Prevention of pressure ulcers from the perspective of frailty, pre-frailty, and health and social inequalities: An opinion paper
Bibliographic record
Abstract
Pressure ulcers affect many people in acute care and community settings. People with pressure ulcers may have delayed ulcer healing due to various factors, such as malnutrition and frailty. Prevention of pressure ulcers by addressing individual risk factors is essential, as it can help maintain skin integrity and functional ability, prevent or delay frailty, reduce care-associated costs, and improve quality of life. There are key factors leading to both frailty and pressure ulcers but the psychosocial aspects of these factors are often overlooked. In the current literature and clinical practice, the key concepts related to the bio-psychosocial aspects of frailty and pressure ulcer prevention are under-explored and not fully considered as part of routine care services. To address this gap in research and practice, a group of experts were invited to an online panel discussion. The expert panel included academics, researchers, and specialist clinical professionals in key leadership roles such as consultant geriatricians, advanced nurse practitioners and tissue viability nurse specialists, the national lead for older person services in Ireland, and the lead person for the National Wound Care Strategy in England. In March 2024, an expert panel meeting was held online with participation from experts in the areas of frailty, wound care, and nutrition to discuss key concepts of frailty and pressure ulcers. The main focus of this expert panel was to identify the connections between frailty and pressure ulcers and discuss priority areas to help address the needs of an ageing population who are at risk of developing pressure ulcers. This opinion paper presents the summary of the expert panel under a number of headings based on the focus of the panel discussions. It highlights the key concepts of frailty and pressure ulcers, discusses the bidirectional complex vicious cycle between them, and emphasises the importance of a preventative approach. While there are many definitions and classifications of frailty in the literature, this paper aims to describe the impact of frailty on the development, treatment and prevention of pressure ulcers from the perspective of experts in wound care, older persons care and nutrition. The key focus explored in this paper is the complex interplay between frailty and pressure ulcers and the role of modifiable risk factors including nutrition, socioeconomic status, and other factors in that relationship.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".