Medical device-related pressure injuries in critical patients: prevalence and associated factors

Abstract

Objective: To determine the prevalence of medical device-related pressure injuries in critical patients and analyze the associated factors. Method: Epidemiological, cross-sectional study. Sociodemographic, clinical and medical device data were collected. Inspection of the skin/mucous membranes was performed to identify and classify the injuries. Analysis using descriptive statistics, Poisson regression and the Spearman correlation coefficient. Results: Ninety-three patients were evaluated and 58 developed injuries, with a prevalence of 62.4%. Injuries by the orotracheal tube (50%), nasogastric tube (44.1%) and urinary catheter (28.6%) were the most prevalent, and the most affected regions were, respectively, the auricular (79.5%), nasal ala (86.7%) and urethral meatus (76.9%). Factors associated with injuries were severe edema (p = 0.005), low Braden (p<0.001) and Glasgow (p = 0.008) scores, length of stay in intensive care (p<0.001) and hospitalization diagnosis classified as other causes (p<0.001). The use of more than one device (p<0.001) and a longer time of use (p<0.001) were correlated. Conclusion: The high prevalence of injuries and the associated factors indicate the need for preventive measures and risk monitoring.

Analysis of the clinical features and risk factors of device‐related pressure injuries in the operating room

“…According to the results of the present study, the DRPIs in the patients occurred most frequently at the point where the cuff of the sphygmomanometer was attached to the upper arm, followed by the thigh and bone protuberances of the chest, head, face, buttocks, sacrum, and heel. A previous study 11 found that the posterior cervical region (66%) and the nose (40%) were the most common injury sites, with these prevalence levels higher than those obtained in the present study. Compared with traditional pressure injuries at bone protuberances, a DRPI is more likely to occur at a location rich in fat tissue, while it is also related to the parts, materials, and use of the surgical instruments and equipment.…”

“…The percentage of DRPIs caused by a tracheal catheter (1.47%) obtained in the present study was lower than that reported in the existing literature (7.7%) 9 . However, the incidence rate of DRPIs caused by vital sign monitoring devices was 31.62% in the present study, a similar value to those reported in previous studies (30%‐70%) 10,11 …”

“… 9 However, the incidence rate of DRPIs caused by vital sign monitoring devices was 31.62% in the present study, a similar value to those reported in previous studies (30%‐70%). 10 , 11 …”

Developing the Baptist Health Injury Risk Assessment Phase 1

“…Given the use of a large variety of commonly used high- and minimal-risk medical devices (MD) in the critical care setting, the cumulative incidence of MDR-HAPIs was recognized at 3.6 per 1000 patient days with reported incidence rates varying between 0.9% and 68% 11,13-15 . Prevalence rates were recognized as high as 62.4% for this population 16 …”

“…11,[13][14][15] Prevalence rates were recognized as high as 62.4% for this population. 16 Traditionally, clinical nursing personnel use assessment instruments in daily practice to calculate and categorize risk scores that trigger implementation of an individualized, nurse-led interprofessional prevention plan of care. Currently, 3 risk assessment instruments originally published between 1963 and 1987 are commonly used in adult critical care: Braden Scale, Norton Scale, and the Waterlow Pressure Area Risk Assessment Chart, later adapted in 2005.…”