Part 2: pressure ulcer assessment: implementation and revision of CALCULATE

Nursing in Critical Care
Annette Richardson, Christine Straughan

Abstract

Critically ill patients are a vulnerable group at very high risk of developing pressure ulcers, and the incidence varies within critical care. A number of strategies were used to implement the pressure ulcer assessment tool CALCULATE across four adult critical care units. Strategies included, nursing leadership, the provision of definitions for each risk factor, information laid out on posters at each patient's bedside, changes to pre-printed nursing documentation and a 30-min focused training package. Two local audits were conducted to measure the number and types of risk factors occurring in patients with pressure ulcers, and to assess the frequency of assessments and gain feedback on the usability of the tool in practice. Critical care acquired pressure ulcer incidence was 3.4%. The two most commonly occurring risk factors were impaired circulation (82%) and mechanical ventilation (75%). Patients had a mean score of 4, and 65% had 4 or more reported risk factors. Feedback on the usability of the tool was mainly positive. The tool CALCULATE was relatively straightforward to implement and was likely to be due to the design and the various change strategies used to implement the new approach. The seven point tool was revised to...Continue Reading

References

Oct 10, 2002·Intensive Care Medicine·B Paul J A KellerChristian van der Werken
Dec 29, 2006·The New England Journal of Medicine·Peter PronovostChristine Goeschel
Dec 17, 2008·Journal of Clinical Nursing·Nele NijsGreet Van Den Berghe
Jan 8, 2010·The Journal of Neuroscience : the Official Journal of the Society for Neuroscience·Mads GrønborgReinhard Jahn
May 27, 2010·Journal of Clinical Nursing·Toshiko KaitaniHiromi Sanada
Mar 29, 2011·Postgraduate Medical Journal·Douglas J NobleEmma Stanton
Jun 19, 2015·Nursing in Critical Care·Annette Richardson

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Citations

Nov 3, 2016·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Peggy KalowesMelanie Li
May 6, 2020·Nursing in Critical Care·Ampornpan TheeranutPanita Limpawattana
Apr 12, 2017·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Annette RichardsonIain J McCullagh

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