Uso de la metodología de paquete de cuidados (care bundle) aplicada a la prevención de lesiones por presión adquiridas en hospital en pacientes adultosrevisión exploratoria

  1. Luis Real-López
  2. Laura Parra-Anguita 1
  3. Pedro L. Pancorbo-Hidalgo 1
  4. M. Carmen Enrique-Arias
  1. 1 Universidad de Jaén
    info

    Universidad de Jaén

    Jaén, España

    ROR https://ror.org/0122p5f64

Revista:
Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

ISSN: 1134-928X

Año de publicación: 2023

Volumen: 34

Número: 1

Páginas: 68-77

Tipo: Artículo

DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

Resumen

Resumen Objetivo: Explorar el estado del conocimiento sobre la metodología del paquete de cuidados (PCuid) en la prevención de lesiones por presión adquiridas en hospital en pacientes adultos. Metodología: Revisión exploratoria en 10 bases de datos bibliográficos. Se incluyeron las publicaciones relacionadas con pacientes adultos ingresados en unidades de hospitalización convencional. Se realizó una descripción narrativa sin análisis de la calidad metodológica. Resultados: Se seleccionaron 31 artículos de diferentes diseños de investigación, identificando 9 PCuid. Como resultados cuantitativos, se obtuvieron reducciones de la incidencia de lesiones por presión desde el 8 al 90%, en la prevalencia del 37 al 94%, o incrementos en el número de días sin lesiones por presión desde el 50 al 59%. Otros efectos fueron un aumento del 36% en la utilización de la escala de Braden para la valoración del riego de lesiones por presión, o la mejora de cumplimentación de los registros de lesiones por presión del 13%. Desde el punto de vista cualitativo, los profesionales consideraron la aplicación de un PCuid como factible y aceptable, destacando como beneficios el aumento de la comunicación, los conocimientos y la participación en la prevención de LPP. Los pacientes consideraron la aplicación del PCuid como aceptable al aumentar su participación en el cuidado, favorecer la interacción con el personal y proporcionar información fácil de entender. Conclusión: La metodología del PCuid mejora la prevención de LPP en adultos hospitalizados. Son necesarios más estudios y de mayor calidad para valorar su efectividad. Resultaría recomendable estandarizar el uso de un único indicador de resultados que permitiera la comparación entre PCuid con distintos contenidos, preferiblemente la incidencia o la prevalencia de lesiones por presión adquiridas en el hospital.

