 |
Final programme EPUAP Oxford 2007, 30 August to 1 September |
Theme - Ten years of progress: the EPUAP past, present and future.
Thursday, 30th August, 2007, Academic Centre, John Radcliffe Hospital,
9.30 |
(Coach transportation from St Anne's College to Academic Centre, John Radcliffe)
Registration |
10.30-12.00 |
KCI Symposium (Lecture Theatre 2)
Integrated Therapy System for Better Wound Care: The Science and Practice of Pressure Ulcer management
George Cherry: Overview holistic approach
Basic Science and Clinical Evidence - Paul Banwell
Surgical Management of the Pressure Ulcer - Raymund Horch
General management of VAC Therapy - Kath Vowden
|
10.30-12.00 |
Gaymar Symposium Lecture Theatre 1)
An Update on the Shear Force Initiative
Chair: Dr Tom Stewart
History of the Shear Force Initiative
Tom Stewart
The Combined Effect of Pressure and Shear on Capillary
Closure in the Microscale of Skeletal Muscle Tissue - Amit Gefen
What Are the Effects of Pressure and Shear on Tissue - Laura Edsberg
Can we define a damage threshold for soft tissues under sustained mechanical Loading? - Cees Oomens
|
12.00 - 13.00 |
Exhibition opening and lunch in Tingewick Hall |
13.00 |
Opening of Conference - Tom Defloor
Chairs:Carol Dealey and Marco Romanelli
|
13.15 |
The EPUAP past, present and future - Carol Dealey. |
13.40 |
Highlights of the free papers and poster presentations -
Mike Clark and Jacqui Fletcher |
14.00 |
Nutrition and pressure ulcers: work of the EPUAP nutrition group - Judith Meijers |
14.20 |
Tea and commercial exhibition Tingewick Hall
Chairs: Zena Moore, Jan Westrate |
14.50 |
Introduction to the conference scientific sessions |
14.55 |
Shear forces: Cees Oomens, |
15.15 |
Redistributing pressure - Tom Defloor |
15.35 |
Heel pressure ulcers - Jeannie Donnelly |
15.55 |
Skin care, continence and pressure ulcers - Lisette SchoonhovenHeel |
16.15 |
Presentation to EPUAP Award winner |
16.30 |
Coffee Break and commercial exhibition in Tingewick Hall |
16.45 - 18.15 |
Smith & Nephew Symposium: (Lecture Theatre 2) |
18.15 |
(Coach transportation to St Anne's College from Academic Centre, John Radcliffe) |
19.30 |
(Coach transportation from St Anne's College to Salter's boatyard) |
20.00 - 23.00 |
Social Event: Thames Jazz Boat Trip with Buffet Supper Abingdon Road) |
Friday, 31st August 2007 Academic Centre, John Radcliffe Hospital
8.00 |
Coach transportation from St Anne's College to Academic Centre, John Radcliffe) |
8.30 |
Poster presentations |
9.30 |
Free Papers Session 1 Lecture Theatre 1
(Chairs Michael Clark, Hilde Heyman)
Deep Tissue Injury: State of the Science
Joyce Black, USA
A Collaborative Statewide Initiative Across Care Settings Reduces Pressure Ulcers in the USA
Elizabeth A. Ayello, USA
The Challenge: Determining Neglect in the Development of a Pressure Ulcer
Kath Vowden, UK
An approximation to the cost of the treatment of Pressure Ulcers in Spain
Joan-Enric Torra I Bou, Spain
Care Dependency Scale: An effective Alarm System for pressure ulcer risk?
Doris Wilborn, Germany
|
9.30 |
Free Papers session 2 Lecture Theatre 2
(Chairs Jacqui Fletcher, Cristina Miguens)
A Systematic Review of Pressure Ulcers and Quality of Life
Claudia Gorecki, UK
Cytokine and chemokine transport through the epidermis upon sustained mechanical loading
L Cornelissen, The Netherlands
Effectiveness of two cushions in the prevention of heel pressure ulcers
Alexander Heyneman, Belgium
A randomized, blinded, conventional treatment controlled trial evaluating the efficacy of injected activated macrophage suspension in decubital ulcers
Zuloff-Shani Adi,
Evaluation of pressure relieving head supports
Vinoth K. Ranganathan, USA
Cutaneo - adipose flaps on perforating arteries in combination with Pulsed Galvanic Stimulation PGS) to enhance treatments of 3. - 4th degree decubitus ulcers."
