Background: Stroke patient has a risk of experiencing pressure injury, which could affect patient’s life and quality of life; therefore, optimum pressure ulcer prevention should be done. Patients experiencing pressure ulcer should be given appropriate care, to prevent infection and worse conditions.
Objective: To identify the prevalence, prevention and treatment of pressure injury of stroke patients in the neurological ward.
Methods: This research was a quantitative descriptive research using Landelijke Prevalentiemeting Zorgroblemen instrument. The samples were collected using consecutive sampling method with inclusion criteria of stroke patients experiencing paraplegia, which obtained 30 respondents. Data were presented in frequency distribution format.
Results: The result showed that the prevalence of pressure injury was 3.3% of degree III and brought from home. Based on risk assessment, 43.3% of patients had a very high risk of getting pressure injury, and 56.7% had changed position, 100% had received nutritional support but 80% of patients had not received health education and 83.3% did not get a pillow on their heels, and 100% did not get pressure injury mattress, massage, moisturizing cream and oil. Treatment of pressure injury was using 0.9% NaCl liquid with hydrocolloid dressing.
Conclusion: It can be concluded that there are still some patients experiencing pressure injury and in terms of items of pressure injury prevention, which often done is malnutrition prevention, the least are the changes of position in using pillows, and in health education. The one that have never been done are the use of oil, moisturizing cream, massage and pressure air mattress. The injury treatment provided to the patient has been adequate. The suggestion that can be given is the preparation of standard operating procedure, leaflets and the provision of pressure air mattress.
Amir, Y. (2015). Quality of pressure ulcer care in Indonesian hospitals. Netherlands: Maastricht University.
Amir, Y., Tan, F., Halfens, R., Lohrmann, C., & Schols, J. (2017). Pressure ulcer prevalence and care in indonesian hospitals: A multicenter, cross-sectional evaluation using an extended donabedian model. Ostomy/Wound Management, 63(2), 8-23.
Batticaca, F. B. (2008). Asuhan keperawatan pada klien dengan gangguan sistem persarafan [Nursing care for patients with neurogical system disorder]. Jakarta: Salemba Medika.
Duimel-Peeters, I., Halfens, R., Berger, M., & Snoeckx, L. (2005). The effects of massage as a method to prevent pressure ulcers. A review of the literature. Ostomy/Wound Management, 51(4), 70-80.
Engels, D., Austin, M., McNichol, L., Fencl, J., Gupta, S., & Kazi, H. (2016). Pressure ulcers: Factors contributing to their development in the OR. AORN Journal, 103(3), 271-281.
Hunter, I. A., & Edwards, K. J. (2017). Managing pressure sores. Surgery (Oxford), 35(9), 505-510.
Jordan, A. (2017). Pressure injury in the ICU: Major reconstructive surgery required. In Vignettes in Patient Safety-Volume 1. London: InTech.
Kirman, C. N., & Geibel, J. (2018). Pressure ulcers and wound care. Retrieved from https://emedicine. medscape.com/article/190115-treatment - showall
Lahmann, N. A., Tannen, A., Dassen, T., & Kottner, J. (2011). Friction and shear highly associated with pressure ulcers of residents in long‐term care–Classification Tree Analysis (CHAID) of Braden items. Journal of Evaluation in Clinical Practice, 17(1), 168-173.
Lechner, A., Lahmann, N., Neumann, K., Blume-Peytavi, U., & Kottner, J. (2017). Dry skin and pressure ulcer risk: A multi-center cross-sectional prevalence study in German hospitals and nursing homes. International Journal of Nursing Studies, 73, 63-69.
Lee, S.-Y., Chou, C.-L., Hsu, S. P., Shih, C.-C., Yeh, C.-C., Hung, C.-J., . . . Liao, C.-C. (2016). Outcomes after stroke in patients with previous pressure ulcer: a Nationwide matched retrospective cohort study. Journal of Stroke and Cerebrovascular Diseases, 25(1), 220-227.
Lupiáñez-Pérez, I., Morilla-Herrera, J. C., Ginel-Mendoza, L., Martín-Santos, F. J., Navarro-Moya, F. J., Sepúlveda-Guerra, R. P., . . . Lupiáñez-Pérez, Y. (2013). Effectiveness of olive oil for the prevention of pressure ulcers caused in immobilized patients within the scope of primary health care: study protocol for a randomized controlled trial. Trials, 14(1), 348.
Mirwanti, R., Agustina, H. R., & Nuraeni, A. (2017). Hambatan yang dirasakan oleh perawat dalam melaksanakan pencegahan luka tekan di ruang perawatan intensif [Obtacles perceived by nurses in implementing pressure wound prevention in intensive care unit]. MEDISAINS, 15(1), 1-9.
Misbach, J. (2011). Stroke. Jakarta: Balai Penerbit FKUI.
Mohamed, S. A., & Weheida, S. M. (2014). Effects of implementing educational program about pressure ulcer control on nurses' knowledge and safety of immobilized patients. Journal of Nursing Education and Practice, 5(3), 12.
