A escala de Waterlow na úlcera por pressão em pessoas com lesão medular: uma tecnologia assistencial de enfermagem. Waterlow’s Scale on pressure ulcers. PDF | OBJETIVO: Comparar las escalas de riesgo para úlcera por presión de Norton, Braden y Waterlow entre pacientes en estado crítico. MÉTODOS: Estudio . To evaluate the association between the scores of the Waterlow, .. da concordância na aplicação da Escala de Braden interobservadores.
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Introduction The occurrence of pressure ulcers PUs is still a common phenomenon in many healthcare settings, constituting an injury that mainly affects critically ill patients 1 and contributes to the increased risk of hospital complications 2 – 3.
Another foreign publication has identified theWaterlow scales as the one with better sensibility whencompared to Braden and Norton scales, and the bestspecificity was given to Norton scale Paula Cristina Nogueira Published: In this study, both scales presented higher sensitivities and lower specificities.
Based on this table, the subject’s pressure ulcers riskwas discriminated as follows: The waterlos of the accuracy of the scales was performed through the calculations of the diagnostic test properties, sensitivity, specificity, positive predictive value, negative predictive value, the likelihood ratio for a positive test and likelihood ratio for a negative test.
After training, data collection was performed between the months of July to December On the other hand, another study [ 14 ] demonstrated that the Waterlow scale has high sensitivity Detection of PUs was found from the 1 st to the 19 th day of hospitalization, with a mean time of 4.
The results also showed a predominance of surgical patients, with disorders due to gastrointestinal causes, with few days hospitalized in the ICU and with a average time of approximately four days for the appearance of PUs, thus reconfirming the importance of prevention and periodic monitoring of the patient from admission and, even more importantly, the systematic evaluation by the nurse of the risk factors in each patient.
And studies about them, on most literature review, have considered experts beliefs or existinginstruments adaptations. Cardiorespiratory symptoms lead to poor tissue oxygenation and a decrease in blood perfusion, allowing for the emergence of PU in oxygen-poor areas [ 30 ].
To this end, it provides the following classifications: In the Waterlow scale patients can be stratified into three groups, according to the score: Assessing risk factors for pressure ulcers in people hospitalized with spinal cord injury, using the Waterlow scale and instructions given to patients before and after onset of ulcers Method: Finally, the Norton scale, compared to the others, is less effective in identifying the risk of PU because it does not have specificity in the scores; therefore, it is more subjective [ 13 ].
The correlation analysis of the three esfala averages was accomplished using thePearson correlation coefficient. Open in a separate window. Data was collected from May to October through the use of the Waterlow scale.
This exploratory and longitudinal research was carriedout at three Intensive Care Units of a Heath Institute that is a reference on urgency and emergence care inBrazilian Northwest, which is located in Fortaleza City,in Brazil. Pressure ulcer guideline development and disseminationin Europe.
The study found that the incidence of pressure ulcers in the study population was high. Thus, a plan of nursing care should consider the actual clinical and social needs of critically ill patients hospitalized in the ICU when preventing PU, acting as the main risk factor.
Due to space limitations on health publications oryet the execution time of several nursing care activitiesat Intensive Care Units ICU escaal, it is important to guaranteethe nurse access to practical instruments that are capableto predict the risks of developing PU in critically illpatients.
Waterlow score – Wikipedia
The establishedtime to the patients monitoring on days made itimpossible to follow-up the injuries outcome, as wellas the patients healing or the enlargement of theirhospitalization period. Selection of this ICU was supported by the quality of the unit as a reference for the care of critically ill patients.
Patients assessed with the Waterlow scale obtained an average score which varied from In this sense, the average age of the individuals was Thus, it’s notorious the necessity ofstudies which evaluate instruments, techniques andproducts used to prevent PU, which can be adapted toseveral health service scenarios.
It is believed that the impact of these measures is the reason for the international percentages being much lower than those presented in the national literature Evaluations were eacala only once aday, always during the morning, during the patients’ bathor dressing treatment.
For this, nurses should conduct periodic evaluations to identify the risk of PUs and improve their knowledge about the use of measurement scales for PUs [ 13 ]. Marechal Campos, Bairro: Predictive validity of waterllow Braden scale for pressure ulcer risk in critical care patients. Journal List Open Nurs J v. The occurrence of PUs in patients in the postoperative period is presented in another study, in which variables related to surgical patients, such as length of anesthesia and extent of the surgery, were predictive for the development of PUs The present study has some limitations.
These evaluations shortly after the hospitalization of the patients in intensive care are critical, as, in many cases, there is an indication of restriction to the bed, use of vasoactive drugs, mechanical ventilation and sedation. PUs develop with tissue pressure over a bony prominence that has an intensive capability of collapsing the capillary of that region, and in association with friction and shear, abrasion may occur, facilitating the onset of injuries [ 45 ].
To unconscious patients, the permission wasgiven by their family or guardians. This result indicates the necessity for nurses to develop health education to prevent PU in this population. ROC curves for the cutoff scores of the Braden scale with critically ill patients, according to the evaluation.
Most did not receive guidance before waterow onset pressure ulcers; only some of them were advised. The instrument used was a composite form of four parts: So, since the patient admission, the nursing care is animportant predictive factor to the PU outcome, becausethe concern in examining the patient’s skin, giving thepreventive inputs and monitoring them with instrumentswhich show effective preventive potential, both negativeand positive, can be the guarantee of PU absence duringthe hospitalization.
Patients were informed of the purpose of the research, method and possible risks, and they were asked to sign an informed consent form. Even though, nurses at theseinstitutions need to identify and understand each medicalspecialty and the PU risk correlations, in order to act onthe intrinsic and extrinsic factors related to PU.
Data included social and clinical information and the risk factors of the Braden, Norton and Dde scales. This finding confirms the study assumptions. In the first stage the PU incidence calculation was performed; in the second the evaluation was performed and the accuracy of the Braden and Waterlow scales was calculated using the statistical package STATA Version Mortality is related to the worsening of clinical conditions.
Rev Lat Am Enfermagem.
Most patients had a high risk for developing a PU. Therefore, preventive actions are necessary to be taken in the ICU, which can help nurses avoid the occurrence of this adverse event [ 10 ]. The mean scores in the three first evaluations were