Argentina Vidrascu, Romania
|
10:30 |
Coffee and commercial exhibition in Tingewick Hall |
11:00 |
Scientific session 1 Heel pressure ulcers (Chairs Anne Witherow, Christina Lindholm)
Jeanne Donnelly, Mark Collier,
Scientific session 2 Shear forces "Can we find a relationship between external pressure and shear and internal deformation?
(Chairs Cees Oomens, José Verdu Soriano )
Can we influence the environment at the Patient Support Interface ? Dan Bader
How dangerous is shear? Cees Oomens
Can we find a relationship between external pressure and shear and internal deformation? Karlien Ceelen |
12:30 |
Exhibition and Lunch in Tingewick Hall |
12:30 |
Highlights and unique advances in the field of Pressure Ulcer care in Japan
The Japanese Society for Pressure Ulcers -
Lecture Theatre 1 (Lunch in the room)
Chairs Dan Bader, George Cherry
1) Recent trends in pressure ulcer management in Japan Prof H Sanada
2) Japanese wound assessment "Design P": Prof T. Moriguchi
3) Guidelines for Pressure Ulcer care and treatment in Japan: Prof S Ichioka
4) Japanese Risk Factors for Pressure Ulcers: Prof T.Ohura:
5) New concepts of Pressure Ulcers from the shear force and pressure perspective
a) Mechanism and Measurements (Engineering Viewpoints): Prof M Takahashi:
b) Clinical Evidence: Prof T Ohura: |
14:10 |
Scientific session 3 - Pressure redistribution (Chairs Ruud Halfens, Anna Polak) Katrien Vanderwee, Zena Moore
Scientific session 4 - Skin care (Chairs Carol Dealey Manuel Gago-Fornells)
Alan Cottenden, Sue Bale |
15.30 |
Tea and commercial exhibition in Tingewick Hall |
16.00 |
Free papers Session 3 - Lecture Theatre 1
(Chairs Lisette Schoonhoven, Lena Gunningberg)
Are record data on pressure ulcers reliable? A comparison between paper based-records and electronic health records
Lena Gunningberg, Sweden
Demographics of Pressure Ulcers: An Analysis of the International Pressure Ulcer PrevalenceTM Survey
Catherine VanGilder, USA
Frequency of pressure ulcers in one emergency hospital and one rehabilitation centre in Harare, Zimbabwe
Martin Sibanda, Zimbabwe
Risk Assessment Tools for the Prevention of Pressure Ulcers - A Cochrane Systematic Review
Zena Moore, Ireland
Pressure Ulcers Risk Evaluation (PURE) Project
Jane Nixon, UK
SAFE or SORRY? Does every patient at risk for pressure ulcers get adequate prevention?
Betsie van Gaal, The Netherlands
Free papers Session 4 Lecture Theatre 2
(Chairs Jos Schols, Helvi Hietanen)
Continuous monitoring of the interface pressure distribution and body movement during bed rest at ICU
Kozue Sakai, Japan
Simultaneous measurement of blood flow and compressive loads applied to the skin
Hitomi Sugiyama, Japan
Development and Evaluation of a new Self-regulating Alternating Pressure Air Cushion
Gojiro Nakagami, Japan
Knowledge, attitudes and practice of nursing staff about pressure ulcer prevention and treatment - a survey in a Swedish health care setting
Ulrika Källman, Sweden
Pressure Ulcers - Prevention and Prevalence on Intensive Care; Observing trends from 2001 to 2006
Nils Lahmann, Germany |
17:30 |
Annual General Meeting |
18:00 |
(Coach transportation from Academic Centre, John Radcliffe to St Anne's College) |
20.00 - 22.00 |
Gala dinner at St Anne's College |
Saturday, 1 September 2007, St Anne's College
09:30 |
Welcome and overview of the day - Carol Dealey |
09:50 |
Special hands-on Workshops
Shear Forces (Duncan Bain)
Heel pressures (Jacqui Fletcher) |
11.20 |
Tea and pastries |
11.50 |
Pressure redistribution without mattresses (Heidi Guy/Jacqui Fletcher)
Sacral skin care (Trudie Young) |
13:25 |
Summary and close - Carol Dealey |
14.00 - 17.00 |
Optional paid Tour to Blenheim Palace, birthplace of Winston Churchill, Woodstock (5 miles from Oxford)
Summary and close - Carol Dealey |
|
References |
The following references mark publications that directly reflect the activities of the EPUAP. There are few associations that can point to their specific contribution to the scientific literature on pressure ulcers.
