Aims and objective.  To verify association between PU development with nursing workload and illness severity and to verify whether nursing workload and illness severity are related with Braden Scale scores. Background.  Critically ill patients are more susceptible to treatment complications because of the severity of their clinical condition. Design.  Prospective descriptive study. Methods.  Patients consecutively admitted to three intensive care units (ICUs) of a public university hospital located in Sao Paulo, Brazil and without pressure ulcer (PU) at admission and a minimum stay of 24 hours were included in the sample. Prospective data collection included demographic, clinical and hospitalisation data, Nursing Activities Score (NAS), Simplified Acute Physiology Score (SAPSII) and Braden Scale. Multivariate linear regression analysis was applied to verify whether nursing workload and illness severity are related with Braden Scale scores. Multivariate logistic regression analysis was used to verify whether nursing workload and illness severity were risk factors associated with PU development. Results.  The study sample included 160 patients. The mean Braden score was 12·0 and PU incidence was 34·4%. Multivariate linear regression analysis identified as factors related to variation of Braden scores: illness severity (SAPSII), nursing workload (NAS) and age. Multivariate logistic regression showed a model with risk factors associated with PU development: sex, length of ICU stay, illness severity and nursing workload. Conclusion.  Nursing workload, severity of illness, sex and length of ICU stay were identified as risk factors associated with PU development. However, nursing workload acted as a protective factor. Illness severity, nursing workload and age were related to Braden scores. Relevance to clinical practice.  Accurate identification of risk factors and the use of clinical judgment in skin assessment are prerequisites for determining appropriate strategies to prevent pressure ulcers, to improve quality of care for patient safety and to reduce length of ICU and hospital stay and costs.

Objectives: to examine the association between pressure ulcer (PU) in critical care patients and their Braden scale score and the association between patient acuity and nursing workload, and to identify the risk factors for pressure ulcer among patients in critical care units (CCUs). Methods: This was a cross-sectional study with 74 patients in three CCUs at a major hospital. Data were collected prospectively using the simplified acute physiology score (SAPS II), the nursing activities score (NAS), and the Braden scale. Results: Approximately a third of patients (31%) had a PU. Factors associated with PUs were age, days of hospital stay, the score on the Braden scale, and the score on the SAPS II. The score on the NAS was not associated with PUs. Scores on the SAPS II and NAS were moderately correlated with the score on the Braden scale. Conclusion: The development of PUs was associated with advanced age, longer hospital stay, and patient acuity. Patient acuity and nursing workload were predictors of UPs. Keywords: Pressure ulcer/nursing; Intensive care units RESUMOObjetivos: Verificar a associação entre ocorrência de úlcera por pressão (UP) em pacientes em estado crítico com escores da escala de Braden, gravidade do paciente e carga de trabalho de enfermagem e, identificar os fatores de risco para UP em pacientes de Unidade de Terapia Intensiva (UTI). Métodos: trata-se de estudo transversal realizado em três UTIs de um hospital, cuja coleta prospectiva incluiu dados clínicos e de internação de 74 pcientes e a aplicação dos índices Simplified Acute Phisiology (SAPS II), Nursing Activities Score (NAS) e Escala de Braden. Resultados: dos 74 pacientes estudados 31% apresentaram UP. As variáveis que se associaram a presença de UP foram: idade, tempo de internação, escores Braden e SAPSII. O NAS não se associou com ocorrência de UP. Escores SAPSII e NAS apresentaram correlação moderada com escores Braden e foram identificados como fatores de risco para UP. Conclusão: A ocorrência de UP associou-se à idade mais elevada, maior tempo de internação e gravidade do paciente. Identificaram-se como preditores de risco para UP a gravidade do paciente associada a carga de trabalho de enfermagem. Descritores: Úlcera por pressão/enfermagem; Unidades de terapia intensiva RESUMEN Objetivos: Verificar la asociación entre la ocurrencia de la úlcera por decúbito (UD) en pacientes en estado crítico con escores de la escala de Braden, gravedad del paciente y carga de trabajo de enfermería e, identificar los factores de riesgo para UD en pacientes de la Unidad de Cuidados Intensivos (UCI). Métodos: se trata de un estudio transversal realizado en tres UCIs de un hospital, cuya recolección prospectiva incluyó datos clínicos y de internamiento de 74 pacientes así como la aplicación de los índices Simplified Acute Phisiology (SAPS II), Nursing Activities Score (NAS) y la Escala de Braden. Resultados: de los 74 pacientes estudiados el 31% presentó UD. Las variables que se asociaron a la presencia de UD fueron: edad, tiempo de interna...

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