Abstract
The purpose of this study was to determine an appropriate way to prevent bedsores in disabled stroke patients while they are still hospitalized. All stroke patients admitted to the Internal Medicine ward in Sichon District Hospital during the period January 2005 - December 2006 were enrolled into this study. Data collection included demographic data, and information on occurrence and details of the bedsores. We invented a new care protocol and equipment to prevent pressure sores. A comparison of the results of care before and after the use of these interventions in the target group was the outcome measured. During 2005, the incidence of bedsores in stroke patients was 18.37 percent. After the new strategies in caring and monitoring had been introduced, the incidence decreased by 5.36 percent in 2006. The knowledge, attitude and practice of caregivers, which included nursing personnel and patients’ relatives, increased; moreover, they tended to participate more in taking care of their patients. The most common pressure ulcer locations were the coccyx and the sacral area. In hospitalized patients, most pressure ulcers were facility-acquired, so we created new equipment from local products, i.e. pillows made from the inner skin of dried coconut in order to support the at-risk surfaces and decrease the pressure on the skin. New strategies in caring and monitoring bedsores included education, empowerment of caregivers and team work. All patients were followed up, and home visits by the family physician and his/her team were made; no new bedsores were found to have occurred in their homes. This study demonstrated that the best way to treat pressure sores in disabled CVA patients is to prevent those conditions in the first place. Given current evidence, using support surfaces, repositioning the patient, optimizing the nutritional status of the patients, and moisturizing the skin were all strategies that prevented pressure ulcers. Caregivers should be empowered to take care of their patients during the entire period of their entire hospital admission. Family physicians should strive to integrate both holistic care and continuity of care for the patients and their families.
