Pressure injury prevalence in Australian intensive care units: A secondary analysis

Coyer, Fiona; Chaboyer, Wendy; Lin, Frances; Doubrovsky, Anna; Barakat‐Johnson, Michelle; Brown, Wendy; Lakshmanan, Ramanathan; Leslie, Gavin; Jones, Sarah L.; Pearse, India; Martin, Kerrie; McInnes, Elizabeth; Powell, Madeleine; Mitchell, Marion; Sosnowski, Kellie; Tallot, Mandy; Thompson, Amy; Thompson, Lorraine; Labeau, Sonia; Blot, Stijn

doi:10.1016/j.aucc.2021.10.009

Cited by 16 publications

(6 citation statements)

References 29 publications

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“…Although the hospital‐acquired pressure injury prevalence in intensive care found in this study is relatively high, it is lower than reported global point‐prevalence (16.2%) (Labeau et al, 2021). In a sub‐set sample of 288 intensive care patients in 16 adult intensive care units across four Australian states, point prevalence was similar (9.7%) (Coyer, Chaboyer, Lin, Doubrovsky, et al, 2022). Forty intensive care‐acquired pressure injuries were found in 28 patients, which were deemed intensive care‐acquired if they were not recorded as being present‐on‐admission to intensive care.…”

Section: Discussionmentioning

confidence: 98%

“…Similarly, the proportion of severe pressure injuries (Stages III‐IV and Suspected deep tissue injuries) reported in an Australian and New Zealand prevalence study was 11.2% (12/107) (Yarad et al, 2021) but around half of these were not intensive care‐acquired injuries. In the Australian point‐prevalence study of Coyer, Chaboyer, Lin, Doubrovsky, et al (2022), the proportion of severe hospital‐acquired pressure injury in intensive care patients was 22.5%. There were no Stage IV pressure injuries, and the majority of severe pressure injuries were Suspected deep tissue injuries, similar to our current study; however, most injuries (65.0%) were reported as Stage I or II, which was higher than found in our study (50.0%).…”

Section: Discussionmentioning

confidence: 99%

“…In the Australian point-prevalence study of Coyer, Chaboyer, Lin, Doubrovsky, et al (2022), the proportion of severe hospital-acquired pressure injury in intensive care patients was 22.5%. There were no Stage IV pressure injuries, and the majority of severe pressure injuries were Suspected deep tissue injuries, similar to our current study; however, most injuries (65.0%) were reported as Stage I or II, which was higher than found in our study (50.0%).…”

Section: Discussionmentioning

confidence: 99%

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State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

Fulbrook

Lovegrove

Hay

et al. 2023

Journal of Clinical Nursing

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Aim:The aim of this study was to analyse prevalence of pressure injury in intensive care versus non-intensive care patients.Background: Hospital-acquired pressure injury is an enduring problem. Intensive care patients are more susceptible due to multiple risk factors. Several studies have indicated that intensive care patients are more likely than general patients to develop pressure injuries.Design: Secondary data analysis.Methods: Eighteen general hospitals with intensive care units were included. The sample included all consenting patients. Logistic regression modelling was used to derive prevalence and effect estimates. STROBE reporting guidelines were followed. Results:The sample comprised 15,678 patients; 611 were in intensive care. The crude prevalence estimate of hospital-acquired pressure injury was 9.6% in intensive care and 2.1% in non-intensive care patients. The ≥Stage II hospital-acquired prevalence estimate in was 8.6% intensive care and 1.2% in non-intensive care patients.Intensive care patients were at markedly increased risk of hospital-acquired pressure injury compared with non-intensive care patients, with risk persisting after adjusting for pressure injury risk score. Risk of ≥ Stage II hospital-acquired pressure injury was further elevated. Intensive care patients had a higher pressure injury risk level and developed a greater proportion of severe hospital-acquired pressure injuries than non-intensive care patients. In intensive care, most hospital-acquired pressure injuries were found on the sacrum/coccyx and heels.Conclusions: There were significant differences between the hospital-acquired pressure injury prevalence of intensive care versus non-intensive care patients, which is consistent with previous studies. Overall, the prevalence of hospital-acquired pressure injury in intensive care is relatively high, indicating that their prevention should remain a high priority within the intensive care setting.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

