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Incidence and Risk Factors for Medical Device-Related Pressure Injury in Hemodynamically Unstable Intensive Care Unit Patients: A Prospective Cohort Study.
Bueno, Luana Furtado; Coelho, Manuela de Mendonça Figueirêdo; Cortez, Daniel Nogueira; Moraes, Juliano Teixeira.
Afiliação
  • Bueno LF; Luana Furtado Bueno, RN, Federal University of São João del-Rei, Divinópolis, Minas Gerais, Brazil.
  • Coelho MMF; Manuela de Mendonça Figueirêdo Coelho, PhD, Federal University of Ceará, Fortaleza, Ceará, Brazil.
  • Cortez DN; Daniel Nogueira Cortez, PhD, Federal University of São João del-Rei, Divinópolis, Minas Gerais, Brazil.
  • Moraes JT; Juliano Teixeira Moraes, PhD, Federal University of São João del-Rei, Divinópolis, Minas Gerais, Brazil.
J Wound Ostomy Continence Nurs ; 51(4): 276-282, 2024.
Article em En | MEDLINE | ID: mdl-38809889
ABSTRACT

PURPOSE:

The purpose of this study was to determine the incidence and identify potential risk factors for medical device-related pressure injury (MDRPI) in critically ill and hemodynamically unstable adults (patients classified class III or IV on the Therapeutic Intervention Scoring System-28; TISS-28).

DESIGN:

Prospective cohort study. SUBJECTS AND

SETTING:

The target population was critically ill adults who were using one or more medical devices and categorized as class III or IV on the TISS-28. The study sample comprised 77 participants followed daily until discharge, death, transfer, or lesion development. Data were collected from January to March 2020. The study setting was an intensive care unit with 40 beds in a large hospital in a municipality in the state of Minas Gerais, Brazil.

METHODS:

Sociodemographic and pertinent clinical data, pressure injury (PI) risk assessed using the Braden Scale for Pressure Sore Risk, and head-to-toe skin inspections were completed. The incidence rate of MDRPIs was calculated, and survival analyses were completed via the Kaplan-Meier method and Cox regression model.

RESULTS:

Forty-nine of 77 participants developed an MDRPI, reflecting an incidence rate of 63.6%. Collectively, 71 MDRPIs occurred in these 49 participants. Univariate analysis indicated significant associations between MDRPI occurrences and level of consciousness ( P = < .001), use of tube holder for ventilation devices ( P = .013), nasal cannula ( P = .034), nasogastric cannula ( P = .034), presence of edema ( P = .001), infection ( P = .007), higher TISS score ( P = .047), and greater number of medical devices ( P = .022). Survival analysis indicated that a high or very high-risk score on the Braden Scale for Pressure Sore Risk ( P = .043) and edema ( P = .030) are risk factors for MDRPI occurrences in this vulnerable population.

CONCLUSIONS:

The incidence rate of MDRPIs was 63.6%. The categories with the highest high or very high risk scores on the Braden Scale for Risk of Pressure Pain and Edema emerged as risk factors for MDRPI in this critically ill and vulnerable population.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Úlcera por Pressão / Unidades de Terapia Intensiva Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Wound Ostomy Continence Nurs Assunto da revista: ENFERMAGEM Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Úlcera por Pressão / Unidades de Terapia Intensiva Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Wound Ostomy Continence Nurs Assunto da revista: ENFERMAGEM Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos