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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Pressure Ulcers and Nursing-Led Mobilization Protocols in ICU Patients: A Retrospective Observational Cohort Study
Anna Korompeli1, Eleni Karakike1, Petros Galanis1
1Department of Health Science, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Healthcare (Basel, Switzerland)
|July 29, 2025
Summary
Advanced nursing protocols improved existing pressure ulcers (PUs) in intensive care units (ICUs) but did not reduce new PU incidence. Structured care benefits high-risk ICU patients with existing ulcers.
Area of Science:
- Critical Care Medicine
- Nursing Science
- Wound Care
Background:
- Pressure ulcers (PUs) are common in intensive care units (ICUs), particularly for immobilized patients.
- The effectiveness of nursing-led mobilization protocols for PU prevention and healing requires further investigation.
Purpose of the Study:
- To assess the impact of nursing-led mobilization protocols on the incidence and progression of PUs in critically ill patients.
- To evaluate the role of structured nursing care in managing pressure ulcers within the ICU setting.
Main Methods:
- A retrospective observational cohort study involving 188 ICU patients.
- Comparison between conventional care (6-hourly repositioning) and an advanced nursing-led protocol (3-hourly repositioning, support surfaces, specialized training).
- Primary outcome: new PU development or worsening of pre-existing ulcers; Secondary outcome: ICU mortality.
Main Results:
- No significant difference in new PU incidence among patients without pre-existing ulcers.
- Significant improvement in existing PU outcomes for patients receiving advanced nursing care (53.3% vs. 0%).
- Mortality was linked to SOFA score, not the care protocol.
Conclusions:
- Advanced nursing-led mobilization protocols do not significantly reduce new PU incidence but improve outcomes for existing PUs.
- Findings support implementing structured protocols for high-risk ICU patients, especially those with existing ulcers.
- Nursing-led interventions play a crucial role in managing complex patient conditions in critical care settings.
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