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

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

The Impact of University Collaborative Learning on Student Academic Achievement: A Wiki for Political and Management Science

El objetivo del proyecto es llevar a la práctica una acción formativa basada en la web 2.0 con la participación de profesores y alumnos pertenecientes a distintos grados, facultades y universidades. En concreto, esta iniciativa pretende continuar con la wiki, www.dcpa.wikidot.com, que comenzó a realizarse en 2015 en virtud de la convocatoria de PIMCD. La wiki contribuye a que los estudiantes, de manera colaborativa, diseñen un proyecto educativo de integración curricular a partir de unos supuestos establecidos previamente por el profesor. Por lo tanto, este tipo de experiencia permite crear una base documental de gran utilidad para otros alumnos que estudian este tipo de asignaturas o para cualquier persona que muestren una inquietud o necesidad de buscar, encontrar o ampliar el conocimiento sobre determinadas cuestiones relacionadas con la Ciencia Política y la Ciencia de la Administración. Además, este año vamos a incorporar al proyecto de innovación la creación de un blog, como una experiencia piloto, en una de las asignaturas de los profesores del equipo. De esta manera, se continúa avanzando en el aprendizaje colaborativo, así como en la interacción entre el profesor y el alumno. El blog, al igual que la wiki, permite difundir de lo que ocurre en el aula al resto de la sociedad, contribuyendo a la transferencia del conocimiento. La razón principal de haber elegido estas herramientas es que este tipo de aplicaciones, bajo la estructura de un procesador de texto en línea, permite que cualquier persona pueda escribir, publicar fotografías o vídeos, archivos o links, sin ninguna complejidad. Además, contribuye a renovar las metodologías de enseñanza, ya que favorece el aprendizaje colaborativo (el conocimiento se comparte) y refuerza la relación de confianza entre profesor-alumno, ya que el estudiante adquiere un rol activo en el proceso de recopilación, análisis y difusión de conocimiento. De este modo, el estudiante adquiere competencias y habilidades de una manera dinámica. No obstante, para que las tecnologías generen valor en los procesos de enseñanza-aprendizaje es necesario que los profesores nos centremos en diseñar unas experiencias de aprendizaje adaptadas a ellas. Solo de esta manera, la wiki y el blog pueden contribuir a la construcción del conocimiento y a la resolución de problemas de manera progresiva y evolutiva, de fomento de la capacidad crítica, evaluación de la información y el cuestionamiento de la realidad, y compromiso por un análisis equilibrado del trabajo de otros y contra los prejuicios. Por tal motivo, se presentará a los estudiantes una serie de pautas que deberán seguir para su buen desarrollo. En cuanto a la wiki, en primer lugar, se explicará el programa de la asignatura y se les indicarán que podrán desarrollar analíticamente cualquier concepto o acontecimiento que guarde relación con la misma, y en segundo lugar, se les señalara que deberán formar un grupo de 4 personas para poder llevar a cabo tal tarea, y que, una vez que determinen el tema a trabajar, deberá concretarlo con la profesora para evitar duplicidades y recibir los fundamentos sobre las cuales deberán vertebrar sus trabajos. En cuanto al blog, se expondrá a los alumnos de la asignatura de “Sistema político español”, que se creará una bitácora común para toda la clase en la que los mismos grupos de la wiki publicar una noticia, un video, una nota de prensa, etc relacionada con cada tema de la asignatura, y además deberán comentar esta aportación y vincularla con la parte teórica. Así, la innovación docente que se pretende conseguir es fomentar el trabajo colaborativo dentro y fuera del aula. En la actualidad, la wiki cuenta con 308 conceptos, por lo que esta iniciativa contribuirá a ampliar la información y el conocimiento sobre la Ciencia Política y la Ciencia de la Administración, incrementado, así, su repercusión, al igual que el blog. Con ello, los alumnos aprenderán a trabajar en grupo y de forma ordenada y continuada, además de adquirir una serie de herramientas que podrán ser empleadas en otras asignaturas y aspectos de su vida personal y profesional. Además, se medirá y evaluará su rendimiento académico para conocer si esta nueva metodología de aprendizaje permite mejorar los resultados de los estudiantes. Gracias a ello, los profesores podrán proponer nuevas herramientas docentes que tiendan a dirigir a los estudiantes hacia aquél enfoque de aprendizaje que proporcione mejor rendimiento.The aim of the project is to implement a training action based on web 2.0 with the participation of teachers and students belonging to different degrees, faculties and universities. Specifically, this initiative aims to continue with the wiki, www.dcpa.wikidot.com, which began to be carried out in 2015 under the PIMCD call for proposals. The wiki helps students, in a collaborative manner, to design an educational project of curricular integration based on assumptions previously established by the teacher. Therefore, this type of experience makes it possible to create a very useful documentary base for other students studying this type of subject or for anyone who shows an interest or need to search for, find or expand knowledge on certain issues related to Political Science and Management Science. In addition, this year we are going to incorporate into the innovation project the creation of a blog, as a pilot experience, in one of the subjects taught by the team's lecturers. In this way, we continue to make progress in collaborative learning, as well as in the interaction between teacher and student. The blog, like the wiki, allows the dissemination of what happens in the classroom to the rest of society, contributing to the transfer of knowledge. The main reason for choosing these tools is that this type of application, under the structure of an online word processor, allows anyone to write, publish photographs or videos, files or links, without any complexity. Moreover, it contributes to renew teaching methodologies, as it favours collaborative learning (knowledge is shared) and reinforces the relationship of trust between teacher-student, as the student acquires an active role in the process of gathering, analysing and disseminating knowledge. In this way, the student acquires competences and skills in a dynamic way. However, for technologies to generate value in the teaching-learning process, it is necessary for teachers to focus on designing learning experiences adapted to them. Only in this way can the wiki and the blog contribute to the construction of knowledge and problem solving in a progressive and evolutionary way, fostering critical capacity, evaluation of information and questioning of reality, and commitment to a balanced analysis of the work of others and against prejudices. For this reason, students will be presented with a series of guidelines to follow for its proper development. As for the wiki, firstly, the syllabus of the subject will be explained and they will be told that they will be able to analytically develop any concept or event related to it, and secondly, they will be told that they will have to form a group of 4 people to carry out this task, and that, once they have determined the topic to work on, they should discuss it with the teacher to avoid duplication and to receive the foundations on which they should base their work. As for the blog, it will be explained to the students of the subject "Spanish political system" that a common blog will be created for the whole class in which the same wiki groups will publish a news item, a video, a press release, etc. related to each subject of the course, and they will also have to comment on this contribution and link it to the theoretical part. In this way, the teaching innovation that is intended to be achieved is to encourage collaborative work inside and outside the classroom. At present, the wiki has 218 concepts, so this initiative will contribute to expanding information and knowledge about Political Science and Administration Science, thus increasing its impact, just like the blog. In this way, students will learn to work in groups and in an orderly and continuous manner, as well as acquiring a series of tools that can be used in other subjects and aspects of their personal and professional lives. In addition, their academic performance will be measured and evaluated to find out whether this new learning methodology improves students' results. As a result, teachers will be able to propose new teaching tools that tend to direct students towards the learning approach that provides the best performance.Depto. de Ciencia Política y de la AdministraciónFac. de Ciencias Políticas y SociologíaFALSEUCMsubmitte

