Pressure Injuries in the Pediatric Population: A National Pressure Ulcer Advisory Panel White Paper

Abstract

Pediatric patients, especially neonates and infants, are vulnerable to pressure injury formation. Clinicians are steadily realizing that, compared with adults and other specific populations, pediatric patients require special consideration, protocols, guidelines, and standardized approaches to pressure injury prevention. This National Pressure Advisory Panel white paper reviews this history and the science of why pediatric patients are vulnerable to pressure injury formation. Successful pediatric pressure injury prevention and treatment can be achieved through the standardized and concentrated efforts of interprofessional teams. GENERAL PURPOSE To review what is known about pediatric pressure injuries (PIs) and the specific factors that make neonates and children vulnerable. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to: 1. Identify the scope of the problem and recall pediatric anatomy and physiology as it relates to PI formation. 2. Differentiate currently available PI risk assessment instruments. 3. Outline current recommendations for pediatric PI prevention and treatment.

Nurses’ knowledge, attitudes, and behaviours related to pressure injury prevention: A large‐scale cross‐sectional survey in mainland China

“…Based on expert consensus that most PIs are preventable (Delmore, Deppisc, Sylvia, Luna-Anderson, & Nie, 2019), the development of PIs has been identified as a "never event" that should never happen in a healthcare setting (Jackson et al, 2016). Stage 3 and 4 PIs are considered to be evidence of serious patient harm (Delmore et al, 2019).…”

Integument: Guidelines for the care of people with spina bifida

“…[7,11,12,16] 1-2 years, 11 months integrity issues in the spina bifida population. Given the large number of people with spina bifida who present with a pressure injury, prevention is a priority [20]. These guidelines provide a rational and effective approach to preventing or minimizing integument issues.…”

Predicting Who Receives Nonpharmacologic Pain Interventions in the Pediatric Intensive Care Unit

“…Repositioning is a key strategy for the prevention of pressure injuries ( Moore & Cowman, 2015 ). Frequent repositioning (every 2-4 hours) is a standard practice for pressure injury prevention, particularly for patients who are limited in their ability to reposition themselves ( Delmore et al, 2019 ). Therefore, the frequent repositioning documented as a nonpharmacologic strategy may more accurately reflect an intervention primarily implemented to prevent pressure injury with a secondary intent to reduce pain associated with the sustained pressure.…”