Moore, Z., Cowman, S., & Conroy, R. M. (2011). A randomised controlled clinical trial of repositioning, using the 30 tilt, for the prevention of pressure ulcers. Journal of Clinical Nursing, 20(17‐18), 2633-2644.
Mubarak, W. I., Indrawati, L., & Susanto, J. (2015). Buku ajar ilmu keperawatan dasar [Teaching book of basic nursing science]. Jakarta: Salemba Medika.
Mutia, L., Pamungkas, K. A., & Anggraini, D. (2015). Profil penderita ulkus dekubitus yang menjalani tirah baring di ruang rawat inap RSUD Arifin Achmad Provinsi Riau periode Januari 2011-Desember 2013 [Profile of bed-rest patients with decubitus ulcer at inpatient unit of RSUD Arifin Achmad Provinsi Riau in the period of January 2011-December 2013]. Jurnal Online Mahasiswa Fakultas Kedokteran Universitas Riau, 2(2), 1-11.
National Pressure Ulcer Advisory Panel, & European National Pressure Ulcer Advisory Panel. (2009). Pressure ulcer TREATMENT: Quick reference guide. Westford: National Pressure Ulcer Advisory Panel & European National Pressure Ulcer Advisory Panel.
Nix, D., Bryant, R. A., & Nix, D. P. (2012). Acute & chronic wounds: Current management concepts. Missouri: Elsevier Mosby.
NPUAP. (2016). National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury. Retrieved from http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/
Okatiranti, O., Sitorus, R. E., & Tsuawabeh, D. (2013). Risiko terjadinya dekubitus berdasarkan tingkat ketergantungan pasien di ruang perawatan neurologi [Risk of decubitus based on the level of patient's dependence at neurological unit]. Jurnal Keperawatan Padjadjaran, 1(3).
Palese, A., Saiani, L., Pota, I., Laquintana, D., Stinco, G., & Di Giulio, P. (2015). What is the healing time of stage II pressure ulcers? Findings from a secondary analysis. Advances in Skin & Wound Care, 28(2), 69-75.
Potter, P. A., & Perry, A. G. (2014). Fundamentals of nursing. Jakarta: Salemba Medika.
Pullen, R., & Anhold, M. (2011). Pressure ulcers: prevention and treatment. MMW Fortschritte der Medizin, 153(38), 80-83; quiz 84.
Qaddumi, J., & Khawaldeh, A. (2014). Pressure ulcer prevention knowledge among Jordanian nurses: a cross-sectional study. BMC Nursing, 13(1), 6.
Sauvage, P., Touflet, M., Pradere, C., Portalier, F., Michel, J., Charru, P., . . . Beauchêne, F. (2017). Pressure ulcers prevention efficacy of an alternating pressure air mattress in elderly patients: E²MAO a randomised study. Journal of Wound Care, 26(6), 304-312.
Simanjuntak, C. M., & Sirait, M. (2013). Pengaruh merubah posisi dan massase kulit pada pasien stroke terhadap terjadinya luka dekubitus di Zaal F RSU HKBP Balige [Effect of repositioning and skin massage in stroke patients on decubitus ulcer at Zaal F RSU HKBP Balige]. Jurnal Keperawatan, 1(2), 117-125.
Sulastri, N. T., Effendy, C., & Haryani, H. (2016). Pengaruh pemberian pendidikan kesehatan terhadap pengetahuan dan keterlibatan keluarga dalam pencegahan dekubitus pada pasien tirah baring [Effect of health education on knowledge and family involvement in preventing decubitus in bedrest patients]. Journal Ilmu Keperawatan, 3(3), 9.
Tallier, P. C., Reineke, P. R., Asadoorian, K., Choonoo, J. G., Campo, M., & Malmgreen-Wallen, C. (2017). Perioperative registered nurses knowledge, attitudes, behaviors, and barriers regarding pressure ulcer prevention in perioperative patients. Applied Nursing Research, 36, 106-110.
Tuffaha, H. W., Roberts, S., Chaboyer, W., Gordon, L. G., & Scuffham, P. A. (2016). Cost-effectiveness analysis of nutritional support for the prevention of pressure ulcers in high-risk hospitalized patients. Advances in Skin & Wound Care, 29(6), 261-267.
Utomo, W., Dewi, Y. I., & Abdurrasyid, T. (2014). Efektifitas nigella sativa oil untuk mencegah terjadinya ulkus dekubitus pada pasien tirah baring lama [Effectiveness of nigella sativa oil to prevent decubitus ulcers in bedrest patients]. Jurnal Ners Indonesia, 2(2), 151-157.
van Nie‐Visser, N. C., Schols, J. M., Meesterberends, E., Lohrmann, C., Meijers, J. M., & Halfens, R. J. (2013). An international prevalence measurement of care problems: study protocol. Journal of Advanced Nursing, 69(9), e18-e29.
This work is licensed under a Creative Commons Attribution 4.0 International License.