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Risk factors and prevalence of medical device-related pressure injuries in pediatric intensive care
Müge Seval1, Emine Uzuntarla Güney2, Tülay Kuzlu Ayyıldız1
1Zonguldak Bülent Ecevit University, Department of Child Health and Diseases Nursing, Zonguldak, Turkey.
Insights
Medical devices in pediatric intensive care units (PICU) cause pressure injuries (PI) in 12.8% of children. Nasal and oral regions are most affected, with nasogastric tubes being a key risk factor.
Area of Science:
- Pediatric Intensive Care
- Medical Device-Related Pressure Injuries
- Patient Safety
Background:
- Critically ill children in the PICU often require medical devices.
- These devices can lead to the development of pressure injuries (PI).
- Understanding the incidence and risk factors for device-related PI is crucial for prevention.
Purpose of the Study:
- To determine the incidence of pressure injuries (PI) in pediatric intensive care unit (PICU) patients using medical devices.
- To identify risk factors associated with medical device-related pressure injuries (MDPI).
- To evaluate the accuracy of different scales in assessing PI risk.
Main Methods:
- A cross-sectional study was conducted with 70 children in the PICU.
- Data were collected between January 12, 2023, and June 30, 2024.
- Risk assessment utilized the Braden Q Scale, BUCH Scale, Glamorgan Scale, and an Injury Monitoring Form.
Main Results:
- The incidence of medical device-related pressure injuries (MDPI) was 12.8%.
- Nasal and oral regions were most affected, with 61.5% being Stage 1 injuries.
- Nasogastric tubes, orogastric feeding equipment, and oral intubation tubes were primary contributors.
Conclusions:
- Medical devices essential for pediatric critical care pose a significant risk for PI development.
- Identifying incidence and risk factors is key for developing effective PI prevention strategies.
- Protocols and interventions can be tailored to manage identified MDPI risks.
Objectives:
This study aimed to determine the incidence of pressure injuries (PI) in patients connected to medical devices during their treatment in the pediatric intensive care unit (PICU), the risk factors, and the most accurate scale that assesses PI.
Methods:
A cross-sectional study adhering to STROBE guidelines. It was carried out with 70 children connected to medical devices during their treatment in the PICU between 12.01.2023 and 06.30.2024. The PI development risk statuses of the patients associated with medical devices were evaluated using the Braden Q Scale, the BUCH Scale, the Glamorgan Pediatric PI Risk Assessment Scale, and an Injury Monitoring Form.
Results:
The incidence of medical device-related pressure injuries (MDPI) in the PICU was 12.8 %. MDPI developed the most frequently in the nasal and oral regions, and 61.5 % of these injuries were Stage 1. The equipment with the highest rates of contribution to PI included nasogastric tubes, orogastric feeding equipment, and oral intubation tubes. The Braden Q, BUCH, and Glamorgan Scales had AUC values of 0.91, 0.83, and 0.80, sensitivity values of 77 %, 77 %, and 66 %, and specificity values of 82 %, 69 %, and 62 %, respectively.
Conclusions:
The results of this study highlight that medical devices used to support the recovery of critically ill children in the PICU pose a significant risk for PI development.
Implications For Clinical Practice:
Determining incidence and risk factors is important to prevent PI. Appropriate protocols, interventions, and strategies can be developed to manage the identified MDPI risk factors.
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