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

Journal article

Fulbrook, Paul, Lovegrove, Josephine, Hay, Karen and Coyer, Fiona. (2023). State-wide prevalence of pressure injury in intensive care versus acute general patients : A five-year analysis. Journal of Clinical Nursing. pp. 1-15. https://doi.org/10.1111/jocn.16687
AuthorsFulbrook, Paul, Lovegrove, Josephine, Hay, Karen and Coyer, Fiona
Abstract

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.

Relevance to Clinical Practice
These results may be used for benchmarking and provide a focus for future education and practice improvement efforts.

Patient or Public Contribution
Neither patients nor the public were directly involved in the project.

Keywordsacute care; benchmarking; critical care; hospital-acquired; intensive care; pressure injury; prevalence
Year2023
JournalJournal of Clinical Nursing
Journal citationpp. 1-15
PublisherJohn Wiley & Sons Ltd
ISSN1365-2702
Digital Object Identifier (DOI)https://doi.org/10.1111/jocn.16687
PubMed ID36932419
Scopus EID2-s2.0-85150842841
Web address (URL)https://onlinelibrary.wiley.com/doi/10.1111/jocn.16687
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range1-15
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online17 Mar 2023
Publication process dates
Accepted28 Feb 2023
Deposited23 Jun 2023
Additional information

© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Fear of falling : Association between the Modified Falls Efficacy Scale, in-hospital falls and hospital length of stay
Gettens, Stephanie and Fulbrook, Paul. (2015). Fear of falling : Association between the Modified Falls Efficacy Scale, in-hospital falls and hospital length of stay. Journal of Evaluation in Clinical Practice (online version). 21(1), pp. 43 - 50. https://doi.org/10.1111/jep.12226
Survey of an Australian general emergency department : Estimated prevalence of mental health disorders
Fulbrook, Paul and Lawrence, Petra. (2015). Survey of an Australian general emergency department : Estimated prevalence of mental health disorders. Journal of Psychiatric and Mental Health Nursing (online version). 22(1), pp. 30 - 38. https://doi.org/10.1111/jpm.12191
Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: A qualitative study
Fulbrook, Paul, Conway, Aaron, Rolley, John and Page, Karen. (2014). Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: A qualitative study. Journal of Clinical Nursing. 23(3-4), pp. 374 - 384. https://doi.org/10.1111/jocn.12147
Compliance with lipid-lowering medication after diagnosis of coronary heart disease
McKellar, Sandra and Fulbrook, Paul. (2014). Compliance with lipid-lowering medication after diagnosis of coronary heart disease. British Journal of Cardiac Nursing. 9(5), pp. 244 - 249.
Trends in nurse-administered procedural sedation and analgesia across cardiac catheterisation laboratories in Australia and New Zealand: Results of an electronic survey
Conway, Aaron, Rolley, John, Page, Karen and Fulbrook, Paul. (2014). Trends in nurse-administered procedural sedation and analgesia across cardiac catheterisation laboratories in Australia and New Zealand: Results of an electronic survey. Australian Critical Care. 27(1), pp. 4 - 10. https://doi.org/10.1016/j.aucc.2013.05.003
South African critical care nurses' views on end-of-life decision-making and practices
Fulbrook, Paul, Langley, Gayle, Schmollgruber, Shelley, Albarran, John and Latour, Jos. (2014). South African critical care nurses' views on end-of-life decision-making and practices. Nursing in Critical Care. 19(1), pp. 9 - 17. https://doi.org/10.1111/nicc.12026
Sleep assessment of hospitalised patients : A literature review
Fulbrook, Paul, Hoey, Lynn and Douglas, James. (2014). Sleep assessment of hospitalised patients : A literature review. International Journal of Nursing Studies. 51(9), pp. 1281 - 1288. https://doi.org/10.1016/j.ijnurstu.2014.02.001
Perceived barriers to healthy lifestyle activities in midlife and older Australian women with type 2 diabetes
McGuire, Amanda, Anderson, Debra and Fulbrook, Paul. (2014). Perceived barriers to healthy lifestyle activities in midlife and older Australian women with type 2 diabetes. Collegian. 21(4), pp. 301 - 310. https://doi.org/10.1016/j.colegn.2013.07.001
Clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory : A modified Delphi study
Fulbrook, Paul, Conway, Aaron, Rolley, John and Page, Karen. (2014). Clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory : A modified Delphi study. Journal of Advanced Nursing. 70(5), pp. 1040 - 1053. https://doi.org/10.1111/jan.12337
The first 18 months: Parental choices regarding their infant's health care needs
Kearney, Lauren and Fulbrook, Paul. (2014). The first 18 months: Parental choices regarding their infant's health care needs. Neonatal, Paediatric and Child Health Nursing. 17(3), pp. 17 - 22.
Risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory : a matched case-control study
Conway, Aaron, Page, Karen, Rolley, John and Fulbrook, Paul. (2013). Risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory : a matched case-control study. European Journal of Cardiovascular Nursing. https://doi.org/10.1177/1474515112470351
Decreasing pressure injury prevalence in an Australian general hospital : a ten-year review
Miles, Sandra, Fulbrook, Paul, Nowicki, Tracy and Franks, Cherie. (2013). Decreasing pressure injury prevalence in an Australian general hospital : a ten-year review. Wound Practice & Research.
Improving statistical analysis of matched case-control studies in nursing literature
Conway, Aaron, Rolley, John, Fulbrook, Paul, Page, Karen and Thompson, David. (2013). Improving statistical analysis of matched case-control studies in nursing literature. Research in Nursing and Health. https://doi.org/10.1002/nur.21536
Understanding the experiences of mothers who are breastfeeding an infant with tongue-tie : a phenomenological study
Edmunds, Janet, Fulbrook, Paul and Miles, Sandra. (2013). Understanding the experiences of mothers who are breastfeeding an infant with tongue-tie : a phenomenological study. Journal of Human Lactation. https://doi.org/10.1177/0890334413479174
Children's conceptions of their parent's lung transplant
Fulbrook, Paul, Leisfield, T and Wiggins, K. (2013). Children's conceptions of their parent's lung transplant. Journal of Child Health Care. https://doi.org/10.1177/1367493512450625
A survey of Italian intensive care nurses' knowledge levels
Fulbrook, Paul. (2012). A survey of Italian intensive care nurses' knowledge levels. Not Listed - Awaiting Journal Creation.
Open Access community child health clinics : the everyday experience of parents and child health nurses
