A systematic review of prevalence and incidence of pressure ulcers/injuries in hospital emergency services

Sardo, Pedro Miguel Garcez; Teixeira, João; Machado, Ana Margarida Sampaio Ferreira; Oliveira, Beatriz Fernandes; Alves, Inês Martins

doi:10.1016/j.jtv.2023.02.001

Cited by 24 publications

(17 citation statements)

References 46 publications

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“…As described in previous literature, we found that the odds of developing pressure ulcers increased with age, and patients covered by Medicare or Medicaid were more likely to have pressure ulcers than patients with private insurance. 5,15,21,23,24 In our study, patients with Medicare or Medicaid were significantly more likely to develop a pressure ulcer than patients with private insurance. Medicare patients had nearly twice the odds of pressure ulcer development compared with private insurance patients.…”

Section: Discussionmentioning

confidence: 48%

Vulnerability to Decubitus Ulcers and Their Association With Healthcare Utilization: Evidence From Nationwide Inpatient Sample Dataset From 2016 to 2020 in US Hospitals

Kim,

Medina,

Hotz

et al. 2023

J Patient Saf

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Objective The aim of the study is to identify vulnerable populations at risk of developing decubitus ulcers and their resultant increase in healthcare utilization to promote the use of early prevention methods. Methods The National Inpatient Sample of the United States was used to identify hospitalized patients across the country who had a length of stay of 5 or more days (N = 9,757,245, weighted N = 48,786,216) from 2016 to 2020. We examined the characteristics of the entire inpatient sample based on the presence of decubitus ulcers, temporal trends, risk of decubitus ulcer development, and its association with healthcare utilization, measured by discounted hospital charges and length of stay. The multivariate survey logistic regression model was used to identify predictors for decubitus ulcer occurrence, and the survey linear regression model was used to measure how decubitus ulcers are associated with healthcare utilization. Results Among 48,786,216 nationwide inpatients, 3.9% had decubitus ulcers. The percentage of inpatients with decubitus ulcers who subsequently experienced increased healthcare utilization rose with time. The survey logistic regression results indicate that patients who were Black, older, male, or those reliant on Medicare/Medicaid had a statistically significant increased risk of decubitus ulcers. The survey linear regression results demonstrate that inpatients with decubitus ulcers were associated with increased hospital charges and longer lengths of stay. Conclusions Patients with government insurance, those of minority races and ethnicities, and those treated in the Northeast and West may be more vulnerable to pressure ulcers and subsequent increased healthcare utilization. Implementation of early prevention methods in these populations is necessary to minimize the risk of developing decubitus ulcers, even if upfront costs may be increased. For example, larger hospitals were found to have a lower risk of decubitus ulcer development but an increased cost of preventative care. Hence, it is imperative to explore and use universal, targeted preventative methods to improve patient safety.

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Section: Discussionmentioning

confidence: 48%

Vulnerability to Decubitus Ulcers and Their Association With Healthcare Utilization: Evidence From Nationwide Inpatient Sample Dataset From 2016 to 2020 in US Hospitals

Kim,

Medina,

Hotz

et al. 2023

J Patient Saf

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“…A systematic analysis reported that the most common areas for PI development were the sacrogluteal region and heel. 31 Medical device-related PIs have a high incidence of 5% to 43% in patients hospitalized in the ICU. 32,33 In parallel with the literature, 35% of patients in the intervention group and 24% of those in the control group in the present study developed MDRPIs.…”

Section: Discussionmentioning

confidence: 99%

“…Most patients developed PIs in the foot, (eg, the heel, malleoli, etc), sacrum, trochanter, and face regions. A systematic analysis reported that the most common areas for PI development were the sacrogluteal region and heel 31 . Medical device-related PIs have a high incidence of 5% to 43% in patients hospitalized in the ICU 32,33 .…”

Section: Discussionmentioning

confidence: 99%

Everyday Prevention: The Impact of Daily Comprehensive Skin Assessments on Pressure Injury Healing in the General ICU

