Subsequent Pressure Injury Development in Mechanically Ventilated Critical Care Patients with Hospital-Acquired Pressure Injury: A Retrospective Cohort Study.
Jenny Alderden, Allen Cadavero, Yunchuan Lucy Zhao and 3 others
PMID 34081637WHAT IT FOUND
Mechanically ventilated ICU patients with an existing hospital-acquired pressure injury developed a second one in 34% of cases despite documented 2-hour turning.
Lower hemoglobin, vasopressin use, and longer ICU stay were associated with a second injury.
Key findings
01Of 226 analysed patients, 77 (34%) developed a second hospital-acquired pressure injury in a new anatomic location.
02The second injuries were 48 Stage 2, 3 Stage 3, 22 deep tissue injuries, and 4 unstageable.
03Decreased hemoglobin, vasopressin infusion, and longer ICU stay were independent risk factors for a subsequent pressure injury.
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 single-site and retrospective, so the findings may not generalise to other ICU populations. The final sample was relatively small, with 226 analysed patients. Electronic health record data were used, and the paper notes that recorded repositioning may not match what actually happened. The study did not separate avoidable from unavoidable pressure injuries or medical-device-related pressure injuries. The risk-factor model had fair discrimination, not strong discrimination. The study showed associations, not proof that any factor caused a second pressure injury.
The easy way to misread this
Do not conclude that lower hemoglobin, vasopressin, or longer ICU stay caused the second pressure injuries. This was a retrospective single-site cohort, and it showed associations only.