Enhancing Quality of Palliative Home Care by Using the Nursing Innovative: A Pilot Study

Authors

  • Nopbhornphetchara Maungtoug 1College of Nursing and Health, Suan Sunandha Rajabhat University, Bangkok, Thailand.
  • Jinpitcha Mamom Faculty of Nursing, Thammasat University, Pathumthani, Thailand

Keywords:

Palliative care, home-based care, nursing innovation, pressure injury

Abstract

Introduction: Pressure injury is a complication which often occurs among patients in  a palliative period. Therefore, to prevent pressure injury, pressure ulcer management is important because it lessen physical and mental suffering of the patients and their families as well as reducing the care-related burden of a family.

          Research objectives: To examine the result of caring process by integrating the innovative turning bed. The average score of duration of pressure ulcer occurrence and level of opinions of patients' relatives towards the use of the care model were compared.

          Research methodology: This study used a two-group quasi-experimental design. Forty patients receiving palliative care at home were assigned to experimental group (n=20) and control group (n=20). The experimental group received the caring process combined with the use of innovative electric turning bed. The control group received regularly care model. This study was conducted between August 2018 and December 2018. Data collection tool consisted of a general data record form and the pressure ulcer occurrence record form. Data were recorded to report number of ulcers, level of pressure ulcers, and date of pressure ulcer occurrence. The tool used to conduct the study was the palliative care model consisting of: 1) the usage of the innovative electric turning bed; and 2) weekly telephone calls for monitoring the symptom.  Data were analyzed using descriptive statistics, and Mann-Whitney U test.

          Results: In the experimental group using the care model, there was no pressure ulcer occurrence.  This was significantly different from the control group receiving regular care whereby there was pressure ulcer occurrence accounting for 12 patients. Regarding opinions of patients’ relatives towards the use of the care model,  they thought that the developed care model together with the innovative electric turning bed was efficient in preventing pressure ulcer occurrence, reducing workload and injuries of caregivers who were patients' relatives.

          Conclusions: The result shows that the palliative care model integrated with the innovative electric turning bed was a practical tool to care for patients receiving palliative care at home. This might help to enhance quality of care among patients in this group.

          Implications: This is a guideline to enhance caregivers’ capability in palliative care at home.  Especially, it is for the prevention of pressure ulcers which will have many impacts on patients, family, and health system.

Downloads

Download data is not yet available.

References

Maida V, Ennis M, Kesthely C. Clinical parameters associated with pressure ulcer healing in patients with advanced illness. Journal of pain and symptom management. 2014;47(6):1035-42.

Phengjard J. Nurse’s Role in Palliative Care. JHNR [Internet]. 2014 [cited 2020Oct.6];30(1):100-9. Available from: https://he01.tci-thaijo.org/index.php/ bcnbangkok/ article/view/29280 (in Thai)

Mamom J, Ruchiwit M, & Hain D. Strategies of Repositioning for Effective Pressure Ulcer Prevention in Immobilized Patients in Home-Based Palliative Care: An Integrative Literature Reviews. J Med Assoc Thai. 2020;103(4):111.

Al Mutairi KB, Hendrie D. Global incidence and prevalence of pressure injuries in public hospitals: a systematic review. Wound Medicine 2018;22:23-31.

Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Advances in Wound Care 2018;7(2):57-67.

Kaur S, Singh A, Tewari MK, Kaur T. Comparison of two intervention strategies on prevention of bedsores among the bedridden patients: a quasi experimental community-based trial. Indian Journal of Palliative Care 2018;24(1):28.

Lavallée JF, Gray TA, Dumville J, Cullum N. Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework. International Journal of Nursing Studies 2018;82:79-89.

Mamom J. The effects of a community-based discharge-planning model for continuing pressure ulcer care on wound healing rates, nutritional status, and infection rates of elderly patients in Thailand. SJST 2017;93(3).

Gefen A, Brienza D, Edsberg L, Milton W, Murphy C, Oomens CW, Perry L, Sari Y. The etiology of pressure injuries. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Injury Advisory Panel (NPIAP) and the Pan Pacific Pressure Injury Alliance (PPPIA). 2019:2019.

Ayello EA, Chabal LO, Tariq G. Around the WCET world. World Council of Enterostomal Therapists Journal 2019;39(4):7.