Yilmaz Akyaz,

Cevizci,

Sengul

2024

Adv Skin Wound Care

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OBJECTIVE To investigate the effect of daily versus weekly comprehensive skin assessments on wound healing status in patients with pressure injuries (PIs) treated in the general ICU. METHODS This quasi-experimental study was conducted at a foundation hospital from November 15, 2022, to March 15, 2023. The sample consisted of 193 patients with PIs who met the inclusion criteria. The Braden Scale, Nutritional Risk Scale 2002 (NRS-2002), and Pressure Ulcer Scale for Healing (PUSH) were used. The intervention group (n = 98) underwent comprehensive skin assessment every day, whereas the control group (n = 95) followed routine procedures. The study findings were reported according to TREND (Transparent Reporting of Evaluations with Non-randomized Designs) guidelines. RESULTS Patients were older adults, with a mean age of 70 ± 15.45 years in the intervention group and 71 ± 13.20 years in the control group. The mean NRS-2002 score was 3 ± 2.01 in the intervention group and 2 ± 1.38 in the control group. Medical device-related PI incidence was high in both groups (intervention: 36.8%, control: 24.5%). In the intervention (14.3%) and control (50%) groups, PIs developed mostly due to antiembolic stockings. Deep-tissue PIs were the most common (intervention: 56.8%, control: 62.2%). The last PUSH scores decreased in both groups. The difference between the PUSH scores of the intervention and control groups was statistically significant (P < .05). CONCLUSIONS The findings of this study demonstrate the critical role of daily comprehensive skin assessment in the healing process of PIs. Especially in ICUs, the study provides compelling evidence for the need to prioritize and implement regular skin assessments to prevent PIs and support the healing process.

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“…Additionally, attention to the typology of each unit and patients’ (clinical) characteristics should be considered [ 43 ]. The (new) epidemiological challenges with critical care patients [ 2 ] raise the awareness of health professionals and institutions for this issue by creating specific training and research strategies [ 44 , 45 ]. Thus, in addition to the critical care needs of patients, the number of dressings, their complexity, and the nursing workload they represent can be considered to reduce the ratio of patients per nurse (one patient per one nurse, for example).…”

Section: Discussionmentioning

confidence: 99%

Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

Reis

Sá‐Couto

Mateus

et al. 2023

IJERPH

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The objective of this study is to understand how the type of wound dressing changes (routine or frequent) in patients admitted to intensive care units influences nurses’ workload. This study used a database of retrospective and analytical observational study from one Portuguese intensive care unit. The sample included 728 adult patients admitted between 2015 and 2019. The nursing workload was assessed by the TISS-28 scale, both at admission and at discharge. The linear regression results show that patients with frequent dressing changes are associated with a higher nursing workload, both at admission (Coef. 1.65; 95% CI [0.53; 2.77]) and discharge (Coef. 1.27; 95% CI [0.32; 2.22]). In addition, age influences the nursing workload; older people are associated with a higher nursing workload (at admission Coef. 0.07; 95% CI [0.04; 0.10]; at discharge Coef. 0.08; 95% CI [0.05; 0.10]). Additionally, an increase in nursing workload at admission would significantly increase the nursing workload at discharge (Coef. 0.27; 95% CI [0.21; 0.33]). The relative stability of the nursing workload over the studied years is also another important finding (the influence of studied years is non-significant). In conclusion, patients with frequent dressing changes presented higher TISS-28 scores when compared with patients with an exchange of routine dressings, which leads to a higher nursing workload.

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A systematic review of prevalence and incidence of pressure ulcers/injuries in hospital emergency services

Cited by 24 publications

References 46 publications

Vulnerability to Decubitus Ulcers and Their Association With Healthcare Utilization: Evidence From Nationwide Inpatient Sample Dataset From 2016 to 2020 in US Hospitals

Vulnerability to Decubitus Ulcers and Their Association With Healthcare Utilization: Evidence From Nationwide Inpatient Sample Dataset From 2016 to 2020 in US Hospitals

Everyday Prevention: The Impact of Daily Comprehensive Skin Assessments on Pressure Injury Healing in the General ICU

Impact of Wound Dressing Changes on Nursing Workload in an Intensive Care Unit

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