Razmus, I. S. (2003). Predicting pressure ulcer risks in pediatric patients: The Braden Q scale. Nursing Research, 52(1), 22-33.
Background
There exist irrefutable and dependable tools to evaluate risks of pressure sores among adults; however, the same cannot be said for children. The Braden Q Scale consequently comes in handy in changing this.
Objective
The study aimed at proving the predictive accuracy of the Braden Q Scale among critically sick children. It also aimed at demonstrating the significant point of interception when categorizing patients’ risk and ascertaining the ideal time to determine it. Methods. Using a combinative, descriptive investigation from three pediatric ICU sites, a convenient sample of 322 pediatric patients with no previously established pressure sores or inherent heart disorders and who were bedridden for over 24 hours were enlisted. Without assessing other measures, data collectors independently rated the Braden Q score and skin evaluation. Patients were kept under surveillance for four weeks by being observed thrice per week at first then once per week until they were discharged from the PICU. Results. 27% of the patients developed pressure sores, 70% had Stage I pressure sores, 27% Stage II while 3% had stage III pressure sores. Most of the pressure ulcers were in existence during the initial observation. A Receiver Operator Characteristic (ROC) curve for individual Braden Q scale results was formulated. The area under the curve was determined as 0.83 while the determinant score was found to be 16. Sensitivity was 0.88 while specificity was 0.58. Alterations were made on the Braden Q Scale and basing only on mobility, sensory cognition and oxygenation of tissues subscales, the AUC was retained at 0.84. At a determining score of 7, sensitivity was 0.92 while specificity was 0.59.
Conclusion
The effectiveness of the Braden Q Scale among hospitalized children is the same with that regularly noted in adult patients. However, the amended 3 subscale Braden Q Scale offers a brief but analogous apparatus.
Samaniego, I. A. (2012). A sore spot in pediatrics: risk factors for pressure ulcers. Pediatric Nursing, 29(4), 278-82.
Background
Pressure sores pose serious threats to growing children as the skin breakdown is a major cause for hospitalization. While there is little done on the consequential events and risk factors of pressure ulcers among the children population, pediatrics should be aware of the problems that are likely to increase a child’s susceptibility to pressure sores. Methods. To explore the incidence and prevalence of pressure ulcers among children in a wound care clinic, medical and documented discoveries were used. An analysis of 227 patients diagnosed with myelomeningocele who developed bedsores in a 20-year time span associated the growth of pressure sores with unnecessary pressure, casts, orthotic contrivances, urinary or fecal soiling and indulgent activity.
Results
Pressure ulcers are likely result from more than one factor and consequently, patients with acute spinal injuries, sensory damage and mental deceleration, a large head, abnormal body development, hunchbacks, and/or unmitigated bed soiling from urine or feces, had a 43% likelihood of developing pressure sores. While these rates are not constant, they increased with age and then leveled off. Age and distribution of body weight are also likely causative factors of pressure sores among children. As children change with age, so do their pressure zones; older children were susceptible to sacral sores while their younger counterparts were likely to develop occipital pressures. The research study concluded that a 2” or 4” mattress could be an effective pressure mitigating material. Another survey in a pediatric ICU on changes in skin quality was carried out with 76% of patients admitted to PICU observed. It was reported that the incidence of pressure ulcers in such conditions is 26%.
Conclusion
It was concluded that skin deterioration is a product of many factors but Pediatric Risk of Mortality Score was the most powerful indicator of bed sores.
Schlüer A. B., Cignacco, E., Müller, M., & Halfens, R. J. (2009). The prevalence of pressure ulcers in four pediatric institutions. Journal of Clinical Nursing, 18(23), 3244-5322.
Background
Pressure ulcers pose nursing care challenges in many hospitals. They are responsible for physical and psychological distress among many patients, increased malignancy and death rates, and increased costs of healthcare. This study aimed at depicting the prevalence of bed sores among hospitalized children, to establish the population susceptible to pressure ulcers and evaluate the factors likely to lead to the growth of pressure sores; a point prevalence investigation was carried out.
Method
The research was carried out in four pediatric hospitals with children aged between 0 to 18years. Data was collected using a methodological examination and appraisal of the skin, bearing in mind the clinical status of the patient under assessment. The irrefutable risk appraisal and data collection tool was employed while every patient was evaluated by a formerly trained rater pair.
Results
Out of the likely patients, the prevalence rate of bed sores was established to be at 27.7%. 84% had grade I sores resulting from external medical equipment. On a Braden score of < or = 20, 65% of the patients were susceptible to pressure ulcers while 35% of the highly susceptible patients had at least one bed sore.
Conclusion
The preponderance of bedsores among pediatric patients is bigger than previously perceived and it warrants more scrutiny. Nursing interposition is required to prevent the grade I bed sores that result from external medical equipment.
The widespread trend of pressure ulcers among hospitalized children is worrying and needs more research especially on interpositions required to ameliorate the health status of children.