Related Experiment Video
Updated: Dec 9, 2025
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Prevention of pressure injuries in critically ill children: A preliminary evaluation
Marta Bargos-Munárriz1, Montserrat Bermúdez-Pérez1, Ana María Martínez-Alonso1
1Pediatric Working Group of the Commission for the Prevention and Treatment of Pressure Ulcer and Wounds. Regional University Hospital of Malaga, Spain; Pediatric Intensive Care Unit. Regional University Hospital of Malaga, Spain.
Insights
A new care bundle significantly reduced pressure injuries in pediatric critical care patients. This prevention strategy is particularly effective for vulnerable children requiring prolonged intensive care.
Area of Science:
- Pediatric critical care medicine
- Nursing science
- Patient safety research
Background:
- Pediatric skin has unique vulnerabilities compared to adults.
- Immaturity, immobility, and medical devices increase pressure injury risk in pediatric ICUs.
- Effective prevention strategies for this population require evaluation.
Purpose of the Study:
- To assess a prevention strategy for positioning-related pressure injuries in pediatric critical care.
- To evaluate compliance with recommended preventive measures.
Main Methods:
- Quasi-experimental before-after study with 110 pediatric patients (≤14 years) in a level III PICU.
- Intervention group received a care bundle based on latest evidence; control group received non-standardized care.
- Data collected over 6 months per group via computer programs and clinical records.
Main Results:
- Cumulative pressure injury incidence decreased from 16% to 13.3%.
- Incidence in prolonged-stay patients (≥28 days) dropped from 55.55% to 20%.
- Category III and IV pressure ulcers were eliminated, and total injuries decreased by 21.43% in the intervention group. Prone positioning was a significant risk factor.
Conclusions:
- A care bundle effectively reduces the incidence and severity of pressure injuries in pediatric intensive care units.
- Vulnerable pediatric patient subgroups show significant benefit from these preventive interventions.
Aims:
To evaluate a prevention strategy implemented to reduce incidence and severity of positioning related pressure injuries affecting pediatric patients in a pediatric critical care unit. Secondary objective was to evaluate compliance with preventive recommendations.
Background:
The skin in infants or children has important physiological and anatomical differences compared with adults. Further, factors such as the immaturity of the skin and limited activity and mobility in pediatric critical care unit, along with the pressure exerted by medical devices, increases the risk of pressure ulcers in infants and children. The most effective preventive measures specific to this intensive care population need to be evaluated.
Material And Methods:
Quasi-experimental before-after study with consecutive sampling. The effectiveness of the care bundle implementation was evaluated based on the latest evidence (intervention group) versus the application of non-standardized care (control group). Pediatric patients up to 14 years old at risk of suffering from pressure injuries and who were admitted more than 48 h in a pediatric intensive care unit (level III) participated. For the collection of data, two computer programs and the hospital clinical records of each participant were consulted. The data collection period was 6 months per group (pre and post intervention).
Results:
A sample of 110 patients was obtained (50 control group and 60 intervention group). The cumulative incidence in pediatric patients exposed to the risk of pressure injuries was reduced from 16% to 13.3%; and in the subgroup of patients with prolonged stay (≥28 days), the incidence was reduced from 55.55% to 20%. In the intervention group, category III and IV pressure ulcers were completely reduced. In addition, the total number of pressure injuries decreased by 21.43%. The care bandle recommendations with the highest level of adhesion recorded were: skin inspection, application of hyperoxygenated fatty acids and use of a special support surface. The main risk factor found during the study was the prone position (p < 0.05).
Conclusions:
The application of a care bundle for prevention can be an effective solution to reduce the number and severity of LPPs in an intensive care unit. The most vulnerable subgroup of patients may benefit from the application of these resources.
More Related Videos
06:04Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...