Frequency of pressure injuries in a resource limited pediatric intensive care unit of Pakistan: a retrospective study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20252955Keywords:
Pressure injury, PICU childrenAbstract
Background: Pressure injuries are a significant global healthcare issue, particularly affecting children, who are identified as high-risk. This study aimed to evaluate the frequency, severity and most vulnerable sites of PIs in critically ill children admitted to the Paediatric Intensive Care Unit (PICU).
Methods: We enrolled children aged 1 month to 15 years who stayed in the PICU for over 24 hours from August 1 to December 30, 2023. Two well trained health professionals called skin champions conducted daily comprehensive skin examinations until discharge or death. Location, severity and possible cause of PIs were noted on data collection sheet as well as trend of occurrence noted.
Results: Among 1,196 patients and 3077 skin assessments, 53 (4.4%) PIs were identified. Of these, 32 injuries (60.4%) were related to medical devices MDRPI and 21 (39.6%) were due to pressure alone. The upper trunk was the most common site (75.5%), with the occiput being particularly affected (24%). Stage 1 and Stage 2 PIs accounted for 45.3% and 54.7%, respectively.
Conclusions: Occurrence of PI was lower than in earlier research, while the frequency of MDRPIs was notably higher underscoring the necessity for improved prevention strategies and ongoing risk evaluations.
Metrics
References
Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised national pressure ulcer advisory panel pressure injury staging system: revised pressure injury staging system. J Wound Ostomy Continence Nurs. 2016;43(6):585-97. DOI: https://doi.org/10.1097/WON.0000000000000281
Delmore B, Deppisch M, Sylvia C, Luna-Anderson C, Nie AM. Pressure injuries in the pediatric population: a national pressure ulcer advisory panel white paper. Adv Skin Wound Care. 2019;32(9):394-408. DOI: https://doi.org/10.1097/01.ASW.0000577124.58253.66
Delmore B, VanGilder C, Koloms K, Ayello EA. Pressure injuries in the pediatric population: analysis of the 2008-2018 international pressure ulcer prevalence survey data. Adv Skin Wound Care. 2020;33(6):301-6. DOI: https://doi.org/10.1097/01.ASW.0000661812.22329.f9
Zhang H, Ma Y, Wang Q, Zhang X, Han L. Incidence and prevalence of pressure injuries in children patients: A systematic review and meta-analysis. J Tissue Viability. 2022;31(1):142-51. DOI: https://doi.org/10.1016/j.jtv.2021.07.003
Berry KG, Seiple SM, Stellar JJ, Nagle ML, Curry K, Immel A, et al. A scoping review to inform a multi-disciplinary approach for nutrition therapy in critically ill children with pressure injuries. Transl Pediatr. 2021;10(10):2799-813. DOI: https://doi.org/10.21037/tp-21-3
Kottner J, Cuddigan J, Carville K, Balzer K, Berlowitz D, Law S, et al. Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international Clinical Practice Guideline 2019. J Tissue Viability. 2019;28(2):51-8. DOI: https://doi.org/10.1016/j.jtv.2019.01.001
Dimanopoulos T, Chaboyer W, Campbell J, Ullman AJ, Battley C, Ware RS, et al. Incidence of hospital-acquired pressure injuries and predictors of severity in a paediatric hospital. J Adv Nurs. 2024;80(10):4161-70. DOI: https://doi.org/10.1111/jan.16140
Stellar JJ, Hasbani NR, Kulik LA, Shelley SS, Quigley S, Wypij D, et al. Medical Device-Related Pressure Injuries in Infants and Children. J Wound Ostomy Continence Nurs. 2020;47(5):459-69. DOI: https://doi.org/10.1097/WON.0000000000000683
Semerci R, Umac EH, Yilmaz D, Karadag A. Analysis of the prevalence and risk factors of pressure injuries in the hospitalized pediatric population: A retrospective study. J Tissue Viability. 2023;32(3):333-8. DOI: https://doi.org/10.1016/j.jtv.2023.04.004
Brown DS, Donaldson N, Burnes Bolton L, Aydin CE. Nursing-sensitive benchmarks for hospitals to gauge high-reliability performance. J Healthc Qual. 2010;32(6):9-17. DOI: https://doi.org/10.1111/j.1945-1474.2010.00083.x
Afaneh T, Abu-Moghli F, Ahmad M. Nursing-sensitive indicators: a concept analysis. Nurs Manag (Harrow). 2021;28(3):28-33. DOI: https://doi.org/10.7748/nm.2021.e1982
Luton M, Stewart M, Steward-Scott M, Mullen M, et al. Evidence-based skin champion program reduces pressure injuries in a pediatric hospital. J Nurs Interprofessional Leadersh Qual Saf. 2018;2(1):2.
Curley MA, Razmus IS, Roberts KE, Wypij D. Predicting pressure ulcer risk in pediatric patients: the Braden Q Scale. Nurs Res. 2003;52(1):22-33. DOI: https://doi.org/10.1097/00006199-200301000-00004
Mishra S, Arayamparambil PV, Chandan GS, Sarada PP, Sharma M. Prevention of hospital-acquired pressure ulcers in patients with prone ventilation: a retrospective observational study. J Panam J Trauma, Crit Care Emerg Surg. 2020;9(3):198-201. DOI: https://doi.org/10.5005/jp-journals-10030-1296
Widiati E, Nurhaeni N, Gayatri D. Medical-Device Related Pressure Injuries to Children in the Intensive Care Unit. Compr Child Adolesc Nurs. 2017;40(1):69-77. DOI: https://doi.org/10.1080/24694193.2017.1386973
Freundlich K. Pressure injuries in medically complex children: a review. Children (Basel). 2017;4(4):25. DOI: https://doi.org/10.3390/children4040025
Curley MAQ, Hasbani NR, Quigley SM, Stellar JJ, Pasek TA, Shelley SS, et al. Predicting Pressure Injury Risk in Pediatric Patients: The Braden QD Scale. J Pediatr. 2018;192:189-95. DOI: https://doi.org/10.1016/j.jpeds.2017.09.045
Downloads
Published
How to Cite
Issue
Section
