Hospital‐acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation

Manzano, F.; Pérez-Pérez, Ana María; Martínez-Ruiz, Susana; Garrido‐Colmenero, Cristina; Roldán, Delphine; Jiménez-Quintana, María del Mar; Sánchez‐Cantalejo, Emilio; Colmenero, Manuel Herrador

doi:10.1111/jep.12137

Cited by 50 publications

(33 citation statements)

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“…Furthermore, Manzano et al investigated the association between newly developed pressure injuries and in‐hospital mortality in a single‐center, prospective cohort study of medical–surgical ICU patients . In this analysis, pressure injury development while hospitalized in the ICU was an independent predictor of in‐hospital death (adjusted hazard ratio 1.28; 95% CI 1.003–1.65, P = .047) . These analyses continue to highlight the significance of HAPIs as an important healthcare issue in those who are acutely ill.…”

Section: Discussionmentioning

confidence: 90%

“…In a secondary analysis of data from a recent multicenter study (n = 7291), ICU patients were 3.8 times more likely to develop a HAPI compared with those not admitted to the ICU (relative risk 3.8; 95% CI 2.7–5.4) . Recent studies have also found pressure injuries to be associated with important clinical outcomes in critically ill patients . Graves et al performed a cross‐sectional analysis from an ongoing prospective study (n = 2500), and found pressure injuries to be independently associated with a prolonged hospital LOS compared with those who did not develop a HAPI (4.31 days; 95% CI 1.85–6.78) .…”

Section: Discussionmentioning

confidence: 99%

“…Graves et al performed a cross‐sectional analysis from an ongoing prospective study (n = 2500), and found pressure injuries to be independently associated with a prolonged hospital LOS compared with those who did not develop a HAPI (4.31 days; 95% CI 1.85–6.78) . Furthermore, Manzano et al investigated the association between newly developed pressure injuries and in‐hospital mortality in a single‐center, prospective cohort study of medical–surgical ICU patients . In this analysis, pressure injury development while hospitalized in the ICU was an independent predictor of in‐hospital death (adjusted hazard ratio 1.28; 95% CI 1.003–1.65, P = .047) .…”

Section: Discussionmentioning

confidence: 99%

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Vitamin D Status Is Associated With Development of Hospital‐Acquired Pressure Injuries in Critically Ill Surgical Patients

et al. 2018

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Vitamin D Status Is Associated With Development of Hospital‐Acquired Pressure Injuries in Critically Ill Surgical Patients

et al. 2018

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“…Pressure ulcers have also been associated with higher mortality and decreased quality of life. (2,3) Therefore, the incidence and severity of PUs have become indicators of the quality of care and safety of patients in the intensive care unit (ICU). (4) …”

Section: Introductionmentioning

confidence: 99%

Reducing pressure ulcers in patients with prolonged acute mechanical ventilation: a quasi-experimental study

Loudet¹,

Marchena²,

Maradeo³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectiveTo determine the effectiveness of a quality management program in reducing the incidence and severity of pressure ulcers in critical care patients.MethodsThis was a quasi-experimental, before-and-after study that was conducted in a medical-surgical intensive care unit. Consecutive patients who had received mechanical ventilation for ≥ 96 hours were included. A "Process Improvement" team designed a multifaceted interventional process that consisted of an educational session, a pressure ulcer checklist, a smartphone application for lesion monitoring and decision-making, and a "family prevention bundle".ResultsFifty-five patients were included in Pre-I group, and 69 were included in the Post-I group, and the incidence of pressure ulcers in these groups was 41 (75%) and 37 (54%), respectively. The median time for pressure ulcers to develop was 4.5 [4 - 5] days in the Pre-I group and 9 [6 - 20] days in the Post-I group after admission for each period. The incidence of advanced-grade pressure ulcers was 27 (49%) in the Pre-I group and 7 (10%) in the Post-I group, and finally, the presence of pressure ulcers at discharge was 38 (69%) and 18 (26%), respectively (p < 0.05 for all comparisons). Family participation totaled 9% in the Pre-I group and increased to 57% in the Post-I group (p < 0.05). A logistic regression model was used to analyze the predictors of advanced-grade pressure ulcers. The duration of mechanical ventilation and the presence of organ failure were positively associated with the development of pressure ulcers, while the multifaceted intervention program acted as a protective factor.ConclusionA quality program based on both a smartphone application and family participation can reduce the incidence and severity of pressure ulcers in patients on prolonged acute mechanical ventilation.

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“…The PUs have a negative impact on the quality of life of patients, hindering functional recovery, often causing pain and suffering, leading to the development of serious infections associated with prolonged hospitalization, sepsis and mortality 3 - 6 . Moreover, the PUs expand the workload of healthcare staff and contribute to expensive costs for health services 7 .…”

Section: Introductionmentioning

confidence: 99%

Experimental study with nursing staff related to the knowledge about pressure ulcers

Baron

Reuter

Burgos

et al. 2016

Rev. Latino-Am. Enfermagem

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Objective:to compare the scores of knowledge in teams participating or not participating in educational interventions about pressure ulcers. Method:a quantitative study with experimental design. Data were collected through a validated questionnaire. The study included 71 individuals, including nurses and nursing technicians from three intensive care units, divided into intervention group and control group. Data analysis considered the scores of the groups in the moment before and after intervention. To check the average rate of correct answers, we calculated the mean and standard deviation. We carried out the Mann-Whitney test for analysis of two independent samples, and the Wilcoxon test for related samples. Results:The mean percentage of correct answers, at the baseline was 74.1% (SD = 26.4) in the intervention group and 76.0% (SD = 22.9) in the control group and post time -intervention, was 87.8% (SD = 18.8) in the group receiving educational intervention, considering that in the control group it was 79.1% (SD = 22.2). The group that participated in educational interventions did not reach the proper average of 90% correct answers for the test. Conclusion:educational interventions on staging, evaluation and prevention of pressure ulcers contributed significantly to the increase of correct responses score in the knowledge test of the intervention group and improved their knowledge on the subject.

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Hospital‐acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation

Abstract: Within the limitations of a single-centre approach, PU development appears to be associated with an increase in mortality among patients requiring MV for 24 hours or longer.

Cited by 50 publications

References 45 publications

Vitamin D Status Is Associated With Development of Hospital‐Acquired Pressure Injuries in Critically Ill Surgical Patients

Vitamin D Status Is Associated With Development of Hospital‐Acquired Pressure Injuries in Critically Ill Surgical Patients

Reducing pressure ulcers in patients with prolonged acute mechanical ventilation: a quasi-experimental study

Experimental study with nursing staff related to the knowledge about pressure ulcers

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