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The prevalence of pressure ulcers in four paediatric institutions
Anna-Barbara Schlüer1, Eva Cignacco, Marianne Müller
1Children's University Hospital, Zurich, Switzerland. b.schluer@bluewin.ch
Insights
Pediatric pressure ulcer prevalence is higher than expected, affecting over 27% of children. Many ulcers are minor, device-related injuries, highlighting the need for targeted nursing interventions to prevent skin breakdown in at-risk children.
Area of Science:
- Pediatric Nursing
- Wound Care
- Hospital Epidemiology
Background:
- Pressure ulcers are a significant nursing challenge in hospitals, causing patient suffering and increasing healthcare costs.
- Understanding the prevalence and risk factors for pressure ulcers in pediatric populations is crucial for effective care.
- Previous research has not fully elucidated the scope of pressure ulcer issues in children.
Purpose of the Study:
- To determine the prevalence of pressure ulcers in a pediatric hospital setting.
- To identify children at risk of developing pressure ulcers.
- To assess factors contributing to pressure ulcer development in pediatric patients.
Main Methods:
- A point prevalence study was conducted across four Swiss pediatric hospitals.
- Direct skin inspection and assessment, including clinical condition and risk stratification (Braden score), were performed.
- Data were collected by trained rater pairs on 155 pediatric patients aged 0-18 years.
Main Results:
- An overall pressure ulcer prevalence of 27.7% (including grade 1) was observed.
- Grade 1 ulcers were most common (84%), with many linked to medical devices.
- 65% of patients were identified as at risk (Braden score ≤ 20), and 35% of these developed pressure ulcers.
Conclusions:
- The prevalence of pressure ulcers in pediatric patients is higher than previously recognized.
- A significant proportion of pressure ulcers are minor and device-related, necessitating specific nursing interventions.
- Further research is needed to explore interventions and improve outcomes for pediatric patients at risk of pressure ulcers.
Aim And Objective:
Pressure ulcers are a common nursing care issue in hospitals. They are associated with psychological and physical suffering, an increased morbidity and mortality rate and higher overall health care costs. The aim of the current study is to describe the frequency of pressure ulcers in a paediatric care setting and to identify the population at risk, as well as to assess the factors predisposing to the development of pressure ulcers.
Design:
A point prevalence study.
Methods:
The study was conducted in four paediatric hospitals in the German-speaking part of Switzerland and included children from the age of 0-18 years. The method of data collection was a direct systematic inspection and assessment of the skin, taking into account the clinical condition of the patient for risk assessment. A valid risk assessment and data collection instrument was used and, each patient was assessed by a previously instructed rater pair.
Results:
Of all possible patients, 81% (n = 155) were included. An overall pressure ulcer prevalence of 27.7% (including grade 1) was registered. Thirty-six patients (84%) had grade 1 ulcers, including many caused by external medical devices. Sixty-five per cent (n = 100) of all patients were considered at risk (Braden score < or = 20) of developing a pressure ulcer. Thirty-five per cent of patients in the risk group were afflicted with one or more pressure ulcers.
Conclusions:
The prevalence of pressure ulcers in paediatric patients is greater then previously appreciated and the problem requires further exploration. The high percentage of grade 1 pressure ulcers caused by medical devices requires nursing interventions to prevent lesions for these patients.
Relevance To Clinical Practice:
The high prevalence rate in paediatric patients is disconcerting and requires further exploration in terms of interventions needed to improve outcomes for this patient group.
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