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Efficacy and Cost‐Effectiveness Analysis of Evidence‐Based Nursing Interventions to Maintain Tissue Integrity to Prevent Pressure Ulcers and Incontinence‐Associated Dermatitis
Author(s) -
Avşar Pınar,
Karadağ Ayişe
Publication year - 2018
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12264
Subject(s) - medicine , psychological intervention , intervention (counseling) , intensive care medicine , nursing
Background A reduction in tissue tolerance promotes the development of pressure ulcers (PUs) and incontinence‐associated dermatitis (IAD). Aims To determine the cost‐effectiveness and efficacy of evidence‐based (EB) nursing interventions on increasing tissue tolerance by maintaining tissue integrity. Methods The study involved 154 patients in two intensive care units (77 patients, control group; 77 patients, intervention group). Data were collected using the following: patient characteristics form, Braden PU risk assessment scale, tissue integrity monitoring form, PU identification form, IAD and severity scale, and a cost table of the interventions. Patients in the intervention group were cared for by nurses trained in the use of the data collection tools and in EB practices to improve tissue tolerance. Routine nursing care was given to the patients in the control group. The researcher observed all patients in terms of tissue integrity and recorded the care‐related costs. Results Deterioration of tissue integrity was observed in 18.2% patients in the intervention group compared to 54.5% in the control group ( p < .05). The average cost to increase tissue tolerance prevention in the intervention and control groups was X ¯ = $204.34 ± 41.07 and X ¯ = $138.90 ± 1.70, respectively. Linking Evidence to Action It is recommended that EB policies and procedures are developed to improve tissue tolerance by maintaining tissue integrity. Conclusions Although the cost of EB preventive initiatives is relatively high compared to those that are not EB, the former provide a significant reduction in the prevalence of tissue integrity deterioration.