Non-Invasive Screening Method for Pressure Ulcers Detailed
Researchers from the University of California at Los Angeles recently described a non-invasive method to identify patients at risk of developing pressure ulcers. The team published their research efforts in the Journal of the American Geriatrics Society.
The team evaluated measurement of subepidermal moisture (SEM) as a non-invasive, biophysical marker of future development of pressure ulcers in a cohort of nursing home patients. The study included 35 participants from two different facilities, the average age of patients was 84.7 years. The significant majority of patients were female (83 percent) and non-Hispanic whites (80 percent).
Patients underwent skin examination with SEM and visual skin assessment (VSA) of erythema. Evaluation considered the buttocks, left and right trochanters, ischial tuberosities, and sacrum.
SEM was measured with a handheld, portable, user-friendly dermal phase meter to determine skin impedance. The device evaluates the amount of moisture content within skin tissues. Higher readings from this device indicate more SEM; results are expressed as dermal phase units (DPUs) and results range between 0 -999. VSA included a three point rating system: normal, Stage 1 pressure ulcer, and Stage 2+ pressure ulcer.
Findings from SEM measurement were correlated with development of Stage 1 ulcers within one week of examination and VSA. Other factors included in the analysis were anatomic site, patient ethnicity, Braden Scale pressure ulcer risk status, and concurrent moisture. Statistical analysis also addressed effects of clustering.
Patients with normal skin had the lowest SEM, followed by patients with Stage 1 ulcers. Patients with Stage 2+ ulcers had the highest levels of SEM; this analysis was statistically significant. Additionally, SEM was able to capture changes noted with VSA. SEM was able to predict risk of developing a Stage 1 ulcer within the next week, higher results indicated greater likelihood. The Odds Ratio calculated was 1.26 for every 100-point increase in DPU, a statistically significant finding.
The team concluded that SEM can accurately identify current pressure ulcers as well as the likelihood of pressure ulcer development within one week. One benefit of this risk assessment approach compared to VSA is that it assessment ameliorates differences introduced by skin color, which can moderate VSA findings. In addition, early identification of patients at risk allows for commencement of preventive efforts. Continued research to identify a threshold of levels procured with SEM may foster development of prevention approaches.
The New Jersey Hospital Association reported positive findings from statewide implementation of new protocols to reduce the incidence of pressure ulcers among inpatients at over 150 different institutions across the state. Details on that effort were previously published on Hospital Buyer.
September 4, 2007 Related topics: New Technology & Innovation, Monitoring, Diagnostic, Gerontology