Fulbrook

Lovegrove

Hay

et al. 2023

Journal of Clinical Nursing

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“…Patients admitted to the ICU are considered a high-risk population for the development of PI due to the complexity and diversity of disease diagnoses and iatrogenic causes (Labeau et al, 2021). According to previous findings, the ICU-required prevalence of PI ranged from 4.31% to 45.5% (Coyer et al, 2021;Labeau et al, 2021;Lin et al, 2022;Sala et al, 2021;Zhao et al, 2010) and the incidence reached 17.5% (Crespo et al, 2021). Validated risk assessment scales may help prevent more than 50% of PI cases (Zhang et al, 2021).…”

Section: Introductionmentioning

confidence: 90%

Validity and reliability of the Waterlow scale for assessing pressure injury risk in critical adult patients: A multi‐centre cohort study

Han,

Guo,

Zhang

et al. 2024

Journal of Clinical Nursing

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AimTo evaluate the predictive validity and reliability of the Waterlow scale in critically adult hospitalised patients.DesignA multi‐centre cohort study.MethodsThis study was conducted in 72 intensive care units (ICUs) in 38 tertiary hospitals in Gansu Province, China. All adults admitted to the ICU for greater than or equal to 24 h without pressure injury (PI) on admission were screened by the Waterlow scale on admission, during ICU stay and ICU discharge from April 2021 to February 2023. Receiver operating characteristic (ROC) curves were used to determine a potential cut‐off value for critical adult hospitalised patients. Cut‐off values were then determined using Youden's index, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated based on these cut‐off values. Test–retest reliability was used to evaluate inter‐rater reliability.ResultsA total of 5874 critical patients on admission were included, and 5125 of them were assessed regularly. The area under curve (AUC) was 0.623 (95% CI, 0.574–0.690), with a cut‐off score of 19 showing the best balance among sensitivity of 62.7%, specificity of 57.4%, positive predictive value of 2.07% and negative predictive value of 99.08%. The test–retest reliability between the first assessment and the regular assessment was 0.447.ConclusionsThe Waterlow scale shows insufficient predictive validity and reliability in discriminating critical adults at risk of PI development. To further modify the items of the Waterlow scale, exploring specific risk factors for PI in the ICU and clarifying their impact degree was necessary. Risk predictive models or better tools are inevitable in the future.Patient or Public ContributionPatients or family members supported nurses with PI risk assessment, skin examination and other activities during the inquiry.

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“…Incidence of 1.33/1000 resident days was reported in RACFs 104 , with no difference between respite and permanent aged care 105 . Reported incidences of HAPIs among intensive care unit (ICU) patients varied from 6.8-16.9% [106][107][108][109][110] , noting that almost 60% of PIs in ICU adults were HAPIs 111 . The reported incidence of HAPIs in general acute hospital settings was lower than that observed in ICUs, and ranged from 3.3% 109,112 to 12.8% 113,114 .…”

Section: Australian Studiesmentioning

confidence: 99%

Assessment, management and prevention of chronic wounds in the Australian context: a scoping review

Bui,

Tehan,

BarakatJohnson

et al. 2023

WPR

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Aims To identify the current research on assessment, management and prevention of chronic wounds in Australia and within the global context.Methods Electronic databases, trial registries and professional organisation websites were searched from 1 January 2010 to 31 May 2022. All original human research studies on chronic wounds conducted in Australia and reviews (systematic reviews (SRs), evidence-based guidelines (EBGs), evidence summaries, consensus documents) conducted worldwide were included. Results were tabulated and synthesised in a narrative review. ResultsOverall, 365 Australian studies and 569 worldwide reviews were included. The designs of Australian studies were mostly cohort (31%) or cross-sectional (20%), with a few randomised trials (10%). Australian studies were mostly concentrated on wound management (43%) or assessment (40%), and only 17% on prevention; this profile was similar for worldwide reviews. The chronic wound types focused on in Australian studies were 43% pressure injuries (PIs), 27% diabetes-related foot ulcers (DFUs), 16% venous leg ulcers (VLUs), 8% mixed chronic wounds, 6% mixed leg/foot ulcers, <1% fungating wounds.Conclusions This review found Australian chronic wound research focused on PIs and DFUs, with few randomised trials (10%), which is likely related to the lack of national competitive funding and difficulties in infrastructure support for adequately powered trials.

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Pressure injury prevalence in Australian intensive care units: A secondary analysis

Cited by 16 publications

References 29 publications

State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

Validity and reliability of the Waterlow scale for assessing pressure injury risk in critical adult patients: A multi‐centre cohort study

Assessment, management and prevention of chronic wounds in the Australian context: a scoping review

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