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Risk factors of medical device-related pressure injury in intensive care units
Objectives:
Intensive care unit (ICU) patients are at high risk of medical device related pressure injury (MDRPI). This study aims to ascertain the MDRPI prevalence in ICU patients and analyse the risk factors of MDRPI.
Background:
The occurrence of MDRPI not only increases hospitalisation time with pain and economic burden, but also causes medical disputes. A better understanding of this condition will increase knowledge and facilitate the ability to recognise and prevent MDRPI for clinical nursing staff. However, there are few multicentre studies of MDRPI prevalence in ICU patients in China.
Design:
A cross-sectional study design was employed.
Methods:
Data from 694 patients in 66 adult ICU at 30 hospitals in China were included between October 2018 and March 2019. The stage of each MDRPI was determined according to the definitions of National Pressure Ulcer Advisory Panel. The study methods were followed by the STORBE guidelines.
Results:
The overall prevalence rate of MDRPI was 13.1% (91/694), with 98 anatomic locations in total. The most common stages of MDRPI were stage 1 (54.1%, 53/98), stage 2 (15.3%, 15/98) and mucosal membrane pressure injury (15.3%, 15/98). MDRPI mainly occurred in the finger (32.7%, 32/98), followed by nose (18.4%, 18/98). The prevalence rate of MDRPI caused by CPAP or BiPAP masks (25%) was highest. Lower Braden scores and having skin oedema were risk factors for MDRPI in adult ICU patients.
Conclusion:
The prevalence of MDRPI in this study was still high. Nurses should take these related factors into consideration when taking care of ICU patients, and appropriate prevention measures should be adopted to decrease the prevalence of MDRPI.
Relevance To Clinical Practice:
The study can help to improve the PI prevention efforts in ICU patients specific to medical device related PI.
Insights
Medical device related pressure injury (MDRPI) affects 13.1% of ICU patients in China. Lower Braden scores and skin edema are key risk factors, highlighting the need for targeted prevention strategies.
Area of Science:
- Critical Care Medicine
- Nursing Research
- Patient Safety
Background:
- Medical device related pressure injury (MDRPI) is a significant concern in intensive care units (ICUs), leading to increased hospitalization, pain, and economic burden.
- Existing research on MDRPI prevalence in Chinese ICUs is limited, necessitating multicenter investigations.
- Understanding MDRPI is crucial for clinical nursing staff to improve recognition and prevention strategies.
Purpose of the Study:
- To determine the prevalence of MDRPI in intensive care unit (ICU) patients in China.
- To identify and analyze the risk factors associated with MDRPI in this patient population.
Main Methods:
- A cross-sectional study was conducted involving 694 patients across 66 adult ICUs in 30 Chinese hospitals from October 2018 to March 2019.
- MDRPI staging followed the National Pressure Ulcer Advisory Panel definitions, adhering to STORBE guidelines.
- Data collection focused on MDRPI occurrence, location, stage, and associated patient factors.
Main Results:
- The overall prevalence of MDRPI was 13.1% (91/694), with 98 affected anatomic locations identified.
- The most frequent MDRPI stages were Stage 1 (54.1%) and Stage 2 (15.3%), with mucosal membrane injuries also at 15.3%.
- Fingers (32.7%) and nose (18.4%) were the most common sites, and CPAP/BiPAP masks caused the highest incidence (25%); lower Braden scores and skin edema were significant risk factors.
Conclusions:
- The prevalence of MDRPI in Chinese ICUs remains high, underscoring the need for vigilant nursing care.
- Clinical nursing staff should consider identified risk factors, such as lower Braden scores and skin edema, for effective MDRPI prevention.
- Implementing targeted prevention measures is essential to reduce the incidence of MDRPI in ICU patients.
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