2.50
Hdl Handle:
http://hdl.handle.net/10755/157466
Type:
Presentation
Title:
BIOPHYSICAL MEASURE TO DETECT PRESSURE ULCERS IN ELDERS WITH DARK SKIN TONE
Abstract:
BIOPHYSICAL MEASURE TO DETECT PRESSURE ULCERS IN ELDERS WITH DARK SKIN TONE
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Chavez, Julienne, BS(c)
P.I. Institution Name:University of California, Los Angeles
Title:3rd Year Nursing Student
Contact Address:700 Tiverton Ave. 5-954 Factor Bldg, Box 956919, Los Angeles, CA, 90095-6919, USA
Co-Authors:Sean Scott; Lisa Miyamoto; Barbara Bates-Jensen
PURPOSE/AIMS: To examine the relationship between a measure of sub-epidermal skin moisture (SEM) and visual assessment of early pressure ulcer (PU) damage in nursing home (NH) residents with dark skin tones.
BACKGROUND: Visual assessment of PUs is difficult in persons with dark skin tones and the blanch response is often not observable in dark skin tones so diagnosing non-blanchable erythema (e.g., stage I PU) is unlikely. Inflammatory changes with local edema occur with tissue ischemia from pressure 3-10 days before visible skin changes. An alternative non-visual method of detecting early PU damage would be beneficial.
METHODS: 82 residents from 4 NHs were followed for 12 weeks. Participants received weekly concurrent visual skin assessments (skin rated as normal, blanchable erythema [BE], non-blanchable erythema/stage I PU [stage I PU], or ? stage II PU) and SEM measured with a hand held dermal phase meter across 9 anatomical locations (sacrum, buttocks, ischium, trochanters, heels) where higher SEM values indicated increased water in the skin and tissues. Data was analyzed with the observation as the unit of analysis with ANOVA used for comparison between groups. Data for the sacral location is presented.
RESULTS: Participants were diverse: 56% (46) female, 49% (n=40) Hispanic, 21% (n=17) African American. Mean Braden Scale score was 17.11 (SD 3.99), indicating risk for PU development. Participants were somewhat functionally dependent as indicated by the Minimum Data Set Bed Mobility mean score = 1.98 (SD 1.48) and Transfer Self Performance mean score =2.05 (SD 1.41). For observations at the sacral location of normal skin, BE, and stage I PU mean SEM values were significantly lower for Hispanics (normal: 38.7, SD 7.36; BE: 40.64 SD 8.35; stage I PU: 49.08, SD 8.24), highest for Caucasians (normal: 42.27, SD 8.38; BE: 51.22, SD 6.21; stage I PU: 52.28, SD 15.61) and in the middle for African American (normal: 40.95, SD 9.48; BE: 49.85, SD 5.59; stage I PU: 51.1, SD 21.24). The same pattern (SEM lower for Hispanic and highest for Caucasian) was observed in the other anatomic locations. In all groups, at the sacral and buttocks locations, mean SEM for normal skin was significantly lower from mean SEM for stage I (all P<.001).
IMPLICATIONS: Although results are preliminary, use of SEM for detecting early PU damage may help better detect early skin damage in persons with darkly pigmented skin. SEM threshold values may differ based on skin tone. This study provides a foundation for a larger study to implement and assess SEM as a more reliable method in comparison to visual assessments alone for detecting PUs. Further, this study provides important beginning information on characteristics of Hispanic and African American NH residents with PUs.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBIOPHYSICAL MEASURE TO DETECT PRESSURE ULCERS IN ELDERS WITH DARK SKIN TONEen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157466-
dc.description.abstract<table><tr><td colspan="2" class="item-title">BIOPHYSICAL MEASURE TO DETECT PRESSURE ULCERS IN ELDERS WITH DARK SKIN TONE</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Chavez, Julienne, BS(c)</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California, Los Angeles</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">3rd Year Nursing Student</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">700 Tiverton Ave. 5-954 Factor Bldg, Box 956919, Los Angeles, CA, 90095-6919, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">juliebird@ucla.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sean Scott; Lisa Miyamoto; Barbara Bates-Jensen</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE/AIMS: To examine the relationship between a measure of sub-epidermal skin moisture (SEM) and visual assessment of early pressure ulcer (PU) damage in nursing home (NH) residents with dark skin tones. <br/>BACKGROUND: Visual assessment of PUs is difficult in persons with dark skin tones and the blanch response is often not observable in dark skin tones so diagnosing non-blanchable erythema (e.g., stage I PU) is unlikely. Inflammatory changes with local edema occur with tissue ischemia from pressure 3-10 days before visible skin changes. An alternative non-visual method of detecting early PU damage would be beneficial. <br/>METHODS: 82 residents from 4 NHs were followed for 12 weeks. Participants received weekly concurrent visual skin assessments (skin rated as normal, blanchable erythema [BE], non-blanchable erythema/stage I PU [stage I PU], or ? stage II PU) and SEM measured with a hand held dermal phase meter across 9 anatomical locations (sacrum, buttocks, ischium, trochanters, heels) where higher SEM values indicated increased water in the skin and tissues. Data was analyzed with the observation as the unit of analysis with ANOVA used for comparison between groups. Data for the sacral location is presented. <br/>RESULTS: Participants were diverse: 56% (46) female, 49% (n=40) Hispanic, 21% (n=17) African American. Mean Braden Scale score was 17.11 (SD 3.99), indicating risk for PU development. Participants were somewhat functionally dependent as indicated by the Minimum Data Set Bed Mobility mean score = 1.98 (SD 1.48) and Transfer Self Performance mean score =2.05 (SD 1.41). For observations at the sacral location of normal skin, BE, and stage I PU mean SEM values were significantly lower for Hispanics (normal: 38.7, SD 7.36; BE: 40.64 SD 8.35; stage I PU: 49.08, SD 8.24), highest for Caucasians (normal: 42.27, SD 8.38; BE: 51.22, SD 6.21; stage I PU: 52.28, SD 15.61) and in the middle for African American (normal: 40.95, SD 9.48; BE: 49.85, SD 5.59; stage I PU: 51.1, SD 21.24). The same pattern (SEM lower for Hispanic and highest for Caucasian) was observed in the other anatomic locations. In all groups, at the sacral and buttocks locations, mean SEM for normal skin was significantly lower from mean SEM for stage I (all P&lt;.001). <br/>IMPLICATIONS: Although results are preliminary, use of SEM for detecting early PU damage may help better detect early skin damage in persons with darkly pigmented skin. SEM threshold values may differ based on skin tone. This study provides a foundation for a larger study to implement and assess SEM as a more reliable method in comparison to visual assessments alone for detecting PUs. Further, this study provides important beginning information on characteristics of Hispanic and African American NH residents with PUs. <br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:53:54Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:53:54Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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