Referencias bibliográficas

  • Resar, R,Griffin, F,Haraden, C,Nolan, T. (2012). Using care bundles to improve health care quality. IHI Innovation.
  • Resar, R,Pronovost, P,Haraden, C,Simmonds, T,Rainey, T,Nolan, T. (2005). Using a Bundle Approach to Improve Ventilator Care Processes and Reduce Ventilator-Associated Pneumonia. Jt Comm J Qual Patient Saf. 31. 243
  • Langley, GL,Moen, R,Nolan, KM,Nolan, TW,Norman, CL. (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2. Publishers J-B. California.
  • Berwick, DM,Calkins, DR,Joseph McCannon, C,Hackbarth, AD. (2006). The 100 000 lives campaign: Setting a goal and a deadline for improving health care quality. J Am Med Assoc. 295. 324
  • McCannon, CJ,Hackbarth, AD,Griffin, FA. (2007). Miles to go: An introduction to the 5 million lives campaign. Jt Comm J Qual Patient Saf. 33. 477
  • Institute for Healthcare Improvement. 5 Million Lives Campaign.
  • Morris, AC,Hay, AW,Swann, DG,Everingham, K,McCulloch, C,McNulty, J. (2011). Reducing ventilator-associated pneumonia in intensive care: Impact of implementing a care bundle. Crit Care Med. 39. 2218
  • NHS75. The NHS Patient Safety Strategy.
  • Gibbons, W,Shanks, HT,Kleinhelter, P,Jones, P. (2006). Eliminating facility-acquired pressure ulcers at ascension health. Jt Comm J Qual Patient Saf. 32. 488
  • Bale, S. (2012). Preventing skin damage: A welsh perspective. Wounds UK. 8. 74-81
  • (2011). Healthcare Improvement Scotland. SSKIN care bundle.
  • McIntyre, L. (2014). Implementing a regional strategy to reduce avoidable pressure ulcers. Wounds UK. 10. 8-13
  • Anthony, D,Hodgson, H,Horner, J. (2017). Reducing avoidable pressure ulcers. Wounds UK. 14
  • Van Gaal, BG,Schoonhoven, L,Hulscher, ME,Mintjes, JA,Borm, GF,Koopmans, RT. (2009). The design of the SAFE or SORRY? study: A cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events. BMC Health Serv Res. 9. 58
  • Van Gaal, BGI,Schoonhoven, L,Mintjes, JAJ,Borm, GF,Koopmans, RTCM,Van Achterberg, T. (2011). The SAFE or SORRY? programme. Part II: Effect on preventive care. Int J Nurs Stud. 48. 1049
  • Van Gaal, BGI,Schoonhoven, L,Mintjes, JAJ,Borm, GF,Hulscher, MEJL,Defloor, T. (2011). Fewer adverse events as a result of the SAFE or SORRY? programme in hospitals and nursing homes. Part I: Primary outcome of a cluster randomised trial. Int J Nurs Stud. 48. 1040
  • Baldelli, P,Paciella, M. (2008). Creation and implementation of a pressure ulcer prevention bundle improves patient outcomes. Am J Med Qual. 23. 136
  • Carson, D,Emmons, K,Falone, W,Preston, AM. (2012). Development of pressure ulcer program across a university health system. J Nurs Care Qual. 27. 20
  • Chaboyer, W,Bucknall, T,Webster, J,McInnes, E,Gillespie, BM,Banks, M. (2016). The effect of a patient centred care bundle intervention on pressure ulcer incidence (INTACT): A cluster randomised trial. Int J Nurs Stud. 64. 63-71
  • Fremmelevholm, A,Soegaard, K. (2019). Pressure ulcer prevention in hospitals: A successful nurse-led clinical quality improvement intervention. Br J Nurs. 28. 6-11
  • Padula, WV,Makic, MBF,Mishra, MK,Campbell, JD,Nair, KV,Wald, HL. (2015). Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States. Jt Comm J Qual Patient Saf. 41. 246
  • Staines, A,Amherdt, I,Burnand, B,Rotzetter, M,Currat, P,Roux, S. (2020). Impact of a Swiss pressure ulcer prevention breakthrough collaborative. J Eval Clin Pract. 27. 1143
  • Al-Otaibi, YK,Al-Nowaiser, N,Rahman, A. (2019). Reducing hospital-acquired pressure injuries. BMJ Open Qual. 8.
  • Lovegrove, J,Fulbrook, P. (2018). Prescription of pressure injury preventative interventions following risk assessment: An exploratory, descriptive study. Int Wound J. 15. 985
  • Reddy, M,Gill, SS,Rochon, PA. (2006). Preventing pressure ulcers: A systematic review. J Am Med Assoc. 296. 974
  • Soban, LM,Hempel, S,Munjas, BA,Miles, J,Rubenstein, LV. (2011). Preventing pressure ulcers in hospitals: A systematic review of nurse-focused quality improvement interventions. Jt Comm J Qual Patient Saf. 37. 245
  • Niederhauser, A,Van Deusen Lukas, C,Parker, V,Ayello, EA,Zulkowski, K,Berlowitz, D. (2012). Comprehensive programs for preventing pressure ulcers: A review of the literature. Adv Ski Wound Care. 25. 189
  • Sullivan, N,Schoelles, KM. (2013). Preventing in-facility pressure ulcers as a patient safety strategy: A systematic review. Ann Intern Med. 158. 410
  • Lavallée, JF,Gray, TA,Dumville, J,Russell, W,Cullum, N. (2017). The effects of care bundles on patient outcomes: A systematic review and meta-analysis. Implement Sci. 12. 142
