Improving pressure ulcer care in intensive care units: Evaluating the impact of bundled care and silver nanoparticle dressings

Table 1 Bundled care in the management of pressure ulcers in critically Ill adults in intensive care units

Bundled care	Contents
1. Multidisciplinary collaboration	Ensure collaboration among healthcare professionals, including physicians, nurses, physical therapists, dietitians, and other specialists, to develop and execute a comprehensive care plan
	Hold regular interdisciplinary meetings to share information, coordinate treatment measures, and provide a unified approach to care
	Nurses conducts a thorough skin inspection during each shift and recording relevant information
2. Assessment	Conduct a thorough pressure ulcer assessment, including a detailed description of the wound's depth, size, shape, edge condition, and characteristics of the wound base
	Evaluate the skin surrounding the wound for signs of inflammation, redness, or swelling
3. Wound cleansing	Use a gentle saline solution or specialized wound cleansing solution to clean the wound with gauze or sterile cotton balls, avoiding the introduction of new bacteria
	Remove necrotic tissue, exudate, and debris to ensure a clean wound surface
4. Maintain moisture	Use the dressing to maintain a moist wound environment, which accelerates healing and supports new tissue growth
	Change the dressing as needed, typically when the dressing changes color from dark green to light green, indicating over 70% of the silver has been released
5. Nutritional support	Dietitians closely monitor the nutritional status of patients and design high-protein dietary plans to support wound healing
	Ensure the patient receives adequate protein and vitamin intake to support wound healing
	Provide oral nutritional supplements or enteral nutrition support through a feeding tube, depending on the patient's oral intake capacity
6. Pain management	Offer effective pain management, including medication, to alleviate wound discomfort
	Use non-pharmacological methods such as heat therapy, cold compresses, or relaxation techniques to reduce discomfort and pain
7. Prevent further deterioration	Ensure regular patient repositioning t least every 2 hours to prevent prolonged pressure on the same area
	Use specialized mattresses, cushions, and care pads to reduce pressure and provide appropriate support
8. Education	Provide comprehensive education to both the patient and family members, including wound monitoring, recognizing signs of infection, and proper wound care methods
	Emphasize the importance of pressure ulcer prevention, including pressure distribution and turning techniques
9. Data monitoring	Continuously monitor wound progress and any changes, documenting observations
	Reassess the pressure ulcer's status regularly to track healing progress