Risk Factors for Pressure Injuries Among Critical Care Patients: A Systematic Review

Objective: To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients. Design: We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. Data sources: We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus. There was no language restriction. Method: A research librarian coordinated the search strategy. Articles that potentially met inclusion criteria were screened by two investigators. Among the articles that met selection criteria, one investigator extracted data and a second investigator reviewed the data for accuracy. Based on a literature search, we developed a tool for assessing study quality using a combination of currently available tools and expert input. We used the method developed by Coleman et al. in 2014 to generate evidence tables and a summary narrative synthesis by domain and subdomain. Results: Of 1753 abstracts reviewed, 158 were identified as potentially eligible and 18 fulfilled eligibility criteria. Five studies were classified as high quality, two were moderate quality, nine were low quality, and two were of very low quality. Age, mobility/activity, perfusion, and vasopressor infusion emerged as important risk factors for pressure injury development, whereas results for risk categories that are theoretically important, including nutrition, and skin/pressure injury status, were mixed. Methodological limitations across studies limited the generalizability of the results, and future research is needed, particularly to evaluate risk conferred by altered nutrition and skin/pressure injury status, and to further elucidate the effects of perfusion-related variables. Conclusions: Results underscore the importance of avoiding overinterpretation of a single study, and the importance of taking study quality into consideration when reviewing risk factors. Maximal pressure injury prevention efforts are particularly important among critical-care patients who are older, have altered mobility, experience poor perfusion, or who are receiving a vasopressor infusion

Advancing Toward Electronic Exchange of Poisoning Information

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lecture

A Low-cost, Low-barrier Clinical Trials Registry to Support Effective Recruitment

Introduction: Recruitment of representative samples is a key factor in reproducible research. Emerging recruitment approaches that leverage the electronic health record (EHR) can strengthen recruitment of representative samples; A clinical trials registry that stores data about clinical and translational studies, including structured inclusion and exclusion criteria, is necessary for EHR based recruitment; Clinical trials registries can support reporting and monitoring of clinical trials. Conclusions: Developed a model for a low-cost, low-barrier institutional clinical trials registry, based upon REDCap; Based upon free, open source software commonly used in clinical research, this model is a low-cost, low-barrier option for institutions conducting clinical and translational research; The structure of the inclusion and exclusion criteria within the registry is essential for EHR supported recruitment approaches; This analysis and design project requires development and evaluation as proof-of-concept

Re-envisioning the Management of Poisoning Information

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lecture

Building a Knowledge Base for Health Information Exchange Between Emergency Departments and Poison Control Centers

Lecture presentations hosted by the College of Nursing featuring faculty, graduate students, nursing professionals, and allied health experts. Each lunchtime lecture is devoted to a timely topic examining the training, research and scholarly needs of the nursing community.Lecture

Grand Rounds Research Reproducibility - Mollie R. Cummins, PhD (03-13-2018)

Spencer S. Eccles Health Sciences Library Grand Rounds: Research Reproducibility (GRRR). "Peer Review and Research Reproducibility" video lecture by Mollie R. Cummins, PhD, RN, FAAN, FACMI, Associate Professor and Associate Dean for Research and PhD Program, College of Nursing, Adjunct Associate Professor, Biomedical Informatics Research School of Medicine. http://bit.ly/Mollie-Cummins GRRR is a weekly endeavor to raise awareness about reproducibility issues, showcase Utah researchers' work, and to create an open forum for discussions. Grand Rounds: Research Reproducibility website: http://campusguides.lib.utah.edu/UtahRR18/GRR

A Low-cost, Low-barrier Clinical Trials Registry to Support Effective Recruitment

<p>Cummins, M.R., Gouripeddi, R., & Facelli, J. (2016). A Low-cost, Low-barrier Clinical Trials Registry to Support Effective Recruitment (poster). Research Reproducibility 2016. Salt Lake City, UT, USA</p

Outcomes Associated with Stage 2 Pressure Injuries Among Surgical Critical Care Patients: A Retrospective Cohort Study

Background Hospital-acquired pressure injuries are a serious problem among critical care patients. Although most hospital-acquired pressure injuries are stage 2 (partial-thickness skin loss with exposed dermis), no studies have examined outcomes of stage 2 pressure injuries among critical care patients. Objectives To examine outcomes of stage 2 hospital-acquired pressure injuries among critical care patients and identify factors associated with nonhealing stage 2 hospital-acquired pressure injuries. Methods Electronic health record data were used to identify surgical critical care patients with stage 2 hospital-acquired pressure injuries at a level I trauma center. Univariate Cox regressions were used to identify factors associated with healed stage 2 hospital-acquired pressure injuries. Results Of 6376 surgical critical care patients, 298 (4.7%) developed stage 2 hospital-acquired pressure injuries; complete data were available for 253 patients. Of these 253 patients, 160 (63%) had unhealed pressure injuries at hospital discharge. Factors inversely related to the presence of a healed hospital-acquired pressure injury were older age (hazard ratio, 0.98; 95% CI, 0.97-0.99; P = .003), elevated serum lactate (hazard ratio, 0.85; 95% CI, 0.75-0.96; P = .01), elevated serum creatinine (hazard ratio, 0.87; 95% CI, 0.77-0.98; P = .02), and lower oxygenation (hazard ratio, 0.64; 95% CI, 0.41-1.00; P = .05). Conclusions Stage 2 hospital-acquired pressure injuries were not healed at discharge in 63% of the patients in our sample. Nurses should be especially vigilant in treating pressure injury patients who are older, have altered oxygenation or perfusion (elevated serum lactate level or decreased oxygenation), or have evidence of renal compromise