Bale, S., C. Dealey, et al. (2007). "The experience of living with a pressure ulcer." Nursing Times 103(15): 42-3.
This short paper presents a qualitative study, reported in detail elsewhere (Hopkins et al, 2006) that investigated the experience of older people with pressure ulcers. The researchers were surprised to find how significant pain associated with the pressure ulcer was to patients or the impact it had on their lives. All quotes from the participants are taken from Hopkins et al (2006).
Defloor, T., M. Clark, et al. (2005). "EPUAP statement on prevalence and incidence monitoring of pressure ulcer occurrence." Journal of Tissue Viability 15(3): 20-7.
Defloor, T. and L. Schoonhoven (2004). "Inter-rater reliability of the EPUAP pressure ulcer classification system using photographs." Journal of Clinical Nursing 13(8): 952-9.
BACKGROUND: Many classification systems for grading pressure ulcers are discussed in the literature. Correct identification and classification of a pressure ulcer is important for accurate reporting of the magnitude of the problem, and for timely prevention. The reliability of pressure ulcer classification systems has rarely been tested. AIMS AND OBJECTIVES: The purpose of this paper is to examine the inter-rater reliability of classifying pressure ulcers according to the European Pressure Ulcer Advisory Panel classification system when using pressure ulcer photographs. DESIGN: Survey was among pressure ulcer experts. METHODS: Fifty-six photographs were presented to 44 pressure ulcer experts. The experts classified the lesions as normal skin, blanchable erythema, pressure ulcer (four grades) or incontinence lesion. Inter-rater reliability was calculated. RESULTS: The multirater-Kappa for the entire group of experts was 0.80 (P < 0.001). Various groups of experts obtained comparable results. Differences in classifications are mainly limited to 1 degree of difference. Incontinence lesions are most often confused with grade 2 (blisters) and grade 3 pressure ulcers (superficial pressure ulcers). CONCLUSIONS: The inter-rater reliability of the European Pressure Ulcer Advisory Panel classification appears to be good for the assessment of photographs by experts. The difference between an incontinence lesion and a blister or a superficial pressure ulcer does not always seem clear. RELEVANCE TO CLINICAL PRACTICE: The ability to determine correctly whether a lesion is a pressure ulcer lesion is important to assess the effectiveness of preventive measures. In addition, the ability to make a correct distinction between pressure ulcers and incontinence lesions is important as they require different preventive measures. A faulty classification leads to mistaken measures and negative results. Photographs can be used as a practice instrument to learn to discern pressure ulcers from incontinence lesions and to get to know the different grades of pressure ulcers. The Pressure Ulcer Classification software package has been developed to facilitate learning.
Defloor, T., L. Schoonhoven, et al. (2005). "Statement of the European Pressure Ulcer Advisory Panel--pressure ulcer classification: differentiation between pressure ulcers and moisture lesions." Journal of Wound, Ostomy, & Continence Nursing 32(5): 302-6; discussion 306.
Defloor, T., L. Schoonhoven, et al. (2006). "Reliability of the European Pressure Ulcer Advisory Panel classification system." Journal of Advanced Nursing 54(2): 189-98.