  • Gaspar, S,Peralta, M,Marques, A,Budri, A,Gaspar de Matos, M. (2019). Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review. Int Wound J. 16. 1087
  • Lozano-Montoya, I,Vélez-Díaz-Pallarés, M,Abraha, I,Cherubini, A,Soiza, RL,O'Mahony, D. (2016). Nonpharmacologic Interventions to Prevent Pressure Ulcers in Older Patients: An Overview of Systematic Reviews (The Software ENgine for the Assessment and optimization of drug and non-drug Therapy in Older peRsons (SENATOR) Definition of Optimal Evidence. J Am Med Dir Assoc. 17. 1-10
  • Moore, ZEH,Webster, J,Samuriwo, R. (2015). Wound-care teams for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 9.
  • Joyce, P,Moore, ZE,Christie, J. (2018). Organisation of health services for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 12.
  • Porter-Armstrong, AP,Moore, ZE,Bradbury, I,McDonough, S. (2018). Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev. 5.
  • O’Connor, T,Moore, ZEH,Patton, D. (2021). Patient and lay carer education for preventing pressure ulceration in at-risk populations. Cochrane Database Syst Rev. 2.
  • Aromataris, E,Munn, Z. (2020). JBI Manual for Evidence Synthesis. JBI.
  • Peters, M,Godfrey, C,McInerney, P,Munn, Z,Tricco, A,Khalil, H. (2020). JBI Manual for Evidence Synthesis. JBI.
  • Tricco, AC,Lillie, E,Zarin, W,O'Brien, KK,Colquhoun, H,Levac, D. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 69. 467
  • Sendelbach, S,Zink, M,Peterson, J. (2011). Decreasing pressure ulcers across a healthcare system: moving beneath the tip of the iceberg. J Nurs Adm. 41. 84
  • Whitlock, J,Rowlands, S,Ellis, G,Evans, A. (2011). Using the SKIN Bundle to prevent pressure ulcers. Nurs Times. 107. 20
  • Birkill, K. (2020). Deal with heels: A pressure ulcer prevention initiative. Br J Community Nurs. 25. 6-10
  • Van Gaal, BGI,Schoonhoven, L,Vloet, LCM,Mintjes, JAJ,Borm, GF,Koopmans, RTCM. (2010). The effect of the SAFE or SORRY? programme on patient safety knowledge of nurses in hospitals and nursing homes: A cluster randomised trial. Int J Nurs Stud. 47. 1117
  • (2011). Australian Commission on Safety and Quality in Health Care National Safety and Quality Health Service Standards. ACSQHC. Sydney.
  • Chaboyer, W,Gillespie, BM. (2014). Understanding nurses' views on a pressure ulcer prevention care bundle: A first step towards successful implementation. J Clin Nurs. 23. 3415
  • Roberts, S,McInnes, E,Wallis, M,Bucknall, T,Banks, M,Chaboyer, W. (2016). Nurses' perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study. BMC Nurs. 15. 64
  • Roberts, S,Wallis, M,McInnes, E,Bucknall, T,Banks, M,Ball, L. (2017). Patients' Perceptions of a Pressure Ulcer Prevention Care Bundle in Hospital: A Qualitative Descriptive Study to Guide Evidence-Based Practice. Worldviews Evid Based Nurs. 14. 385
  • Whitty, JA,McInnes, E,Bucknall, T,Webster, J,Gillespie, BM,Banks, M. (2017). The cost-effectiveness of a patient centred pressure ulcer prevention care bundle: Findings from the INTACT cluster randomised trial. Int J Nurs Stud. 75. 35-42
  • Deakin, J,Gillespie, B,Chaboyer, W,Nieuwenhoven, P,Latimer, S. (2020). An education intervention care bundle to improve hospitalised patients' pressure injury prevention knowledge: a before and after study. Wound Pract Res. 28. 154
  • McIntyre, L. (2013). A communication project to prevent pressure ulcers. Nurs Times. 109. 12
  • Gillespie, BM,Chaboyer, W,Sykes, M,Oêbrien, J,Brandis, S. (2014). Development and pilot testing of a patient-participatory pressure ulcer prevention care bundle. J Nurs Care Qual. 29. 74-82
  • Kiernan, M,Downie, F. (2011). Prevention of pressure ulcers: Could a care bundle approach be a success?. Wounds UK. 7. 157
  • Whitlock, J. (2013). SSKIN bundle: Preventing pressure damage across the health-care community. Br J Community Nurs. 32-38
  • Downie, F,Perrin, AM,Kiernan, M. (2013). Implementing a pressure ulcer prevention bundle into practice. Br J Nurs. 22. 4-8
  • Downie, F. (2014). Pressure ulcer prevention: How documentation can help. Wounds UK. 10. 14
  • Chaboyer, W,Bucknall, T,Webster, J,McInnes, E,Banks, M,Wallis, M. (2015). INTroducing A Care bundle To prevent pressure injury (INTACT) in at-risk patients: A protocol for a cluster randomised trial. Int J Nurs Stud. 52. 1659
  • Roberts, S,McInnes, E,Bucknall, T,Wallis, M,Banks, M,Chaboyer, W. (2017). Process evaluation of a cluster-randomised trial testing a pressure ulcer prevention care bundle: A mixed-methods study. Implement Sci. 12. 18
Fuente de los datos: Dialnet