Incidence and risk factors for pressure ulcers in the intensive care unit

Nijs, Nele; Toppets, Adinda; Defloor, Tom; Bernaerts, Kris; Milisen, Koen; Berghe, Greet Van den

doi:10.1111/j.1365-2702.2008.02554.x

Cited by 159 publications

(178 citation statements)

References 22 publications

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“…Preventive interventions include offloading pressure via turning, repositioning of pressure points, and use of pressure-relieving devices. The results of previous research support the timely placement of at-risk patients on low air loss and pressure-relieving or pressure-redistribution mattresses [23][24][25][26][27][28] or air-fluidized beds. 29 Low air loss mattresses help control the skin microclimate to reduce skin moisture and temperature, thereby reducing injury of tissue surfaces that interface with the mattress.…”

Section: Discussionmentioning

confidence: 58%

A Model of Pressure, Oxygenation, and Perfusion Risk Factors for Pressure Ulcers in the Intensive Care Unit

Bly

Schallom

Sona

et al. 2016

American Journal of Critical Care

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This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: Background Although most intensive care patients are at risk for pressure ulcers, not all experience such ulcers.Objective To examine a model of variables related to extrinsic and intrinsic pressure on skin and underlying tissues, oxygenation, perfusion, and baseline comorbid conditions to identify risk factors associated with pressure ulcers in critically ill adults. Method A retrospective chart review was conducted on patients identified by weekly rounds from January 2010 through October 2010 to determine the prevalence of pressure ulcers. Variables were analyzed via bivariate analysis and logistic regression for unit-acquired pressure ulcers. Results Data on 345 patients with 436 intensive care admissions were reviewed. Variables were significant in each model category at P < .05. In the regression analysis of first admission only (n = 306), the model was significant (P < .001) and yielded correct classification of 86.3% of patients. For all intensive care admissions (n = 391), the model was significant (P < .001) and yielded correct classification of 83.9% of patients. In both models, 4 of the same variables were significant: any transport off the unit, number of days to bed change, systolic blood pressure less than 90 mm Hg, and use of more than 1 vasopressor. History of pulmonary disease and presence of a feeding tube were also significant in regression analyses. Conclusions Several variables within the model of pressure, oxygenation, and perfusion were significantly associated with development of pressure ulcers.

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Section: Discussionmentioning

confidence: 58%

A Model of Pressure, Oxygenation, and Perfusion Risk Factors for Pressure Ulcers in the Intensive Care Unit

Bly

Schallom

Sona

et al. 2016

American Journal of Critical Care

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“…[7][8][9][14][15][16][20][21][22][23][24][25][26][27][28][29][30] These patients are often exposed to pressure from being immobile and unconscious, thus unable to change positions independently. [4][5][6][7][8][9][31][32][33][34] Shear forces are present on the sacrum from head-of-bed elevation with mechanical ventilation. 15,[27][28][29]35 Preventive care is frequently organized into a comprehensive plan, including the "SKIN" (surfaces, keep the patients turning, incontinence management, nutrition) bundle.…”

mentioning

confidence: 99%

“…34 These bundles reduce pressure ulcer rates but have not eliminated HAPUs. [31][32][33][34]36 Despite advances in support surfaces and the use of formalized prevention programs that are based on clinical practice guidelines, 37 the incidence of HAPUs among critically ill patients remains a worldwide problem that contributes significantly to increasing health care costs and patients' suffering, morbidity, and mortality. 6,12,[15][16][17][18] The use of sacral foam dressings to augment standard procedures for preventing pressure ulcers in ICUs has been reported but not rigorously tested in the United States.…”

mentioning

confidence: 99%

Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit

Kalowes

Messina

2016

American Journal of Critical Care

105

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Background In critically ill patients, prevention of pressure ulcers is a challenge because of the high risk for multiple comorbid conditions, immobility, hemodynamic instability, and increased use of medical devices. Objectives To compare the difference in incidence rates of hospital-acquired pressure ulcers (HAPUs) in critically ill patients between those treated with usual preventive care and a 5-layered soft silicone foam dressing versus a control group receiving usual care. Secondary goals were to examine risk factors for HAPUs in critically ill patients and to explicate cost savings related to prevention of pressure ulcers. Methods A prospective, randomized controlled trial in the intensive care units at a 569-bed, level II trauma hospital. All 366 participants received standard pressure ulcer prevention; 184 were randomized to have a 5-layered soft silicone foam dressing applied to the sacrum (intervention group) and 182 to receive usual care (control group). Results The incidence rate of HAPUs was significantly less in patients treated with the foam dressing than in the control group (0.7% vs 5.9%, P = .01). Time to injury survival analysis (Cox proportional hazard models) revealed the intervention group had 88% reduced risk of HAPU development (hazard ratio, 0.12 [95% CI, 0.02-0.98], P = .048). Conclusion Use of a soft silicone foam dressing combined with preventive care yielded a statistically and clinically significant benefit in reducing the incidence rate and severity of HAPUs in intensive care patients. This novel, cost-effective method can reduce HAPU incidence in critically ill patients.

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“…The number of studies on the prevalence and incidence of PUs in intensive care units is limited in our country. The incidence of PUs in the neurology intensive care unit was reported to be 18.3% in the study of Kurtuluş and Pınar (16), 4.8% in the surgery intensive care unit in the study of Karadağ and Gümüşkaya (17), 11.6% in the 2 study of Uzun and Tan (18), 14.3% in the study of Sayar et al (19) and 10.4% in the study of Inan and Oztunc (20). Therefore, risk assessment is very important to identify of patients who are at high risk of developing PU in ICUs, in order to encourage effective PU management (21,22).…”

Section: Introductionmentioning

confidence: 99%

“…Although the prevention and treatment of PUs necessitates a multidisciplinary team approach, everybody is like-minded in their opinion that nurses are foreground in preventing PUs (6,7). Furthermore, PUs are an indicator of the quality of the nurse-specific provided by health care organizations (8)(9)(10). In studies conducted before 2008-2009 reveal a reduction in the prevalence of PUs in hospitals (4%-20%), (4,(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden Scale

Özyürek¹,

Gıersbergen²,

Yıldız³

2016

Eastern J Med

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Incidence and risk factors for pressure ulcers in the intensive care unit

Abstract: The novel insights have implications for risk assessment for patients in intensive care units. Patients admitted to intensive care units have other risk factors for pressure ulcers which are eligible to be included in a new risk assessment scale.

Cited by 159 publications

References 22 publications

A Model of Pressure, Oxygenation, and Perfusion Risk Factors for Pressure Ulcers in the Intensive Care Unit

A Model of Pressure, Oxygenation, and Perfusion Risk Factors for Pressure Ulcers in the Intensive Care Unit

Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit

Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden Scale

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