title: [The effectiveness of care bundles in maintaining the skin integrity and reducing the incidence density of pressure ulcers in lung cancer inpatients].
abstract: OBJECTIVE
  Pressure ulcers are tissue defects that form on the skin as a result of progressive skin damage. Pressure ulcers are a skin-integrity-related care issue and an important clinical indicator of care quality, especially for lung cancer inpatients who face rapidly deteriorating health conditions due to multiple symptoms and the side effects of treatment. Treating severe pressure ulcers may consume considerable manpower, time, and medical resources. Pressure ulcers may be avoided or effectively treated when nurses conduct proper skin assessments and care for wounds properly.
  
  
  OBJECTIVE
  This project evaluates the efficacy of skin care bundles in terms of reducing the incidence density of pressure ulcers in lung cancer inpatients.
  
  
  METHODS
  Data gathered between January 2010 and March 2011 showed unstable incidence density for pressure ulcers. The average pressure-ulcer incidence density in lung cancer inpatients was 2.09%, which was 8-times higher than the average for all patients. Using evidence-based care bundles for pressure ulcer prevention, we trained nurse staffs to incorporate these bundles into their clinical daily care of lung cancer patients in our hospital.
  
  
  RESULTS
  During the study period between November 2011 and January 2012, the pressure-ulcer incidence density gradually fell to 0.55%. The incidence density continued to fall to 0.33% over the subsequent 8 months.
  
  
  CONCLUSIONS
  We used the concept of "care bundles" to establish a standard skin-care protocol for advanced lung cancer inpatients. This protocol improved the clinical ability of nursing staffs and effectively maintained skin care quality in lung cancer patients.
authors.affiliation: Department of Nursing, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Wen-Ling
authors.initials: WL
authors.lastname: Lin
authors.affiliation: Division of Thoracic Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Puli Branch, Taiwan, ROC.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Tseng
authors.affiliation: Department of Nursing, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chung
authors.affiliation: Department of Nursing, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Hsin-Chu
authors.initials: HC
authors.lastname: Chuang
authors.affiliation: Department of Nursing, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Yun-Lan
authors.initials: YL
authors.lastname: Lin
authors.affiliation: Department of Nursing, Taichung Veterans General Hospital and Doctoral Candidate, Department of Nursing, College of Medicine, National Taiwan University, Taiwan, ROC. phchang@vghtc.gov.tw.
authors.forename: Pi-Hua
authors.initials: PH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008175:Lung Neoplasms / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D064872:Patient Care Bundles; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control*
keywords: care bundles; lung cancer; pressure ulcer