RESUMO Objetivo Identificar e analisar os coeficientes de incidência de úlceras por pressão (UP) e os fatores de risco para o seu desenvolvimento em pacientes críticos com doenças cardiopneumológicas. Método Estudo de coorte, prospectivo realizado na Unidade de Terapia Intensiva (UTI) Cardiopneumológica de um hospital de grande porte na cidade de São Paulo, durante os meses de novembro de 2013 a fevereiro de 2014. Participaram do estudo 370 pacientes maiores de 18 anos, que não apresentavam UP na admissão e que estavam na UTI há menos de 24 horas. Os dados foram analisados por meio de análises univariadas e multivariada (Classification And Regression Tree - CART). Resultados Os coeficientes de incidência de UP foram: 11,0% para o total, distribuindo-se em 8,0% entre os homens e 3,0% para as mulheres (p=0,018); 10,0% na raça branca e 6,5% em pessoas com idade igual e superior a 60 anos. Os principais fatores de risco encontrados foram tempo de permanência na UTI igual ou superior a 9,5 dias, idade igual ou superior a 42,5 anos e raça branca. Conclusão O estudo contribui para os conhecimentos relacionados à epidemiologia das UP em pacientes críticos com doenças cardiopneumológicas, favorecendo o planejamento de cuidados preventivos específicos para essa clientela.

Aim:To estimate the incidence of pressure injury and its predictors including nursing workload in critical patients. Background:There is controversy about the influence of the nursing workload on the occurrence of pressure injury in intensive care units. Methods:A retrospective cohort of 766 patients in nine intensive care units of two university hospitals was studied. The nursing workload was measured using the Nursing Activities Score. The predictors were identified by logistic regression. Results:The pressure injury incidence was 18.7%. The odds ratio of the development of pressure injury, increased 3.5 times in mechanical ventilation (p < 0.001), 7.8 times in palliative care (p = 0.004), 2.3 times in the 60-84 years old group (p = 0.005); it also increased 10% for each day of hospitalization (p < 0.001), and 1.5% for each registered point of the Nursing Activities Score (p = 0.016). Conclusion:Existing risks for the development of pressure injury have been confirmed and nursing workload identified as a new predictor. Much still needs to be done in the area of prevention, especially in groups at risk. Implications for Nursing Management:Increasing nursing resources in the intensive care unit may assist in reducing the pressure injury rate. K E Y W O R D Sincidence, intensive care units, nursing, pressure ulcer, workload | 309 STRAZZIERI-PULIDO ET AL.

Objective: To identify and analyse skin tear prevalence and factors associated with its occurrence. Method: Systematic review of literature of studies published until June 2014 including studies published in full in English, Spanish or Portuguese. The studies were analysed according to the Strengthening the Reporting of Observational Studies in Epidemiology and the Guidelines for Critically Appraising Studies of Prevalence or Incidence of a Health Problem. Results: The analysis of eight studies showed skin tear prevalence of 3.3% to 22% in the hospital setting and 5.5% to 19.5% in homecare. Advanced age, dependence on basic activities of daily life, frail elderly, level of mobility, agitated behavior, non-responsiveness, greater risk for concurrent development of pressure ulcers, cognitive impairment, spasticity and photoaging were cited as risk factors. Conclusion: Skin tear prevalence ranged from 3.3% to 22% and is mainly associated with advanced age and dependence on basic activities of daily life.

AIMS: to perform the cultural adaptation of the STAR Skin Tear Classification System into the Portuguese language and to test the content validity and inter-rater reliability of the adapted version. METHODS: methodological study with a quantitative approach. The cultural adaptation was developed in three phases: translation, evaluation by a committee of judges and back-translation. The instrument was tested regarding content validity and inter-rater reliability. RESULTS: the adapted version obtained a regular level of concordance when it was applied by nurses using photographs of friction injuries. Regarding its application in clinical practice, the adapted version obtained a moderate and statistically significant level of concordance. CONCLUSION: the study tested the content validity and inter-rater reliability of the version adapted into the Portuguese language. Its inclusion in clinical practice will enable the correct identification of this type of injury, as well as the implementation of protocols for the prevention and treatment of friction injuries.