A new pressure ulcer conceptual framework. (31st March 2014)

• Record Type: Journal Article
• Authors: Coleman, Susanne; Nixon, Jane; Keen, Justin; Wilson, Lyn; McGinnis, Elizabeth; Dealey, Carol; Stubbs, Nikki; Farrin, Amanda; Dowding, Dawn; Schols, Jos M.G.A.; Cuddigan, Janet; Berlowitz, Dan; Jude, Edward; Vowden, Peter; Schoonhoven, Lisette; Bader, Dan L.; Gefen, Amit; Oomens, Cees W.J.; Nelson, E. Andrea
• Is Part Of: Journal of advanced nursing. Volume 70:Number 10(2014:Oct.)
• Page Start: 2222
• Page End: 2234
• Publication Date: 2014-03-31
• Subjects: Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.12405
• Languages: English
• ISSNs: 0309-2402

Abstract

<abstract abstract-type="main" id="jan12405-abs-0001"> <title>Abstract</title> <sec id="jan12405-sec-0001" sec-type="section"> <title>Aim</title> <p>This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework.</p> </sec> <sec id="jan12405-sec-0002" sec-type="section"> <title>Background</title> <p>Recent work to develop and validate a new evidence‐based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP‐PG‐0407‐10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework.</p> </sec> <sec id="jan12405-sec-0003" sec-type="section"> <title>Design</title> <p>Discussion Paper.</p> </sec> <sec id="jan12405-sec-0004" sec-type="section"> <title>Data Sources</title> <p>The new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010–2011) and an international expert group meeting (conducted December 2011).</p> </sec> <sec id="jan12405-sec-0005" sec-type="section"> <title>Implications for Nursing</title> <p>A new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally.</p> </sec> <sec id="jan12405-sec-0006" sec-type="section"> <title>Conclusion</title> <p>By integrating existing knowledge from epidemiological, physiological and biomechanical evidence, a theoretical causal pathway and new conceptual framework are proposed with potential implications for practice and research.</p> </sec> </abstract>