Risk Factors for Hospital-Acquired Pressure Injury in Surgical Critical Care Patients.
Jenny Alderden, Linda J Cowan, Jonathan B Dimas and 4 others
PMID 33130863WHAT IT FOUND
Surgical ICU patients with skin irritation were 79% more likely to develop a hospital-acquired pressure injury.
Longer ICU stay and lower Braden score were also associated with injury, but the Braden difference may be too small to act on.
Key findings
01Of 5,101 surgical critical care patients, 399 (7.8%) developed at least one hospital-acquired pressure injury.
02The final predictor model selected length of SICU or CVICU stay, minimum Braden Scale score, and skin irritation.
03Patients with skin irritation were 79% more likely to develop a hospital-acquired pressure injury than patients without irritation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective electronic health record design, so only data available in the record were used. Skin irritation was judged by clinicians, and one nurse's definition may not match another's. Medical device-related pressure injuries were not separated from other hospital-acquired pressure injuries. Some predictor variables were not available from the electronic health record. Pressure injury prevention protocol compliance was not included because documentation of repositioning may not show whether it was actually done. Single-site study with a predominantly White population, limiting generalizability. The Braden Scale association may not be clinically actionable because minimum scores differed only from 13 to 12.
Declared interests
No author conflict-of-interest declaration is included in the supplied text. The article is marked as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read the 79% higher likelihood as proof that skin irritation causes pressure injury or that treating it will prevent injury. This was an observational study of records, and it did not test an intervention.