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Area of Science:

  • Nursing Quality Indicators
  • Patient Safety
  • Pediatric Healthcare

Background:

  • Hospital-acquired pressure injuries (HAPIs) are a significant concern in pediatric patient care.
  • Understanding risk factors and associated characteristics is crucial for effective prevention strategies.
  • Previous research has primarily focused on adult populations, leaving a gap in pediatric-specific data.

Purpose of the Study:

  • To identify associations between pediatric patient characteristics, hospital factors, and HAPIs.
  • To examine risk factors for HAPIs in pediatric patients, including those identified as high-risk.
  • To explore the relationship between unit type, nurse staffing, and HAPI occurrence in pediatric units.

Main Methods:

  • A descriptive, correlational analysis was performed on a large dataset from the National Database of Nursing Quality Indicators (NDNQI).
  • Data included 39,984 pediatric patients (1 day to 18 years) across 678 units in 271 US hospitals collected in 2012.
  • Hierarchical logistic regression was used to analyze patient demographics, unit type, risk status, prevention practices, staffing, and hospital characteristics related to HAPI.

Main Results:

  • Patients identified as at risk for pressure injuries had over 9 times higher odds of developing HAPIs (OR: 9.42).
  • HAPIs were more likely in pediatric critical care units (OR: 2.59) and rehabilitation units (OR: 4.05).
  • Hospitals exclusively serving children had higher HAPI rates (OR: 2.6), and no specific prevention interventions were associated with reduced HAPI occurrence.

Conclusions:

  • Supports the routine use of pressure injury risk assessment in pediatric patients.
  • Highlights specific pediatric unit types and hospital characteristics associated with increased HAPI risk.
  • Indicates a need for further research into effective HAPI prevention strategies tailored for pediatric populations.