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Risk Factors Related to the Development of Full-thickness Pressure Injuries in Hospitalized Pediatric Patients
Ann Marie Nie1, Elizabeth Hawkins-Walsh, Barbara Delmore
1Ann Marie Nie, PhD, MSN, APRN, FNP-BC, CWOCN, is Wound, Ostomy Nurse Practitioner and Pressure Injury Preventionist, Dayton Children's Hospital, Dayton, Ohio, United States. Elizabeth Hawkins-Walsh, PhD, MSN, CPNP-PC, PMHS, FAANP, is Professor of Nursing Practice (Emerita), Conway School of Nursing, Catholic University of America, Washington, District of Columbia. Barbara Delmore, PhD, RN, CWCN, MAPWCA, FAAN, is Senior Nurse Scientist, Center for Innovations in the Advancement of Care, Departments of Nursing, NYU Langone Health, and Clinical Assistant Professor, Hansjörg Wyss, Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York.
Pediatric pressure injury (PI) risk factors differ by age. Key factors include tissue perfusion, oxygenation, edema, nutrition, and fragile skin, highlighting the need for age-specific prevention strategies in children.
Area of Science:
- Pediatric critical care medicine
- Nursing research
- Wound prevention
Background:
- Current pediatric pressure injury (PI) prevention strategies are adapted from adult guidelines.
- Children's developing bodies and unique skin properties necessitate distinct PI risk factor considerations.
- Pediatric PIs pose a unique challenge due to developmental differences.
Purpose of the Study:
- To identify and analyze risk factors associated with the development of full-thickness pressure injuries (PIs) in hospitalized children.
- To investigate age-specific risk factors for PIs in pediatric patients from 21 weeks' gestation to 21 years.
Main Methods:
- Retrospective, observational, correlational study design.
- Inclusion of 799 hospitalized children diagnosed with PIs.
- Utilized a stepwise multivariate logistic regression model to analyze risk factors.
Main Results:
- Risk factors for full-thickness PIs varied significantly across different pediatric age groups.
- Infants (38 weeks to 12 months) were at risk due to edema, OR conditions, and nutrition deficits.
- Older children (8-21 years) faced risks from decreased oxygenation and extracorporeal membrane oxygenation (ECMO).
- Overall significant risk factors included ECMO, decreased oxygenation, and malnutrition.
Conclusions:
- Full-thickness pressure injury risk factors are not uniform across pediatric age spans.
- Age-specific risk factor identification is crucial for effective PI prevention in children.
- Tailored prevention protocols based on age-related risks are recommended.
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