Kearney, Lauren and Fulbrook, Paul. (2012). Open Access community child health clinics : the everyday experience of parents and child health nurses. Journal of Child Health Care. 16(1), pp. 5 - 14. https://doi.org/10.1177/1367493511419874
Effect of feedback on ventilator care bundle compliance : before and after study
Lawrence, Petra and Fulbrook, Paul. (2012). Effect of feedback on ventilator care bundle compliance : before and after study. Nursing in Critical Care. 17(6), pp. 293 - 301. https://doi.org/10.1111/j.1478-5153.2012.00519.x
A survey of European intensive care nurses' knowledge levels
Fulbrook, Paul, Albarran, John W., Baktoft, Birte and Sidebottom, Ben. (2012). A survey of European intensive care nurses' knowledge levels. International Journal of Nursing Studies. 49(2), pp. 191 - 200. https://doi.org/10.1016/j.ijnurstu.2011.06.001
Critical care nursing organizations and activities: A third worldwide review
Williams, Ged, Bost, Nerolie, Chaboyer, Wendy, Fulbrook, Paul, Alberto, Laura, Thorsteinsdóttir, Rósa, Schmollgruber, Shelley and Chan, David. (2012). Critical care nursing organizations and activities: A third worldwide review. International Nursing Review. 59(1), pp. 73 - 80. https://doi.org/10.1111/j.1466-7657.2011.00926.x
Person-centered medicine and chronic disease :the role of interdisciplinary education and treatment adherence
Boyle, Cathy, Post, Gerardus, Masel, Philip, Fulbrook, Paul and Clark, Kevin. (2011). Person-centered medicine and chronic disease :the role of interdisciplinary education and treatment adherence. International Journal of Person Centered Medicine. 1(3), pp. 606 - 611.
Tongue-tie and breastfeeding: A review of the literature
Edmunds, Janet, Miles, Sandra J. and Fulbrook, Paul. (2011). Tongue-tie and breastfeeding: A review of the literature. Breastfeeding Review (print version). 19(1), pp. 19 - 26.
The ventilator care bundle and its impact on ventilator-associated pneumonia: A review of the evidence
Lawrence, Petra and Fulbrook, Paul. (2011). The ventilator care bundle and its impact on ventilator-associated pneumonia: A review of the evidence. Nursing in Critical Care (print version). 16(5), pp. 222 - 234. https://doi.org/10.1111/j.1478-5153.2010.00430.x
Die anwesenheit von angehörigen während der kardiopulmonalen reanimation / the presence of family members during cardiopulmonary resuscitation
Fulbrook, Paul. (2010). Die anwesenheit von angehörigen während der kardiopulmonalen reanimation / the presence of family members during cardiopulmonary resuscitation. Intensiv: Fachzeitschrift fuer Intensivpflege und Anaesthesie. 18(1), pp. 38 - 40.
Preparation of nurses for novice entry to perioperative practice: Evaluation of a short education program
Allanson, Anne Maree and Fulbrook, Paul. (2010). Preparation of nurses for novice entry to perioperative practice: Evaluation of a short education program. ACORN : The Journal of Perioperative Nursing in Australia. 23(2), pp. 14 - 27.
Bed safety off the rails
Nowicki, Tracy, Fulbrook, Paul and Burns, Cheryl. (2010). Bed safety off the rails. Australian Nursing and Midwifery Journal. 18(1), pp. 31 - 34.
Pressure injury prevention : continence, skin hygiene and nutrition management
Roosen, Kerri, Fulbrook, Paul and Nowicki, Tracy. (2010). Pressure injury prevention : continence, skin hygiene and nutrition management. Australian Nursing Journal. 18(2), pp. 31 - 34.
EfCCNa survey: European intensive care nurses' attitudes and beliefs towards end-of-life care
Latour, Jos M., Fulbrook, Paul Richard and Albarran, John W.. (2009). EfCCNa survey: European intensive care nurses' attitudes and beliefs towards end-of-life care. Nursing in Critical Care. 14(3), pp. 110 - 121. https://doi.org/10.1111/j.1478-5153.2008.00328.x
Provision of child health services 2005-2009: Evaluation of an open access clinic
Kearney, Lauren, Fulbrook, Paul Richard and Howlett, Lorrie. (2009). Provision of child health services 2005-2009: Evaluation of an open access clinic Queensland Health.
Changing the mindset: An inter-disciplinary approach to management of bariatric patient
Nowicki, Tracy, Burns, Cheryl, Fulbrook, Paul Richard and Jones, Jacqueline. (2009). Changing the mindset: An inter-disciplinary approach to management of bariatric patient. Collegian. 16(4), pp. 171 - 175. https://doi.org/10.1016/j.colegn.2009.03.002
Intensive and critical care nursing perspectives
Williams, G. F., Fulbrook, Paul Richard, Alexandrov, A. W., Montanez, W. Canon, Salisu-Kabara, H. M. and Chan, D. W.K.. (2009). Intensive and critical care nursing perspectives. In In A. Gullo, J. Besso and P.D.Lumb & G.F.Williams (Ed.). Intensive and critical care medicine pp. 119 - 132 Springer-Verlag.
A clinical improvement project to develop and implement a decision-making framework for the use of seclusion
Hyde, Sandra, Fulbrook, Paul Richard, Fenton, Keryn and Kilshaw, Michael. (2009). A clinical improvement project to develop and implement a decision-making framework for the use of seclusion. International Journal of Mental Health Nursing. 18, pp. 398 - 408. https://doi.org/10.1111/j.1447-0349.2009.00631.x
The effectiveness of a caring protocol: An evaluation study
Fulbrook, Paul. (2009). The effectiveness of a caring protocol: An evaluation study. Journal of Research in Nursing. 14(4), pp. 317 - 318. https://doi.org/10.1177/1744987108093360
The presence of family members during cardiopulmonary resuscitation: Position statement
