Yeong Jun Ju, Eun-Cheol Park, Juyeong Kim, Sang Gyu Lee
European Journal of Public Health.2017; 27(5): 822. CrossRef
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Yun Jin Lee, Jung Yoon Kim
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Misoo Yoo, Myungsun Yi
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Yun Jin Lee, Seungmi Park
Journal of Korean Biological Nursing Science.2014; 16(4): 342. CrossRef

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Optimal Time Interval for Position Change for ICU Patients using Foam Mattress Against Pressure Ulcer Risk: Hyean Jeong Kim, In Sook Jeong; J Korean Acad Nurs 2012;42(5):730-737. Published online October 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.5.730

Abstract PDF

Purpose

This study was done to identify the time interval to pressure ulcer and to determine the optimal time interval for position change depending on pressure ulcer risk in patients using foam mattress in intensive care units.

Methods

The Braden scale score, occurrence of pressure ulcers and position change intervals were assessed with 56 patients admitted to an intensive care unit from April to November, 2011. The time to pressure ulcer occurrence by Braden scale risk group was analyzed with Kaplan-Meier survival analysis and log rank test. Then, the optimal time interval for position change was calculated with ROC curve.

Results

The median time to pressure ulcer occurrence was 5 hours at mild or moderate risk, 3.5 hours at high risk and 3 hours at very high risk on the Braden scale. The optimal time interval for position change was 3 hours at mild and moderate risk, 2 hours at high and very high risk of Braden scale.

Conclusion

When foam mattresses are used a slight extension of the time interval for position change can be considered for the patients with mild or moderate pressure ulcer risk but not for patients with high or very high pressure ulcer risk by Braden scale.

Citations

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The effect of support surface on the prevention of pressure injury in acute care settings: A multi-center prospective observational study
Mi-Ock Shim, Chul-Gyu Kim, Ja Kyung Min, So Yeon Kwak, Hyunhee Ghil, Seungmi Park
Journal of Tissue Viability.2024; 33(4): 652. CrossRef
Predicting the cut‐off point for interface pressure in pressure injury according to the standard hospital mattress and polyurethane foam mattress as support surfaces
Mi Yu, Kyung Hee Park, Jiseon Shin, Ji Hyun Lee
International Wound Journal.2022; 19(6): 1509. CrossRef
Effectiveness of Devices for Prevention and Treatment of Pressure Ulcers: A scoping Review
Soo Youn Jung, Mina Park, Kyoung Ja Moon
Korean Journal of Adult Nursing.2022; 34(2): 123. CrossRef
Comparing Pressure Injury Incidence Based on Repositioning Intervals and Support Surfaces in Acute Care Settings: A Quasi-Experimental Pragmatic Study
Jeong Sil Choi, Seon Young Hyun, Sun Ju Chang
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Perioperative factors and pressure ulcer development in postoperative ICU patients: a retrospective review
Neha Kumta, Fiona Coyer, Michael David
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Improving the quality of nurse‐influenced patient care in the intensive care unit
Lynsey J. Sutton, Rebecca J. Jarden
Nursing in Critical Care.2017; 22(6): 339. CrossRef
The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients
Kyung Hee Park, Joohee Park
Journal of Wound, Ostomy & Continence Nursing.2017; 44(5): 440. CrossRef
Automated Pressure Injury Risk Assessment System Incorporated Into an Electronic Health Record System
Yinji Jin, Taixian Jin, Sun-Mi Lee
Nursing Research.2017; 66(6): 462. CrossRef
Prophylactic Effect of Transparent Film Dressing on Sacrum and Coccyx in SICU Patients*
Heejeong Kim, Sun-Mi Lee, Hee young Choi, Yu Kyung Min, Yoo Jin Jung
Journal of Korean Academy of Fundamentals of Nursing.2016; 23(3): 256. CrossRef
A Phenomenological Study on Illness Experience of Patients with Pressure Ulcer
Misoo Yoo, Myungsun Yi
Korean Journal of Adult Nursing.2015; 27(5): 515. CrossRef
Reusability of EMR Data for Applying Cubbin and Jackson Pressure Ulcer Risk Assessment Scale in Critical Care Patients
Eunkyung Kim, Mona Choi, JuHee Lee, Young Ah Kim
Healthcare Informatics Research.2013; 19(4): 261. CrossRef

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Predictive Bayesian Network Model Using Electronic Patient Records for Prevention of Hospital-Acquired Pressure Ulcers: In Sook Cho, Eunja Chung; J Korean Acad Nurs 2011;41(3):423-431. Published online June 13, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.3.423

Abstract PDF

Purpose

The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers.

Methods

Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and -II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method.

Results

Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR.

Conclusion

Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.

