Paper: Assessing Risk for Pressure Ulcers Using Ultrasound Technology (19th International Nursing Research Congress Focusing on Evidence-Based Practice)

Wednesday, 9 July 2008

Chin-Hong Lin, BA , Decker School of Nursing, Binghamton University, Binghamton, NY

Sarah Gueldner, DSN, RN , Decker School of Nursing, Binghamton University, Binghamton, NY

Learning Objective 1: Describe conditions that predispose patients to be at risk for the development of skin ulcers.

Learning Objective 2: Identify methods for assessing patients at risk for developing pressure ulcers.

Nine percent of all hospitalized patients and 23 percent of all nursing home patients develop pressure ulcers, defined as damage or injury to the skin and underlying tissue caused by pressure or friction. Pressure ulcers are associated with morbidity and mortality, and contribute to the cost of health care, longer hospital stays, and quality of life. Over the past two decades several assessment tools have been developed, including the Braden Scale, and more recently the Evaluation of Quality Improvement Program (EQuiP). While these measures have improved the ability to assess for risk of skin breakdown to some degree, they lack the sensitivity to predict skin breakdown in many cases. But exciting high frequency ultrasound technology has recently been developed that specifies the level of risk for developing pressure ulcers by examining the distribution of fluid under each of the three layers of the skin. The risk of developing pressure ulcers is classified into higher, moderate, or lower level of risk. Those with high and very high risk were reported to be 1.6 to 3 times more likely to develop a pressure ulcer. The images generated can also be compared with previous images, giving nurses and other health care providers an objective measure of the effectiveness of preventive care interventions. Registered nurses can be trained to conduct the assessment and interpret the images. The instrument itself is about the size of a laptop computer, and is portable. This presentation will provide a review of literature related to high frequency ultrasound technology as a method for predicting risk for skin break down, and will discuss the application of this technology to improve quality of skin care in populations known to be at risk for skin break down.

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