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Krysiak Pressure Ulcers and Skin Care Bundles - Coggle Diagram
Krysiak Pressure Ulcers and Skin Care Bundles
Article 1: Using the SKKIN care bundle to prevent pressure ulcers in the intensive care unit
SKINN bundle
S--surface
S--skin inspection
K--kinetics/keep moving
I--incontinence/moisture
N--Nutrition/Hydration
SURFACE
--Skin can be in contact with mattresses for extended periods
--Reduce amount and duration of pressure on the skin
--Reduce shear and friction
Foam mattresses can redistribute pressure
Avoid harsh soaps
Body fluids (urine/feces) can have negative impact if on skin for prolonged period
SKIN INSPECTION
--Head to toe exams
--Redness over bony prominences should be recorded
Assess all bony prominences
KINETICS/KEEP MOVING
--Movement relieves pressure at vulnerable sites
--Timing of repositioning schedules should be based on patient risk factors
INCONTINENCE/MOISTURE
--Skin surface has microclimate that can damage skin
--Body fluids that contact skin for prolonged period (urine, feces)
--Avoid soaps to prevent alteration in skin pH
NUTRITION
--Compromised nutrition = risk ulcer formation
--Adequate nutrition/hydration needed
Protein, fluids
--avoid sugars
Most vulnerable sites of pressure ulcers are sacrum and heels
Those with impaired nutrition, circulation, limited mobility and acute/chronic illnesses are high risk
ICU patients high risk because lack ability to move independently
Pressure Ulcer Defined
Area of soft tissue damage
Leads to impaired blood supply and injury to skin
Article 3: The Effectiveness of the SKINCARE bundle in preventing medical-device related pressure injuries in critical care units: a clinical trial
Preventing pressure ulcers caused by medical devices
Foleys, respiratory devices, NG tubes, traction equipment
Critically ill are reliant on these devices
SKINCARE bundle
S--Secure devices
K--Keep repositioning
I--inspect
N--Nutrition/hydrate
C--Correct size/type device
A--Avoid devices on injured sites
R--Report pressure ulcers
E--Education
90% reduction in incidence with this bundle
Uses a care bundle approach
Standard care doesn't include education/consistent monitoring
Care based on personal preferences
Article 2: Effects of care bundles for patients with pressure ulcers and the impact on self-care efficacy
Control group
Routine nursing care
--Grading of ulcer
--Dressing changes
--respositioning
--nutrition
Care bundles
Observation group
Routine nursing AND care bundles
--Braden Assessment/ other assessments
--Repositioning
--Treatments
--Follow up care
Care bundles promoted patient participation and understanding
Scores r/t:
--Self-efficacy
--PU management
--Awareness
These factors higher in observation group with care bundle
Figure 1 shows observation grop had more self-efficacy after 1 month compared to control group
Care bundles can decrease grades of pressure ulcers