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Development of a Pressure Injury Machine Learning Prediction Model and Integration into Clinical Practice: A Prediction Model Development and Validation Study
Ju Hee Lee, Jae Yong Yu, So Yun Shim, Kyung Mi Yeom, Hyun A Ha, Se Yong Jekal, Ki Tae Moon, Joo Hee Park, Sook Hyun Park, Jeong Hee Hong, Mi Ra Song, Won Chul Cha
Korean Journal of Adult Nursing.2024; 36(3): 191. CrossRef
Evaluation of the risk prediction model of pressure injuries in hospitalized patient: A systematic review and meta‐analysis
Yuxia Ma, Xiang He, Tingting Yang, Yifang Yang, Ziyan Yang, Tian Gao, Fanghong Yan, Boling Yan, Juan Wang, Lin Han
Journal of Clinical Nursing.2024;[Epub] CrossRef
The predictive effect of different machine learning algorithms for pressure injuries in hospitalized patients: A network meta-analyses
Chaoran Qu, Weixiang Luo, Zhixiong Zeng, Xiaoxu Lin, Xuemei Gong, Xiujuan Wang, Yu Zhang, Yun Li
Heliyon.2022; 8(11): e11361. CrossRef
Predictive Modeling of Pressure Injury Risk in Patients Admitted to an Intensive Care Unit
Mireia Ladios-Martin, José Fernández-de-Maya, Francisco-Javier Ballesta-López, Adrián Belso-Garzas, Manuel Mas-Asencio, María José Cabañero-Martínez
American Journal of Critical Care.2020; 29(4): e70. CrossRef
Development and Evaluation of Electronic Health Record Data-Driven Predictive Models for Pressure Ulcers
Seul Ki Park, Hyeoun-Ae Park, Hee Hwang
Journal of Korean Academy of Nursing.2019; 49(5): 575. CrossRef
Development and Comparison of Predictive Models for Pressure Injuries in Surgical Patients
Seul Ki Park, Hyeoun-Ae Park, Hee Hwang
Journal of Wound, Ostomy & Continence Nursing.2019; 46(4): 291. CrossRef
Automated Pressure Injury Risk Assessment System Incorporated Into an Electronic Health Record System
Yinji Jin, Taixian Jin, Sun-Mi Lee
Nursing Research.2017; 66(6): 462. CrossRef
Recommendation of Personalized Surveillance Interval of Colonoscopy via Survival Analysis
Jayeon Gu, Eun Sun Kim, Seoung Bum Kim
Journal of Korean Institute of Industrial Engineers.2016; 42(2): 129. CrossRef
Medical Data Based Clinical Pathway Analysis and Automatic Ganeration System
Hanna Park, In Ho Bae, Yong Oock Kim
The Journal of Korea Information and Communications Society.2014; 39C(6): 497. CrossRef
Reusability of EMR Data for Applying Cubbin and Jackson Pressure Ulcer Risk Assessment Scale in Critical Care Patients
Eunkyung Kim, Mona Choi, JuHee Lee, Young Ah Kim
Healthcare Informatics Research.2013; 19(4): 261. CrossRef
Using EHR data to predict hospital-acquired pressure ulcers: A prospective study of a Bayesian Network model
Insook Cho, Ihnsook Park, Eunman Kim, Eunjoon Lee, David W. Bates
International Journal of Medical Informatics.2013; 82(11): 1059. CrossRef

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The Effects of the Ulmus Root-bark Dressing in Tissue Regeneration of Induced Pressure Ulcers in Rats: Yeon Kyung Na, Hae Sook Hong; Journal of Korean Academy of Nursing 2006;36(3):523-531. Published online June 30, 2006; DOI: https://doi.org/10.4040/jkan.2006.36.3.523

Abstract PDF

Purpose

The purpose of this study was to examine the effects of the ulmus root-bark dressing on tissue regeneration in experimentally-induced pressure ulcers in rats.

Method

A randomized pretest/post-test control group time-series study design was used. Thirty-three male Sprague-Dawley rats were used in this study. The rats were anesthetized with 100mg/kg of ketamine. Pressure ulcers were induced at 140mmHg for three hours using a personally-designed pressing apparatus. For four weeks, the ulmus root-bark dressing was applied every other day in the experimental group (n=18) and a wet gauze dressing in the control group (n=15). For data analysis, the statistical program SPSS WIN 12 was used. The wounds were examined by light microscopy and electron microscopy.

Result

There were significant statistical differences in the size of the pressure ulcers as time went by(p=0.006). It should be noted that there were no significant statistical differences in the number of capillaries. Using light microscopy the inflammatory infiltration and neovascularization in the dermis in the experimental group emerged densely in the early stages, but recovered rapidly at the latter stages. In addition, the reepithelization of the epidermis occurred earlier than in the control group. By electron microscopy, the cell organelles of the capillary endothelial cells and the basal lamina of capillaries in the experimental group showed a more rapid maturation during the latter stages, compared with the control group.

Conclusion

According to this study, it can be concluded that the ulmus root-bark dressing is effective regarding the healing of pressure ulcers.

Citations

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Use of Animals for Nursing Research in Korea
Hae Young Yoo
Journal of Korean Biological Nursing Science.2015; 17(4): 324. CrossRef
The Effect of Ulmus Root-bark Dressing in Fibroblast Growth Factor and Vascular Endothelial Growth Factor of Induced Pressure Ulcer in Rats
Yeon Kyung Na
Journal of Korean Biological Nursing Science.2013; 15(4): 257. CrossRef
Factors Affecting the Healing of Pressure Ulcers in a Korean Acute Care Hospital
Young Hee Sung, Kyung Hee Park
Journal of Wound, Ostomy & Continence Nursing.2011; 38(1): 38. CrossRef

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