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Altered skin integrity in children admitted to a pediatric intensive care unit
M B Zollo1, M L Gostisha, R J Berens
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, USA.
Insights
Altered skin integrity affects 26% of pediatric intensive care unit admissions. The Pediatric Risk of Mortality Score and white race are key risk factors for skin issues in critically ill children.
Area of Science:
- Pediatric critical care medicine
- Nursing quality improvement
- Dermatology in intensive care
Background:
- Altered skin integrity is a common complication in pediatric intensive care units (PICUs).
- Identifying risk factors is crucial for effective prevention strategies.
- Previous research has not fully elucidated specific predictors in this population.
Purpose of the Study:
- To investigate the incidence and severity of altered skin integrity in a tertiary PICU.
- To identify demographic, severity of illness, and practice-related risk factors for skin compromise.
- To inform quality improvement initiatives aimed at reducing skin integrity issues.
Main Methods:
- Prospective quality improvement study over an 18-week period.
- Inclusion of 271 admissions to a tertiary pediatric intensive care unit.
- Data collection on demographics, illness severity (Pediatric Risk of Mortality Score), and practice variables.
- Analysis of data from PICU admission until skin integrity change or discharge.
Main Results:
- Altered skin integrity occurred in 26% of admissions; 7% experienced skin breakdown.
- Multivariate analysis identified the Pediatric Risk of Mortality Score as a significant risk factor.
- White race was also found to be associated with altered skin integrity.
Conclusions:
- The incidence of altered skin integrity in this PICU warrants attention.
- The Pediatric Risk of Mortality Score is a valuable predictor for identifying at-risk pediatric patients.
- Targeted interventions for high-risk patients, considering race, may improve outcomes.
Abstract:
As part of a quality improvement study, the incidence and severity of altered skin integrity in a tertiary pediatric intensive care unit (PICU) were investigated in an attempt to identify contributing risk factors. Demographic, severity of illness, and practice variables were collected on 271 of 357 admissions during an 18-week period. Data were analyzed from the date of PICU admission until a change in skin integrity occurred or until PICU discharge. Altered skin integrity occurred in 26 percent of admissions; 7 percent of the cases had skin breakdown. By multivariate analysis, only the Pediatric Risk of Mortality Score and white race were associated with altered skin integrity.