Incidence and clinical manifestations of giant cell arteritis in Spain: results of the ARTESER register

Objective This study aimed to estimate the incidence of giant cell arteritis (GCA) in Spain and to analyse its clinical manifestations, and distribution by age group, sex, geographical area and season.Methods We included all patients diagnosed with GCA between 1 June 2013 and 29 March 2019 at 26 hospitals of the National Health System. They had to be aged ≥50 years and have at least one positive results in an objective diagnostic test (biopsy or imaging techniques), meet 3/5 of the 1990 American College of Rheumatology classification criteria or have a clinical diagnosis based on the expert opinion of the physician in charge. We calculated incidence rate using Poisson regression and assessed the influence of age, sex, geographical area and season.Results We identified 1675 cases of GCA with a mean age at diagnosis of 76.9±8.3 years. The annual incidence was estimated at 7.42 (95% CI 6.57 to 8.27) cases of GCA per 100 000 people ≥50 years with a peak for patients aged 80–84 years (23.06 (95% CI 20.89 to 25.4)). The incidence was greater in women (10.06 (95% CI 8.7 to 11.5)) than in men (4.83 (95% CI 3.8 to 5.9)). No significant differences were found between geographical distribution and incidence throughout the year (p=0.125). The phenotypes at diagnosis were cranial in 1091 patients, extracranial in 337 patients and mixed in 170 patients.Conclusions This is the first study to estimate the incidence of GCA in Spain at a national level. We found a predominance among women and during the ninth decade of life with no clear variability according to geographical area or seasons of the year

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 (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected