Pressure Injuries in Critical Care Patients in US Hospitals: Results of the International Pressure Ulcer Prevalence Survey.
Jill Cox, Laura E Edsberg, Kimberly Koloms and 1 others
PMID 35040812WHAT IT FOUND
In US critical care units, 14.3% of ICU patients had a pressure injury and 5.85% had a hospital-acquired pressure injury.
Deep tissue pressure injuries were most common; sacrum/coccyx, buttocks, and heels were top sites, and documented prevention use was high.
Key findings
01In the 2018 and 2019 survey, 14.3% of critical care patients had a pressure injury and 5.85% had a hospital-acquired pressure injury.
02Deep tissue pressure injury was the most common hospital-acquired stage, and the sacrum/coccyx, buttocks, and heel were the top hospital-acquired locations.
03In patients with severe hospital-acquired pressure injuries, diabetes was present in 29.5%, mechanical ventilation in 27.6%, and vasopressor agents in 18.9%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The survey looked at one day of care, so it cannot show when a hospital-acquired pressure injury started or whether prevention practices were consistent before those 24 hours. Data were collected by local clinical teams, so reporting errors or response bias could affect the prevalence and prevention percentages. The prevention comparisons included only patients with a Braden Scale score of 18 or less, so they do not describe all critical care patients. The study is observational, so differences between prevention practices and pressure injury groups do not prove that any practice caused or prevented a pressure injury. The sample came from hospitals that participated in the survey, so it reflects participating US facilities rather than every US critical care unit.
Declared interests
The International Pressure Ulcer Prevalence survey is facilitated by Hillrom, Inc. The authors declared no disclosures.
The easy way to misread this
Do not conclude that pressure injuries happened because prevention practices were missing. The survey only captured care in the 24 hours before data collection, and patients with severe hospital-acquired pressure injuries had the highest documented use of skin assessment, repositioning, pressure redistribution surfaces, nutrition support, and moisture management.