Incidence and risk factors for pressure ulcers in the intensive care unit

• Published in: Journal of clinical nursing Vol. 18; no. 9; pp. 1258 - 1266
• Main Authors: Nijs, Nele, Toppets, Adinda, Defloor, Tom, Bernaerts, Kris, Milisen, Koen, Van Den Berghe, Greet
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2009; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Dobutamine - administration & dosage; Dopamine - administration & dosage; Female; Humans; Incidence; Intensive care; intensive care unit; Intensive Care Units; Male; Middle Aged; nurses; Nursing; nursing assessment; Patient admissions; Pressure Ulcer - classification; Pressure Ulcer - epidemiology; Pressure ulcers; Prospective Studies; Regression analysis; Renal Dialysis; Respiration, Artificial; risk assessment; Risk Factors; Surgery; Belgium
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/j.1365-2702.2008.02554.x

Aims.  To determine the incidence of pressure ulcers occurring at least 48 hours after admission and risk factors for pressure ulcers grade 2–4 in a long‐stay surgical Intensive Care Unit (ICU) population. Background.  The incidence of pressure ulcers in intensive care units is larger than in non‐intensive environments. Design.  Prospective descriptive research design. Methods.  Using pressure ulcers grade 2–4 as an outcome measure, a multivariate logistic regression analysis was used to identify the risk factors. Data were obtained on a daily basis in a surgical intensive care unit of the University Hospital Leuven between November 2003–March 2004. A total of 520 long‐stay (≥ 24 hours) intensive care patients were included. Results.  Cumulative incidence of pressure ulcers grade 2–4 was 20·1%. The following variables were positively associated with pressure ulcers grade 2–4: history of vascular disease, treatment with Dopamine® or Dobutamine®, intermittent haemodialysis (IHD) or continuous veno‐venous haemofiltration (CVVH), mechanical ventilation. Also preventive measures were statistically positively associated with pressure ulcers grade 2–4: turning, floating heels, alternating mattresses, adequate prevention. The use of sedatives, body temperature above 38·5 °C and sitting in chair where negatively associated with pressure ulcers. Pressure ulcers are statistically associated with different risk factors and preventive measures. Conclusion.  The identified risk factors are eligible to be included in a new risk assessment scale for patients admitted to intensive care units. Relevance to clinical practice.  The novel insights have implications for risk assessment for patients in intensive care units. Patients admitted to intensive care units have other risk factors for pressure ulcers which are eligible to be included in a new risk assessment scale.