Hospital-Acquired Pressure Injury Development Among Surgical Critical Care Patients Admitted With Community-Acquired Pressure Injury: A Retrospective Cohort Study.
Jenny Alderden, Mollie Cummins, Sunniva Zaratkiewicz and 3 others
PMID 32925591WHAT IT FOUND
Among ICU patients admitted with a community-acquired pressure injury, 28% developed a hospital-acquired pressure injury, compared with 7% of those admitted without one.
Low albumin and excessively dry skin were associated with new injuries, so nurses should monitor these factors closely.
Key findings
01Among 167 ICU patients admitted with a community-acquired pressure injury, 47 (28%) developed a hospital-acquired pressure injury, compared with 352 of 4,934 patients without one (7%).
02In the multivariate analysis of 151 patients, decreased serum albumin and excessively dry skin were independent predictors of hospital-acquired pressure injury development.
03The 47 patients with a community-acquired pressure injury developed 77 hospital-acquired pressure injuries.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and used only data available in the electronic health record, so information that was not documented may be missing. It was done at a single site, so the results may not apply to other surgical critical-care populations. Only 167 patients had a community-acquired pressure injury, and the multivariate analysis used 151 patients. The predictive model had poor to fair discrimination, with an area under the receiver operating characteristic curve of 0.69. The authors noted that other variables not examined may also be important predictors. The Braden Scale nutrition subscale finding was paradoxical, and the subscale is a poor proxy for general nutrition status.
The easy way to misread this
Do not conclude that applying moisturizers prevents hospital-acquired pressure injuries. This study only found excessively dry skin associated with new pressure injuries and did not test moisturizing.