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Clinical Research
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Braden scale: a pathway to quality of care Cristina Miguens, Joao Gouveia, Pedro Ferreira, Katia Furtado INTRODUCTION: Actually, the pressure sores are a public health problem. However, it doesn't reflect on better work conditions, such as more and better prepared health care professionals and materials, maybe because of the lack of data about pressure sores in Portugal. In 2002, the Institute of Quality in Health, with the partnership of GAIF, implemented a project financed by the Program Health XXI, with the purpose of achive a better quality of care to paciente inward in the Portuguese Hospitals, through the prevention of pressure sores, with special atention on the Braden Scale. This is a 3 year project and itÕs expected to achieve 130.000 patients during the study. The funds granted were 12000. This project includes 8 hospitals from medium dimension to Central Hospitals, been suported on the field by 3000 nurses (mean of 10% of the total nurses in Portugal) METHODS: The method choosen to apply this project, weÕre to give education about the Braden Scale and the ways to prevent pressure sores, to 2 nurses from each ward, who we're responsable for educate all the nurses from their own ward, and all the nurses who had received eduction from the main investigators, had to create guidelines about prevention of pressure sores, who should be applied in association with the Braden Scale. There weÕre made prevalence studys all hospitals at the same time, and incidence studys, to evaluate the efficacy of the measures applied. There we're made follow-ups to all the 8 hospitals, with evaluation of the inter e intra-rater reliability. RESULTS: On the 31th August, we had collected datas from 24925 patients on the incidence studys and 3095 patients on the prevalence studys. For the first time, it was possible to determinate the mean prevalence of pressure sores in Portugal, that was 13,60%, and the mean incidence of pressure sores, which was 5,60%. We still have ongoing datas to look at, so in May we belive to be in position to present the evolution of the aplication of the Braden Scale and the evolution of the prevalence and incidence rates of pressure sores. SUMMARY: We do belive that a project, based on a validated tool and the implementation of guidelines on prevention of pressure sores, may be useful to achive standards of quality of care and better use of health care professionals and the diminution on the time of hospital stay and better cust-efectiviness on the means and materials used on the prevention of pressure sores. We do belive that this is the way to achive a better quality of care. |
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