Amir Y, Lohrmann C, Halfens RJ, Schols JM. Pressure ulcers in four Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics, prevention and treatment. International Wound Journal 2017;14(1):184-93.

Yap TL, Kennerly SM, Horn SD, Bergstrom N, Datta S, Colon-Emeric C. TEAM-UP for quality: a cluster randomized controlled trial protocol focused on preventing pressure ulcers through repositioning frequency and precipitating factors. BMC Geriatrics 2018;18(1):1-5.

Haesler E, editor. Prevention and treatment of pressure ulcers: quick reference guide. Osborne Park, Western Australia: Cambridge Media; 2014.

Edger M. Effect of a Patient-Repositioning Device in an Intensive Care Unit On Hospital-Acquired Pressure Injury Occurences and Cost: A Before-After Study. Journal of Wound Ostomy & Continence Nursing 2017;44(3):236-40.

Samuriwo R. Enhancing end-of-life skin care to prevent pressure ulcers in primary care. Journal of Community Nursing 2019;33(3).

Mervis JS, Phillips TJ. Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology 2019;81(4):893-902.

Mamom J. Development of an Innovative Repositioning Bed as a Prevention of Pressure Ulcers.Thai Journal of Nursing Council 2016;30(4):84-93.(in Thai)

Mamom J. Presuure Ulcer: The challenging of bedridden patient care. In: Vongkittirux S, Vilaichone R, editors. Diversity in multidisciplinary approach to patient self-care. Pratumthani: Faculty of medicine; 2017. p. 179-98. (in Thai)

Erdfelder E, Faul F, Buchner A. GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers 1996;28(1):1-10.

Mamom J, Rungreungduayboon B, Ratanadecho P. Autometic repositioning bed innovation. In: Vongkittirux S, Vilaichone R, editors. Diversity in multidisciplinary approach to patient self-care. Pratumthani: Faculty of medicine; 2017. p. 135-154. (in Thai)

Ko F. Hip Fracture in Nursing Home Residents with Advanced Dementia: An Opportunity for Palliative Care. Journal of Clinical Outcomes Management. 2019;26(1):13-5.

Winaiprasert P & Mamom J. Development the Required Daily Nutrition Applications (NuTu-App) to Promote Nutrition Status in Patients with Pressure Ulcers. Thai Science and Technology Journal 2019:485-98. (in Thai)

Boland JW, Boland EG. Constipation and malignant bowel obstruction in palliative care. Medicine. 2020;48(1):18-22.

Mamom J, Rungroungdouyboon B, Chuanasa J. Enhancing the Quality of Long-Term Patient Care by Use of the Innovative Electrical Bed-Turning System for the Prevention of Pressure Injuries: A Pilot Study. Science & Technology Asia.2020;27, (1), IN PRESS.

Woodhouse M, Worsley PR, Voegeli D, Schoonhoven L, Bader DL. How consistent and effective are current repositioning strategies for pressure ulcer prevention?. Applied Nursing Research. 2019;48:58-62.

Kapp S, Gerdtz M, Gefen A, Prematunga R, Santamaria N. An observational study of the maintenance of the 30° side-lying lateral tilt position among aged care residents at risk of developing pressure injuries when using the standard care pillow and a purpose-designed positioning device. International Wound Journal 2019;16(5):1080-6.

Ferris A, Price A, Harding K. Pressure ulcers in patients receiving palliative care: a systematic review. Palliative medicine. 2019;33(7):770-82.

Chiaprasert S, Sakunhongsophon S, Terathongkum S. Effects of Pressure Sore Prevention Program on Knowledge and Self-Efficacy of Family Caregivers in Decreasing Pressure Sore Risk of Persons with Cerebrovascular Disease. The Bangkok Medical Journal. 2019;15(1):51-.61. (in Thai)

Rodchua A. Effects of self-care promoting program toward knowledge and practice for cataract surgery patients, Rajavithi hospital. Journal of Health and Nursing Research 2012;2(28):1-12. (in Thai)

Published

2021-10-28

How to Cite

1.
Maungtoug N, Mamom J. Enhancing Quality of Palliative Home Care by Using the Nursing Innovative: A Pilot Study . JHNR [Internet]. 2021 Oct. 28 [cited 2022 Dec. 4];37(3):170-8. Available from: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/243652

Issue

Section

Research articles