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Incidence and risk factors for pressure ulcers in the intensive care unit
Author(s) -
Nijs Nele,
Toppets Adinda,
Defloor Tom,
Bernaerts Kris,
Milisen Koen,
Van Den Berghe Greet
Publication year - 2009
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/j.1365-2702.2008.02554.x
Subject(s) - medicine , intensive care , intensive care unit , incidence (geometry) , population , risk factor , mechanical ventilation , emergency medicine , risk assessment , intensive care medicine , physics , computer security , environmental health , computer science , optics
Aims. To determine the incidence of pressure ulcers occurring at least 48 hours after admission and risk factors for pressure ulcers grade 2–4 in a long‐stay surgical Intensive Care Unit (ICU) population. Background. The incidence of pressure ulcers in intensive care units is larger than in non‐intensive environments. Design. Prospective descriptive research design. Methods. Using pressure ulcers grade 2–4 as an outcome measure, a multivariate logistic regression analysis was used to identify the risk factors. Data were obtained on a daily basis in a surgical intensive care unit of the University Hospital Leuven between November 2003–March 2004. A total of 520 long‐stay (≥ 24 hours) intensive care patients were included. Results. Cumulative incidence of pressure ulcers grade 2–4 was 20·1%. The following variables were positively associated with pressure ulcers grade 2–4: history of vascular disease, treatment with Dopamine ® or Dobutamine ® , intermittent haemodialysis (IHD) or continuous veno‐venous haemofiltration (CVVH), mechanical ventilation. Also preventive measures were statistically positively associated with pressure ulcers grade 2–4: turning, floating heels, alternating mattresses, adequate prevention. The use of sedatives, body temperature above 38·5 °C and sitting in chair where negatively associated with pressure ulcers. Pressure ulcers are statistically associated with different risk factors and preventive measures. Conclusion. The identified risk factors are eligible to be included in a new risk assessment scale for patients admitted to intensive care units. Relevance to clinical practice. 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.