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Hospital-acquired pressure injury: our seven years of experience
Pinar Oztas1, Emine Karabulut Demirci2, F Nur Baran Aksakal3
1Lokman Hekim University Faculty of Medicine, Department of Dermatology, Ankara, Turkey.
Insights
Hospital-acquired pressure injuries (HAPIs) are a concern in patient care. Airbeds significantly protect against HAPIs, while zinc-containing barrier creams may delay wound onset but lack definitive protective efficacy.
Area of Science:
- Medical Research
- Patient Care Quality
- Wound Prevention
Background:
- Hospital-acquired pressure injuries (HAPIs) are a significant indicator of patient care quality.
- HAPIs can lead to substantial medical, legal, and economic burdens on healthcare systems.
- Understanding factors contributing to HAPI formation is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the factors contributing to the formation of hospital-acquired pressure injuries (HAPIs).
- To assess the efficacy of interventions like zinc-containing barrier creams (ZnBC) and airbeds in preventing HAPIs.
Main Methods:
- Retrospective analysis of 2327 hospitalised patients' data from June 2014 to June 2021.
- Data collected included patient demographics, Waterlow scale scores, mobility, use of ZnBC and airbeds, and duration of hospitalisation.
- Outcomes assessed were the development of Stage 2 and deeper pressure injuries (PIs).
Main Results:
- A total of 303 patients (13%) developed Stage 2 or deeper PIs.
- Male patients exhibited an increased risk of HAPI development.
- Airbed usage demonstrated the most significant protective effect against HAPI formation.
- Zinc-containing barrier creams (ZnBC) did not show a protective effect but appeared to delay wound onset.
Conclusions:
- Healthcare professionals need increased awareness of HAPI risks associated with prolonged hospitalisation.
- Airbeds are identified as a protective measure for patients hospitalised long-term.
- Further research, including randomised trials, is necessary to clarify the role and efficacy of ZnBC in HAPI prevention.
Objective:
A pressure injury (PI) happens on the skin and in deeper tissues. Generally, it occurs due to prolonged compression over bony structures. A PI, when occurring during a hospital stay, is regarded as a hospital-acquired pressure injury (HAPI), and is considered as a marker for patient care quality. It might cause medical, legal or economic problems, and could be a burden on health systems. In this study we evaluate the factors contributing to HAPI formation.
Method:
Between June 2014-June 2021, we retrospectively investigated the files of patients who were hospitalised with different medical conditions in Bayindir Sögütözü Hospital, Ankara, Turkey, for patients' age, sex, Waterlow scale score, mobilisation status, application of zinc-containing and/or barrier creams (ZnBC), airbed usage, hospitalisation period, and the day of wound opening.
Results:
The study cohort comprised 2327 hospitalised patients: 303 (13%) developed Stage 2 and deeper PIs; 2024 patients were hospitalised and discharged without wound opening. We found an increased risk in male patients and a lack of efficacy of ZnBC in protection from HAPI in our study population. However, we observed that ZnBC helped to delay wound opening and that the most protective treatment was the use of airbeds.
Conclusion:
Health professionals should be more aware of HAPI formation with prolonged hospitalisation periods. Only the use of an airbed for a patient hospitalised for a long period appears to be protective against PI formation. On the other hand, use of ZnBC delays wound opening. However, further research is needed to demonstrate the protective effect of ZnBC, due to the lack of randomisation in our study and the lack of some nursing records.
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