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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
MDRPU -an uncommonly recognized common problem in ICU: A point prevalence study
Chitra Mehta1, MdTariq Ali1, Yatin Mehta1
1Institute of Critical Care and Anesthesia, Medanta the Medicity, Gurgaon, Haryana, 122001, India.
Background:
Pressure ulcers (PU) usually occur over bony prominences in hospitalized patients. But they may occur due to medical devices referred also as Medical device related pressure ulcers (MDRPU). The United States National advisory panel (NPUAP) recognizes it as an important entity. MDRPU is one of the key quality indicators of hospital care, so far no data is available on MDRPU from the Indian Sub-continent.
Aim:
The primary objective of the study was to examine prevalence and Risk factors of MDRPU in critically sick patients.
Design:
A Cross-sectional point prevalence study.
Methods:
All patients above 18 years of age admitted in Intensive care units (ICU) on the date of the survey were included in the study. It was conducted in medical, cardiothoracic and neurosurgical ICUs. Demographic and MDRPU data were recorded. MDRPU was staged as per National Pressure ulcer advisory panel staging system. Ethics Committee approval was obtained prior to the start of the study.
Results:
One hundred and forty-six patients were included. The prevalence of PU was 26.0%. The prevalence of MDRPU was found to be 19.2%. MDRPUs most commonly occurred with non-invasive ventilation mask (NIV) and nasogastric tube (NGT) (20% and 12.3% respectively). MDRPUs were associated with a longer ICU Stay.
Conclusions:
MDRPUs pose a significant burden on healthcare. Our study showed significant prevalence rate of MDRPU which is comparable to those seen internationally. There is a compelling need to have continuous audits and structured training programs among healthcare professionals to prevent MDRPUs in critically sick patients.
Insights
Medical device-related pressure ulcers (MDRPU) affect 19.2% of critically ill patients in India, often linked to ventilation masks and feeding tubes. This highlights a significant healthcare burden and the need for prevention strategies.
Area of Science:
- Critical care medicine
- Nursing research
- Patient safety
Background:
- Pressure ulcers (PU) commonly affect hospitalized patients, particularly over bony prominences.
- Medical device-related pressure ulcers (MDRPU) are a recognized subset of PU, impacting hospital quality indicators.
- No prior data on MDRPU prevalence existed for the Indian subcontinent.
Purpose of the Study:
- To determine the prevalence of MDRPU in critically ill patients.
- To identify risk factors associated with MDRPU in this population.
Main Methods:
- A cross-sectional point prevalence study was conducted.
- 146 adult patients in medical, cardiothoracic, and neurosurgical Intensive Care Units (ICUs) were surveyed.
- MDRPU data was collected and staged using the National Pressure Ulcer Advisory Panel system.
Main Results:
- The overall prevalence of PU was 26.0%, with MDRPU prevalence at 19.2%.
- Non-invasive ventilation masks (NIV) and nasogastric tubes (NGT) were the most common devices associated with MDRPU (20% and 12.3%).
- MDRPU occurrence was linked to a longer ICU stay.
Conclusions:
- MDRPUs represent a substantial healthcare burden, with prevalence rates comparable to international findings.
- There is a critical need for continuous audits and structured training for healthcare professionals to prevent MDRPU.
- Implementing targeted prevention strategies is essential for critically ill patients.
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