Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

COVID-19's Impact on Ypsilanti's Residents of Color

COVID-19's impact on Ypsilanti's residents of color is discussed, with particular attention to deaths, unemployment, ability to work from home and so forth.Poverty Solutionshttp://deepblue.lib.umich.edu/bitstream/2027.42/171897/1/covid-19-impact-on-ypsilanti-residents-of-color.pdfDescription of covid-19-impact-on-ypsilanti-residents-of-color.pdf : Main articleSEL

Dismantling borders and boundaries: capturing the perspectives of the 'other'

Recent discussion in higher education that followed from the Bradley Report (2009) and Masters Report (2008) highlights the importance of supporting first year pre-service teachers' transition to university, particularly in regional universities which have a higher proportion of students from culturally diverse backgrounds including a high proportion of Indigenous students. Kift (2009) contends that a "transition pedagogy" in first year curriculum is particularly important in facilitating a successful first year university experience for diverse student cohorts. A holistic approach involving cross-institution partnerships between academic and support staff is key to enhancing first year experience (Kift, 2009, Kift & Nelson, 2005).\ud \ud This paper reports on the successful collaboration between academic staff, a Faculty librarian and graduating students across disciplinary boundaries in conceptualising and producing a multi-layered, online induction in core academic skills (iCAS) for over 400 first year Education students in James Cook University. The creation of iCAS drew on first year experience literature and cross-institution collaboration with an emphasis on information literacy to enable the development of student research and information access. Cross-institution discourse was focused on the process and outcomes of harnessing different knowledges and perspectives from varying disciplines.\ud \ud Additionally, preliminary survey findings from student feedback on iCAS indicate that students are greatly valuing the presence of a transition pedagogy embedded within the curriculum. A key to the articulation of this 'transition' is the presence of multiple voices and perspectives in making visible the 'hidden curriculum' in university study, with the focus on first year Education students. When engaging students with diverse knowledges, gathering the expertise and perspectives of colleagues from non-education faculties augments the knowledge present in education schools. This article concludes with reflections on the importance and the process of implementation for cross-institution partnerships in teacher education and transition pedagogies

Making room for Gadamer: "promoting intellectual well-being in academic learning"

Student retention, particularly first year undergraduates, is a key concern in Australian universities as it has an implication on universities' financial health. This paper contends that the development of methodologies for communicative agendas that respect student diversity and create spaces for open-ended dialogue in the tradition of Gadamer's proposals is a worthwhile consideration in supporting first year student retention and engagement in university study. It discusses an online induction in core academic skills (iCAS) program for about 400 first year Education undergraduates in a university in regional Australia. Given the diversity in sociocultural and academic backgrounds of the student cohort, the expertise that contributed to iCAS crossed disciplinary and traditional boundaries, and it was this collaboration that enabled the design of an empathetic, inclusive and holistic support to the development of students' academic skills and the promotion of intellectual well-being in relation to their university endeavours. In addition, in this paper we ask how we might open spaces for more equitable communication wherein self-evaluative awareness is promoted for learners and educators equally. With the recognition that there is urgent need for the development of programs and strategies that embrace diverse learner cohorts and promote self-reliance, we look at the role of personal trust in learner-educator relationships in the development of first year university learners

Relationships are key: building intercultural capabilities for Indigenous postgraduate coursework students and their teachers [final report of the project Keeping on track: teacher leaders for Indigenous postgraduate coursework students]

Relationships are key is the final report of the project Keeping on track: teacher leaders for Indigenous postgraduate coursework students. The project focused on disciplinary and cross-disciplinary leadership to enhance learning and teaching through leadership capacity-building in discipline structures, communities of practice and cross-disciplinary networks, with an emphasis on strengthening teacher leader capabilities of lecturers involved in the teaching of Indigenous postgraduate coursework students.\ud \ud The overall purpose of Keeping on Track was to clearly delineate and to improve teacher leadership practices across higher education institutions in Australia serving Indigenous postgraduate coursework students, as differentiated from practices in supervision of postgraduate research students. Marshall (2008) states that studies that focus on the 'how' of development of leadership capability in learning and teaching are limited. It is the 'how' of teacher leadership which this project addressed, through the design and development of a Blueprint for Intercultural Capabilities informed by the experiences of Indigenous postgraduate course work students and their teachers.\ud \ud The Keeping on Track project aimed to answer three research questions focused on the Indigenous postgraduate coursework experience by collecting and analysing the teaching an d learning experiences of Indigenous students and their teachers in postgraduate coursework programs. Data were collected through an online survey and the establishment and operation of a University Community of Practice (UCoP) at participating universities, through which focus group discussions and interviews were held. Project end aims were to consider the implications of the data collected, and make recommendations for strengthening teacher leadership capabilities in the teaching and learning of Indigenous postgraduate students through the development of a teacher leadership capabilities framework which would be developed, trialled and evaluated.\ud \ud Four findings became clear towards the end of the project:\ud \ud 1. the value of UCoP in forming an intercultural space in which the process of teaching and learning is the focus;\ud \ud 2. that intercultural capabilities are required by both teachers and students to engage fully with the cultural interface of teaching and learning;\ud \ud 3. that this requires intercultural sensitivity (Bennett, 2004); and,\ud \ud 4. that relationships are key to intercultural exchanges and building intercultural sensitivity.\ud \ud As such, there is no recommendation for a teacher leadership framework, but rather recommendation s for encouraging intercultural development through student/teacher encounters facilitated through the establishment of UCoPs . These are:\ud \ud 1. where UCoPs aren't established, that universities through their Learning and Teaching Centres (or equivalent departments), facilitate the development of one in order to encourage student/teacher encounters; and,\ud \ud 2. that the Blueprint for Intercultural Capabilities forms the basis for the functioning of UCoPs