Incidence rate and severity of hapus in intensive

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incidence rate and severity of HAPUs in intensive care patients. A study conducted of 461 patients, 5 developed pressure ulcers with adhesive foam dressings, 7 developed pressure ulcers using fatty acid oil dressings, and 10 developed pressure ulcers in the standard care group. Level II Quasi-experimental study Systematic review of combination of RCTs and quasi- experimental, or non-experimental with/without meta- analysis 2 A- High Quality The repositioning of routine management group had the highest-pressure injury incidence rate, followed by the hydrocolloid-dressing group. The foam- dressing group recorded no pressure injuries. The number of unit-acquired sacral pressure injuries decreased by 3.4 to 7.6 per 1000 patient days depending on the unit using adhesive foam dressing. Level III Non-experimental study Systematic review of combined RCTs, quasi-experimental, and non- experimental studies only, with/without meta-analysis Qualitative study or systematic review of qualitative studies with/without meta- synthesis 2 B- Good Quality Out of 128 patients using foam dressings (Mepilex), 45 pressure ulcers resolved, 48 pressure ulcers decreased, 12 remained unchanged, and 20 increased in severities. The average baseline sacral HAPU prevalence during the 35-month observation was 13.6% as compared to an incidence of 1.8% during the 6-month prospective study. Three of the 5 patients developed suspected deep tissue injuries and subsequently expired. The remaining 2 subjects developed stage 2 pressure ulcers, one of who also expired. Following application of a silicone- bordered foam dressing, we were able to achieve a HAPU of 1.8%. Level IV Opinion of respected authorities and/or reports of nationally recognized expert 2 B- Good Quality Recommendation 1: ACP recommends that clinicians should perform a risk assessment to identify patients who are at risk of developing pressure ulcers Recommendation 2: ACP recommends that 16
Running head: EVIDENCE BASED PRACTICE PAPER committees/ consensus panels based on scientific evidence clinicians should choose advanced static mattresses or advanced static overlays in patients who are at an increased risk of developing pressure ulcers. Recommendation 3: ACP recommends against using alternating-air mattresses or alternating-air overlays in patients who are at an increased risk of developing pressure ulcers. Foam dressings are encouraged versus standard pressure ulcer care. These recommendations combined reduce the risk of HAPU’s. Recommendation 1: ACP recommends that clinicians use protein or amino acid supplementation in patients with pressure ulcers to reduce wound size Recommendation 2: ACP recommends that clinicians use hydrocolloid or foam dressings in patients with pressure ulcers to reduce wound size.

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