AIM: This paper reports a study examining the interrater and intrarater reliability of classifying pressure ulcers according to the European Pressure Ulcer Advisory Panel classification system when using photographs of pressure ulcers and incontinence lesions. BACKGROUND: Pressure ulcer classification is an essential tool for assessing ulcers and their severity and determining which preventive or therapeutic action is needed. Many classification systems are described in the literature. There are only a limited number of studies that evaluate the interrater reliability of pressure ulcer grading scales. The intrarater reliability is seldom studied. METHODS: The study consisted of two phases. In the first phase 56 photographs, together with a random selection of nine photographs from the same set, were presented to 473 nurses. In the second phase, the 56 photographs were presented twice to 86 other nurses with an interval of one month and in a different order. All the nurses were familiar with the European Pressure Ulcer Advisory Panel classification. They did not receive any additional training on classification, and were asked to classify the lesions as normal skin, blanchable erythema, pressure ulcers (four grades, European Pressure Ulcer Advisory Panel classification) or incontinence lesions. RESULTS: In the first phase, the multirater-Kappa for the 473 participating nurses was 0.37 (P < 0.001). Non-blanchable erythema was often confused with blanchable erythema and incontinence lesions. Also incontinence lesions were frequently not correctly classified. The intrarater agreement was low (kappa = 0.38). In the second phase, the interrater agreement was not significantly different in both sessions. The intrarater agreement was 0.52. CONCLUSION: Both the interrater and intrarater reliability of the European Pressure Ulcer Advisory Panel classification of lesion photographs by nurses was very low. Differentiation between pressure ulcers and incontinence lesions seems to be difficult.
Hopkins, A., C. Dealey, et al. (2006). "Patient stories of living with a pressure ulcer." Journal of Advanced Nursing 56(4): 345-53.
AIM: This paper reports the findings of a pilot study exploring the experience of older people living with pressure ulcers. BACKGROUND: Pressure ulcers are known to be a significant health burden, but little is known of the impact on the quality of life of the sufferer. They mainly affect older people, and this is a neglected group in previous studies of this topic. METHODS: A Heideggerian phenomenological approach was used and patients were recruited if they were over 65 years of age and had a grade 3 or 4 pressure ulcer that had been present for more than a month. Patients were recruited from multiple centres but the data were analysed centrally. The study took place in 2003-2004. FINDINGS: Analysis of the transcripts revealed three main themes, all with associated subthemes: pressure ulcers produce endless pain; pressure ulcers produce a restricted life; coping with a pressure ulcer. The endless pain theme had four subthemes: constant presence, keeping still, equipment pain and treatment pain. Some patients found that keeping still reduced their pain. Several patients also reported that pain was exacerbated by their pressure relieving equipment and at dressing change. There were three subthemes for the restricted life theme: impact on self, impact on others and consequences. Patients found that the pressure ulcer restricted their activities and had an impact on their families. In addition, for some, the restrictions delayed their rehabilitation. To cope with their pressure ulcers, patients developed ways of accepting their situation or comparing themselves with others. CONCLUSIONS: Although a pilot, this study has produced a wealth of data that demonstrates the impact of pressure ulcers on people. While a larger study is required to obtain a European perspective, it is still reasonable to conclude that the issues of pain and restrictions should be considered in the development of pressure ulcer treatment and prevention guidelines.
Vanderwee, K., M. Clark, et al. (2007). "Pressure ulcer prevalence in Europe: a pilot study." Journal of Evaluation in Clinical Practice 13(2): 227-35.
RATIONALE AND AIMS: Numerous prevalence studies have been conducted. The problem with these studies is that prevalence proportions cannot be compared with each other, because of differences in performance of each survey. There is no agreed standardized method for determining prevalence proportions. This study aimed to develop and pilot a uniform data collection instrument and methodology to measure the pressure ulcer prevalence and to get some insight into pressure ulcer prevalence across different patient groups in Europe. METHODS: Pressure ulcer experts from different European countries developed a data collection instrument, which included five categories of data: general data, patient data, risk assessment, skin observation and prevention. A convenience sample of university and general hospitals of Belgium, Italy, Portugal, UK and Sweden participated in the study. In each participating hospital, teams of two trained nurses who collected the data on the wards were established. All patients admitted before midnight on the day of the survey and older than 18 years were included. RESULTS: The data collection instrument and study procedure of the survey were found to be effective by all participants. 5947 patients were surveyed in 25 hospitals in five European countries. The pressure ulcer prevalence (grade 1-4) was 18.1% and if grade 1 ulcers were excluded, it was 10.5%. The sacrum and heels were the most affected locations. Only 9.7% of the patients in need of prevention received fully adequate preventive care. CONCLUSION: The methodology is sufficiently robust to measure and compare pressure ulcer prevalence in different countries. The pressure ulcer prevalence was higher than expected and relatively few patients received adequate prevention. This indicates that more attention to prevention is needed in Europe.
|
Download this newsletter in PDF format