Risk factors of medical device‐related pressure injury in intensive care units

Abstract

Objectives: Intensive care unit (ICU) patients are at high risk of medical device related pressure injury (MDRPI). This study aims to ascertain the MDRPI prevalence in ICU patients and analyse the risk factors of MDRPI. Background:The occurrence of MDRPI not only increases hospitalisation time with pain and economic burden, but also causes medical disputes. A better understanding of this condition will increase knowledge and facilitate the ability to recognise and prevent MDRPI for clinical nursing staff. However, there are few multicentre studies of MDRPI prevalence in ICU patients in China. Design:A cross-sectional study design was employed.Methods: Data from 694 patients in 66 adult ICU at 30 hospitals in China were included between October 2018 and March 2019. The stage of each MDRPI was determined according to the definitions of National Pressure Ulcer Advisory Panel. The study methods were followed by the STORBE guidelines. Results:The overall prevalence rate of MDRPI was 13.1% (91/694), with 98 anatomic locations in total. The most common stages of MDRPI were stage 1 (54.1%, 53/98), stage 2 (15.3%, 15/98) and mucosal membrane pressure injury (15.3%, 15/98). MDRPI mainly occurred in the finger (32.7%, 32/98), followed by nose (18.4%, 18/98). The prevalence rate of MDRPI caused by CPAP or BiPAP masks (25%) was highest. Lower Braden scores and having skin oedema were risk factors for MDRPI in adult ICU patients. Conclusion:The prevalence of MDRPI in this study was still high. Nurses should take these related factors into consideration when taking care of ICU patients, and appropriate prevention measures should be adopted to decrease the prevalence of MDRPI.Relevance to clinical practice: The study can help to improve the PI prevention efforts in ICU patients specific to medical device related PI.

The prevalence of facial pressure injuries among nurses during COVID-19 pandemic and its relationship to COVID-19 infection

“…In this study, the risk of the development of FPI in the nurses who had chronic diseases was found to be 1.5 times as high as the risk of others. Dang et al also reported that having a chronic disease increased the risk of pressure injury development [ 28 ]. According to the report published in 2018 by Jaul et al, the risk of developing pressure injuries increases as comorbidities disrupt circulation and the nutrition of tissues [ 29 ].…”

Medical Device-Related Pressure Injury: Frequency and Associated Factors

“…Medical device-related pressure injury: frequency and associated factors Several comorbidities were observed in the present study. A study with 694 patients in the ICU in China observed the prevalence of several comorbidities, among which: 30.4% were hospitalized due to respiratory diseases and, in general, 60.1% had a history of chronic diseases 4 . In Italy, a study on MDRPI identified cardiovascular diseases as the main comorbidities 13 .…”

“…The literature emphasizes that among the main risk factors for the formation of MDRPI are the medical diagnoses that influence the severity of the patient's hospitalization; the length of stay; the use of drugs (mainly vasoactive drugs and sedatives/analgesics, which influence sensory perception);comorbidities that worsen the prognosis; hemodynamic worsening that progresses to death; and skin changes resulting from previous PIs, among others 3,4 .…”

“…Patients most at risk for MDRPI are those with impaired sensory perception, such as neuropathy and communication deficits (oral intubation, language barriers, unconsciousness, or non-verbal status) 4 . To carry out this identification of patients who are at greater or lesser risk of developing PI, several assessment scales have been used.…”

Factors Associated with Pressure Injury Among Critically Ill Patients in a Coronary Care Unit

“…[5][6][7] To avoid the development of PIs in the ICU, providers must identify patients who are at risk of PIs and initiate prevention interventions as required. 8 Pressure injury incidence is an important clinical indicator for the quality control of medical centers. Every medical institution has applied its own guidelines for the prevention of PIs.…”