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Prevalence and Risk Factors of Pressure Injuries in Norwegian Intensive Care Units: A Secondary Analysis
Antonija Petosic1,2, Solveig Sofie Amalie Bock3, Stina Kornstad Nordahl1
1General Intensive Care Unit Ulleval, The Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Insights
The prevalence of intensive care unit (ICU)-acquired pressure injuries in Norway was 24%, highlighting a significant challenge in critical care settings. This underscores the need for enhanced prevention strategies to reduce patient harm and healthcare costs.
Area of Science:
- Critical care medicine
- Nursing research
- Patient safety
Background:
- Pressure injuries are a significant complication in critically ill patients, leading to increased morbidity and healthcare costs.
- Limited national data exists on the prevalence of pressure injuries in Norwegian intensive care units (ICUs).
- This study addresses the gap by describing the prevalence, characteristics, and risk factors of ICU-acquired pressure injuries in Norway.
Purpose of the Study:
- To determine the prevalence of ICU-acquired pressure injuries in Norwegian ICUs.
- To identify the characteristics and common locations of these pressure injuries.
- To investigate associated risk factors for developing pressure injuries during ICU stays.
Main Methods:
- Secondary analysis of Norwegian data from the international DecubICUs study (May 15, 2018).
- Cross-sectional, multicenter study including 119 patients from 25 Norwegian ICUs.
- Prevalence calculated based on the presence of one or more ICU-acquired pressure injuries.
Main Results:
- The prevalence of ICU-acquired pressure injury was 24% (28/119 patients).
- Most injuries were Stage I (71%) and Stage II (27%), commonly on heels and buttocks.
- Length of stay in the ICU (LOS-ICU) was a significant risk factor (OR=1.06/day increase).
Conclusions:
- The 24% prevalence of ICU-acquired pressure injuries in Norway is surprisingly high.
- This highlights the ongoing challenge of pressure injury prevention, even in high-resource settings.
- Emphasizes the need for continued focus on prevention strategies like skin assessment and repositioning.
Background:
Pressure injuries among critically ill patients are complications that may lead to increased morbidity, prolonged hospital stays, and higher healthcare costs. Despite this fact, there is limited national data on the prevalence of pressure injuries in Norwegian intensive care units (ICUs). This study describes the prevalence, characteristics of, and associated risk factors for ICU-acquired pressure injuries in Norway.
Methods:
A secondary analysis of the Norwegian data from the international one-day prevalence study, DecubICUs, conducted on 15 May 2018. Data on pressure injuries, patient characteristics, and exposure to potential risk factors were analyzed. Prevalence was calculated based on the presence of one or more ICU-acquired pressure injuries on the study day.
Result:
This multicenter cross-sectional study included 119 patients from 25 Norwegian ICUs. The prevalence of ICU-acquired pressure injury was 24% (28/119). These 28 patients had 52 ICU-acquired pressure injuries. Of these, the majority were stage I (71%), followed by stage II (27%), and one was categorized as suspected deep tissue injury (2%). The most common locations were the heels (23%), buttocks (23%), ears (17%), nose (12%) and mouth (10%). The risk factor associated with ICU-acquired pressure injuries was LOS-ICU (OR = 1.06/day increase, 95% CI: 1.02-1.11, p = < 0.001).
Conclusion:
The prevalence of ICU-acquired pressure injury was surprisingly high considering Norway is a high-income country, with a high nurse-to-patient ratio and well-educated critical care nurses. These findings highlight the need for continued focus on early prevention strategies, such as thorough skin assessments, "floating heels" and repositioning of medical devices.
Editorial Comment:
This subgroup analysis for Norwegian cases reported in a point-prevalence study presents intensive care unit patients with pressure injuries along with selected case factors. Pressure injuries are complications that appear to remain an intensive care unit challenge, even in units with high nurse to patient ratios.
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