Preventing pressure injuries among patients in the intensive care unit: insights gained

Coyer, Fiona; Labeau, Sonia; Blot, Stijn

doi:10.1007/s00134-022-06838-3

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…The assessment of care needs and nursing workload assumes a prominent role [ 30 ] with the intention to reconcile care quality, resource optimization, and cost reductions [ 31 , 32 ]. Health management becomes a higher challenge when patients present simple and/or complex wounds [ 33 , 34 , 35 ]. It is very important to reinforce the idea that it is better to work on wound prevention (low-cost interventions and resources) than on wound treatment (complex interventions and expensive resources), aiming to reduce the health financial costs and the intangible costs to the patient, to the professional, and to the family caregiver [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

Reis

Sá‐Couto

Mateus

et al. 2023

IJERPH

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The objective of this study is to understand how the type of wound dressing changes (routine or frequent) in patients admitted to intensive care units influences nurses’ workload. This study used a database of retrospective and analytical observational study from one Portuguese intensive care unit. The sample included 728 adult patients admitted between 2015 and 2019. The nursing workload was assessed by the TISS-28 scale, both at admission and at discharge. The linear regression results show that patients with frequent dressing changes are associated with a higher nursing workload, both at admission (Coef. 1.65; 95% CI [0.53; 2.77]) and discharge (Coef. 1.27; 95% CI [0.32; 2.22]). In addition, age influences the nursing workload; older people are associated with a higher nursing workload (at admission Coef. 0.07; 95% CI [0.04; 0.10]; at discharge Coef. 0.08; 95% CI [0.05; 0.10]). Additionally, an increase in nursing workload at admission would significantly increase the nursing workload at discharge (Coef. 0.27; 95% CI [0.21; 0.33]). The relative stability of the nursing workload over the studied years is also another important finding (the influence of studied years is non-significant). In conclusion, patients with frequent dressing changes presented higher TISS-28 scores when compared with patients with an exchange of routine dressings, which leads to a higher nursing workload.

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Section: Discussionmentioning

confidence: 99%

Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

Reis

Sá‐Couto

Mateus

et al. 2023

IJERPH

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show abstract

“…However, the site data submitted and the patient diagnostic data are in line with broader UK critical care ( online supplemental appendix B table 2 ). 26 Conceivably, participating sites may have had greater interest in PI or evaluative practice, which may be different from non-contributing sites, and be reflected in the quality of care. Finally, bedside nurses may perhaps have been inhibited from reporting injuries over anxieties that this would be regarded badly by managers.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of skin pressure injury in critical care patients in the UK: results of a single-day point prevalence evaluation in adult critically ill patients

et al. 2022

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ObjectivesHospital-acquired pressure injuries (PIs) are a source of morbidity and mortality, and many are potentially preventable.DesignThis study prospectively evaluated the prevalence and the associated factors of PIs in adult critical care patients admitted to intensive care units (ICU) in the UK.SettingThis service evaluation was part of a larger, international, single-day point prevalence study of PIs in adult ICU patients. Training was provided to healthcare givers using an electronic platform to ensure standardised recognition and staging of PIs across all sites.ParticipantsThe characteristics of the ICUs were recorded before the survey; deidentified patient data were collected using a case report form and uploaded onto a secure online platform.Primary and secondary outcome measuresFactors associated with ICU-acquired PIs in the UK were analysed descriptively and using mixed multiple logistic regression analysis.ResultsData from 1312 adult patients admitted to 94 UK ICUs were collected. The proportion of individuals with at least one PI was 16% (211 out of 1312 patients), of whom 8.8% (n=115/1312) acquired one or more PIs in the ICU and 7.3% (n=96/1312) prior to ICU admission. The total number of PIs was 311, of which 148 (47.6%) were acquired in the ICU. The location of majority of these PIs was the sacral area, followed by the heels. Braden score and prior length of ICU stay were associated with PI development.ConclusionsThe prevalence and the stage of severity of PIs were generally low in adult critically ill patients admitted to participating UK ICUs during the study period. However, PIs are a problem in an important minority of patients. Lower Braden score and longer length of ICU stay were associated with the development of injuries; most ICUs assess risk using tools which do not account for this.Trial registration numberNCT03270345.

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“…Although routine prevention strategies such as regular repositioning can be prioritised, the critical nature of their health condition and the required supportive therapies can compromise skin integrity (Alshahrani et al., 2021 ). Understanding knowledge gains in PI prevention reveals valuable insights, emphasising elevated risks for all ICU patients, particularly some at exceptionally high risk (Coyer et al., 2022 ). Given the high risk of compromised skin integrity among critical care unit patients, especially in the form of PIs, it is crucial to prioritise PI prevention in critical care units to ensure patient safety (Liu et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Pressure injury prevalence in critical care settings: An observational pre‐post intervention study

Alshahrani,

Middleton,

Rolls

et al. 2024

Nursing Open

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AimTo explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention.DesignA multi‐centre observational study.MethodData were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included.ResultsA total of 181 patients in critical care units were included at the two‐time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital‐acquired, 37.9% unit‐acquired and 23.0% medical device‐related. Post‐intervention prevalence decreased significantly to 28.7%, including 21.3% hospital‐acquired, 14.9% unit‐acquired, and 8.5% medical device‐related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries.ConclusionsThis study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence‐based education strategies are implemented.Patient Care ImpactPressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries.Reporting MethodStrengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist.Patient or Public ContributionNo patient or public contribution.

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Preventing pressure injuries among patients in the intensive care unit: insights gained

Cited by 6 publications

References 15 publications

Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

Prevalence of skin pressure injury in critical care patients in the UK: results of a single-day point prevalence evaluation in adult critically ill patients

Pressure injury prevalence in critical care settings: An observational pre‐post intervention study

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