[Multicenter nursing study on the importance of nutritional support for the prevention of bedsores in the elderly at risk].
Bedsores prevention is part of the specific role of the nurse, as defined namely in the order 84-869 of the 17. July 1984. The analysis of the risk factors for the appearance of bedsores shows that immobilization, reduction of mobility linked to vigilance disorders and the urinary and faecal incontinence are major elements which justify protocols of well defined local cares. More recently, the role of undernutrition was highlighted but the recommendations lack accuracy. The proteino-energizing undernutrition is frequent among the elderly patients in hospital, reaching 60% of all the patients in the department of acute affections. The association of a constituted bedsore and of clinical and/or biological scars of protein-energizing undernutrition is demonstrated and justifies a re-feeding of the patients suffering from bedsores. On the other hand, although a bad nutrition state seems to favour the appearance of a bedsore, it is not proved that the nutrition intensification associating the diagnosis of an under-nutrition and the starting of an adapted re-feeding (with enriched food or assistance) decreases the actual incidence of the bedsores. A prospective, multicentered, randomized survey was therefore proposed. Its aim was to study the Influence of Nutrition in the Bedsores Prevention among the Elderly Patients in hospitals, suffering from acute affections. This research follows upon the preventions audits of bedsores and the nutrition protocol started up in a department of geriatrics intern medicine in the Regional Center of Geriatrics of Bordeaux.


CONCLUSIONS
Two results must be retained in this nursing survey. It gave the possibility of calling into question the professional experience of the nursing teams which participated to the research and to update their knowledge in the field of the bedsores prevention. They could thus be acquainted with the existence of the grids which evaluate the risk of bedsore, the dependence or even the nutrition supply and to assess the interest for improving the cares quality. On the other hand, we highlighted the possibility of increasing the energy and protein supply by a distribution of enriched food supplements. Moreover, this action has had a beneficial influence in the bedsores prevention among the old people.
Barateau
M
M
Corompt
A
A
Soulan
J
J
Bourdel-Marchasson
I
I
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000379:methods* / Q000451:nursing; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D015596:Nutrition Assessment; D003668:Pressure Ulcer / Q000209:etiology* / Q000451:nursing / Q000517:prevention & control*; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors