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Artificial Intelligence-Based Model for Monitoring Pressure Ulcer Changes in Bedridden Patients: A Case Study from Taiwan
Published in Connie White Delaney, Charlotte A. Weaver, Joyce Sensmeier, Lisiane Pruinelli, Patrick Weber, Nursing and Informatics for the 21st Century – Embracing a Digital World, 3rd Edition, Book 3, 2022
Usman Iqbal, Chun-Kung (Rock) Hsu, Yu-Chuan (Jack) Li
The Ministry of Health and Welfare (Ministry of Health and Welfare Taiwan, 2013) estimated up to 33% of long-term bedridden patients develop pressure ulcers, and the mortality rate by pressure ulcer complications is four times higher compared to the general hospitalized patients. Although there are more nursing institutions added each year as the population's age increases, there is still a shortage of healthcare workforce (Lin et al., 2013). Pressure ulcers are frequent complications of bedridden patients, occurring in as many as 60% of patients with quadriplegia. There are currently 100,190 long-term care beds in Taiwan (62,724 beds in 1,098 nursing homes and 37,466 beds in 528 nursing institutions), and there are more than 600,000 individuals in Taiwan who are in need of nursing care. Currently, Taiwan's nurse-to-patient ratio is nearly 1:13, which is more than twice the optimal ratio of 1:6, bringing a vast burden to healthcare staff and affecting the well-being of patients (see Figure 8.1) (Ministry of Health and Welfare Taiwan, 2011; Aiken et al., 2014).
Neurological Diseases
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Once the patient is stable and if services are available, physiotherapy, occupational and/or speech therapy can help restore function and improve quality of life. The severity of neurological deficits is the main predictor of recovery. For those with decreased mobility or bedridden status, caregivers should be trained on minimising the risk of pressure sores, contractures, aspiration and other complications. Depression is prevalent in stroke patients and should be screened for regularly; treatment of depression (see Chapters 10.1 and 10.2) is recommended to promote recovery from stroke deficits.
Clinical Rehabilitation of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Early activity: Ensure patients are given sufficient oxygen during activities. Prevent the pipeline connecting the patients from detaching and monitor vital signs throughout the process. If SpO2 <88%, terminate the rehabilitation treatment. Bedridden patients can perform progressive active limb movements or passive instrumental movement on the bed, turn over and regularly move on the bed, and receive active/passive whole-joint exercise training. With the help of breathing control technology, patients who can get out of bed can sit up from bed, move from bed to chair, sit on a chair, stand up and march on the spot. Perform these exercises one to two times per day without increasing fatigue. All activities should not cause oxygen saturation or blood pressure to drop. For those with transfer disorders, this can be done with a walker, a sturdy chair or a bed file, or a therapist’s assistance. Patients with sedative use or cognitive impairment or physical limitations, choose passive power for lower limbs by the bedside, passive joint movement and stretching, and neuromuscular electrical stimulation. The total training time should not exceed 30 minutes at a time, so as not to cause aggravation of fatigue.
Locational effects on oral microbiota among long-term care patients
Published in Journal of Oral Microbiology, 2022
Fa-Tzu Tsai, Ding-Han Wang, Cheng-Chieh Yang, Yu-Cheng Lin, Lin-Jack Huang, Wei-Yu Tsai, Chang-Wei Li, Wun-Eng Hsu, Hsi-Feng Tu, Ming-Lun Hsu
Factors affecting microbiota composition between different patient groups include age, physical function, general health, systemic disease, cognitive function, and indwelling devices such as urinary catheters and nasogastric tubes [38–42]. Langmore et al. (1998) found that factors associated with aspiration pneumonia included dependency on feeding methods, oral care, and number of decayed teeth [43]. Due to limited physical function, home-care patients suffered from severe and profound disability and were often bedridden. Our study indicated that bacterial species of bedridden patients were less abundant than those who were physically mobile. Our work was in agreement with previous studies [44–46] that higher risk of pneumonia was associated with bedridden lifestyle. Furthermore, several studies also showed that pneumonia of bedridden patients may be induced by oral care [27,47].
Using the PEOP Model to Understand Barriers to Functioning in Postural Orthostatic Tachycardia Syndrome
Published in Occupational Therapy In Health Care, 2022
It is important to note how the four variables of the PEOP model can invariably impact each other. An example of this phenomenon is deconditioning. The cultural normative response to illness is rest and recumbency. However, with environmental policy factors causing significant diagnostic delays, individuals with undiagnosed POTS experience long periods of time with symptoms without an explanation. Prolonged unexplained symptoms can heed further decreases in physical activity, sometimes progressing to becoming bedridden (Masuki et al., 2007). An increasingly sedentary lifestyle evokes physical consequences, namely deconditioning (Parsaik et al., 2013). An inaccessible physical environment and improper use of assistive technology are yet additional catalysts exacerbating the deconditioned state.
Relation of mobilization after hip fractures on day of surgery to length of stay
Published in Baylor University Medical Center Proceedings, 2022
James M. Rizkalla, Scott J. B. Nimmons, Asad Helal, Purvi Prajapati, Alan L. Jones
To our knowledge, this is the first study to prospectively evaluate the mobilization of hip fracture cohorts. Furthermore, this is the first to compare the effects of mobilization within 24 hours after operation. To date, only a handful of studies have described their mobilization protocols—all of which consisted of mobilization within 48 hours.3,7,10 It is a widely accepted practice in many institutions to encourage early mobilization and ambulation of hip fracture patients to minimize potential postoperative outcomes.1,7–11 Bedridden patients are more likely to develop pneumonia, urinary tract infections, pressure ulcers, deep vein thrombosis, and delirium.6,7 Nevertheless, few studies have described protocols for early mobilization after hip fractures as well as the perceived benefits of such plans.