Modifiable patient‐related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses

Abstract

Aim To explore factors associated with the presence of category I–IV pressure ulcers on the sacrum and heels. Design Cross‐sectional, secondary data analysis using data collected from the Landelijke Prevalentiemeting Zorgproblemen (LPZ) project, a multicentre prevalence study including nursing home residents and community care clients (N = 4,842) in the Netherlands in 2017. Methods A single binary logistic regression model was designed to identify factors associated with the presence of pressure ulcers. Additionally, a multiple binary logistic regression model including modifiable explanatory factors associated with the presence of pressure ulcers was designed. Results Impaired mobility, friction and shear (evaluated using the Braden Scale) are significantly associated with the presence of both sacral and heel category I–IV pressure ulcers. Incontinence‐associated dermatitis is significantly associated with category I–IV sacral pressure ulcers. Conclusion In pressure ulcer prevention, nursing interventions should focus on frequent repositioning and mobilization while avoiding exposure of the skin to friction and shear. The need to consider incontinence‐associated dermatitis, incontinence and moisture as important factors in pressure ulcer risk assessment is confirmed. Impact Pressure ulcers occur when skin and tissues are deformed between bony prominences and the support surface in a sitting or lying position. They are the result of a complex interaction between direct causal factors and a wide range of indirect factors. Recognition of these factors influences risk assessment guidance and practice. Knowledge of skin‐specific factors at the patient level, modifiable by nursing interventions, enables a better targeted and tailored preventive approach.

The Impact of COVID-19 on Levels of Adherence to the Completion of Nursing Records for Inpatients in Isolation

“…The decrease in the number of PUs recorded may also be explained or influenced by the decrease in the mean age of the patients admitted to the study units during the pandemic, since age is considered to be a risk factor in developing PUs [ 21 ]. However, the number of PUs that occurred while in strict isolation in hospital is particularly worrying, since frequent patient repositioning and mobilisation avoid skin exposure to friction and are vital in PU prevention [ 24 ]. The study findings suggest that patient isolation may be associated with a decrease in the frequency of risk assessment and patient mobilisation, leading to decreased PU prevention.…”

Risk factors associated with heel pressure ulcer development in adult population: A systematic literature review

“…For this review, they are reported as separate studies distinguished by the year of publication. Muntlin-Athlin et al (2016) (32) and Manderlier et al (2019) (33) were secondary analyses of HPU risk factors based on data collected from a randomised controlled trial (RCT) and a cross-sectional point-prevalence survey, retrospectively [33,34]. Table 1 provides further study characteristics of all eligible studies.…”

“…Median HPU incidence rate was 17.4% (range: 2.9%-to 29.5%) based on the incidence rate from the four prospective and two retrospective cohort studies [29,32,[35][36][37][38]. Median prevalence was 11.7% (range: 1.5%-20.8%) based on the two cross-sectional studies and two retrospective case control cohort studies [30,31,31,33]. Across all studies, the participant population was diverse and included: patients from hospital wards with high HPU prevalence, a geriatric rehabilitation centre, major abdominal surgery, elective or trauma orthopaedic surgery, nursing homes and patients receiving community care.…”

Development and validation of the Pressure Injury Prevention Barriers questionnaire in hospital nurses in Spain

“…12 There is an international consensus on the consideration of PIs as an avoidable adverse event in healthcare (excluding the Kennedy terminal ulcers or other skin changes at life's end, that were considered as unavoidable injuries) 13 ; the National Quality Forum has included PIs in a list of reportable serious events categorised as an event that should never occur. 14 A number of factors have been associated with the development of PIs, some as aetiologic factors (friction, shear, pressure, moisture) 15 and others as risk factors (age, diabetes, malnutrition, poor circulation, blood disorders). 16 There are several models or frameworks that establish the relationships between these factors and their effect on the development of PIs.…”