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A Quality Improvement Project Comparing Two Treatments for Deep-Tissue Pressure Injuries to Feet and Lower Legs of
Autumn Henson1, Laurie Kennedy-Malone
1Autumn Henson, DNP, GNP-BC, WCC is Nurse Practitioner, Physicians Eldercare, Winston-Salem, North Carolina. Laurie Kennedy-Malone, PhD, GNP-BC, FAANP, FGSA is Professor of Nursing, University of North Carolina at Greensboro, Greensboro, North Carolina. The authors have disclosed no financial relationships related to this article. Submitted September 26, 2019; accepted in revised form November 26, 2019.
Objective:
To retrospectively examine clinical outcomes from a feasibility study that compared two treatment options for deep-tissue pressure injuries (DTPIs), including the clinical indicators increasing the risk of deteriorating DTPIs among long-term care residents.
Methods:
A retrospective chart audit of 40 DTPIs from 33 long-term care residents in two long-term care facilities was conducted to compare (1) polymeric membrane dressings (PMDs) with offloading and (2) a skin barrier film with offloading.
Results:
Of the 13 DTPIs treated with PMDs, only 23% deteriorated to a stage 3 or 4 pressure injury (PI), whereas of the 27 DTPIs treated with skin barrier film, 41% deteriorated to a stage 3 or 4 PI. The clinical factors found to increase the risk of developing and deteriorating DTPIs included weight loss, hypoalbuminemia, debility, dementia, coronary artery disease, and cerebrovascular disease.
Conclusions:
The PMD group's DTPIs evolved into fewer open PIs despite having higher percentages of clinical indicators for DTPIs. The project findings support the use of PMD dressings for DTPIs; however, more robust research is warranted.
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