Lynch, Fiona, Fulbrook, Paul, Latour, Jos, Albarran, John, de Graaf, Wouter, Devictor, Denis and Norekval, Tone. (2008). The presence of family members during cardiopulmonary resuscitation: Position statement. Infant: for neonatal and paediatric healthcare professionals (print version). 4(2), pp. 44 - 45.
Enteral feeding practices in European ICUs: A survey from the European federation of critical care nursing associations (EFCCNA)
Roynette, C., Numico, Anke Bongers, Fulbrook, Paul, Albarran, John and Hofman, Z.. (2008). Enteral feeding practices in European ICUs: A survey from the European federation of critical care nursing associations (EFCCNA). e-SPEN Journal: the European e-journal of clinical nutrition and metabolism. 2(2), pp. 33 - 39. https://doi.org/10.1016/j.eclnm.2007.10.004
Paediatric critical care nurses' attitudes and experiences of parental presence during cardiopulmonary resuscitation: A European survey
Fulbrook, Paul, Latour, Jos and Albarran, John. (2007). Paediatric critical care nurses' attitudes and experiences of parental presence during cardiopulmonary resuscitation: A European survey. International Journal of Nursing Studies. 44(7), pp. 1238 - 1249. https://doi.org/10.1016/j.ijnurstu.2006.05.006
Critical care nursing organizations and activities - a second worldwide review: Original article
Willia, Ged, Chaboyer, Wendy, Alberto, Laura, Thorsteinsdottir, Rosa, Schmollgruber, Shelley, Fulbrook, Paul, Chan, Dominic and Bost, Nerolie. (2007). Critical care nursing organizations and activities - a second worldwide review: Original article. International Nursing Review. 54(2), pp. 151 - 159. https://doi.org/10.1111/j.1466-7657.2007.00543.x
A European survey of enteral nutrition practices and procedures in adult intensive care units
Fulbrook, Paul, Bongers, Anke and Albarran, John. (2007). A European survey of enteral nutrition practices and procedures in adult intensive care units. Journal of Clinical Nursing. 16(11), pp. 2132 - 2141. https://doi.org/10.1111/j.1365-2702.2006.01841.x
The presence of family members during cardiopulmonary resuscitation: European federation of critical care nursing associations, European society of paediatric and neonatal intensive care and European society of cardiology council on cardiovascular
Fulbrook, Paul, Latour, Jos, Albarran, John, de Graaf, Wouter, Lynch, Fiona, Devictor, Denis and Norekval, Tone. (2007). The presence of family members during cardiopulmonary resuscitation: European federation of critical care nursing associations, European society of paediatric and neonatal intensive care and European society of cardiology council on cardiovascular. European Journal of Cardiovascular Nursing. 6(4), pp. 255 - 258. https://doi.org/10.1016/j.ejcnurse.2007.07.003
Understanding the experiences of mothers who are breast feeding an infant with tongue-tie: a hermeneutic phenomenology study.
Miles, Sandra and Fulbrook, Paul. (2007). Understanding the experiences of mothers who are breast feeding an infant with tongue-tie: a hermeneutic phenomenology study [Dataset]. Australian Catholic University. https://doi.org/10.26199/acu.85095
Portable oxygen: Longer for less with oxymizer pendant
Fulbrook, Paul and Serginson, John. (2006). Portable oxygen: Longer for less with oxymizer pendant. Airways Journal (print version). 4(2), pp. 105 - 108.
Education for outreach: Development of an inter-professional MSC in critical care
Fulbrook, Paul and Cockerell, Janet. (2005). Education for outreach: Development of an inter-professional MSC in critical care. Nursing in Critical Care. 10(5), pp. 255 - 262. https://doi.org/10.1111/j.1362-1017.2005.00123.x
Advancing the clinical perspective: A practice development project to develop the nurse practitioner role in an acute hospital trust
Walsgrove, Hilary and Fulbrook, Paul. (2005). Advancing the clinical perspective: A practice development project to develop the nurse practitioner role in an acute hospital trust. Journal of Clinical Nursing. 14(4), pp. 444 - 455. https://doi.org/10.1111/j.1365-2702.2004.01089.x
Realizing advanced nursing practice through reflection
Fulbrook, Paul. (2004). Realizing advanced nursing practice through reflection. Nursing in Critical Care. 9(6), pp. 255 - 256. https://doi.org/10.1111/j.1362-1017.2004.00089.x
Developing a network protocol: Nurse-led weaning from ventilation
Fulbrook, Paul, Delaney, N., Rigby, J., Sowden, A., Trevett, M., Turner, L. and Whittam, A.. (2004). Developing a network protocol: Nurse-led weaning from ventilation. Connect: The World of Critical Care Nursing. 3(2), pp. 28 - 37.
Why do student nurses leave? Suggestions from a Delphi study
Fulbrook, Paul. (2003). Why do student nurses leave? Suggestions from a Delphi study. Nurse Education Today. 23(6), pp. 449 - 458. https://doi.org/10.1016/S0260-6917(03)00063-7
Developing best practice in critical care nursing: Knowledge, evidence and practice
Fulbrook, Paul. (2003). Developing best practice in critical care nursing: Knowledge, evidence and practice. Nursing in Critical Care. 8(3), pp. 96 - 102. https://doi.org/10.1046/j.1478-5153.2003.00010.x
Care bundles in critical care: A practical approach to evidence-based practice
Fulbrook, Paul and Mooney, Sharon. (2003). Care bundles in critical care: A practical approach to evidence-based practice. Nursing in Critical Care. 8(6), pp. 249 - 255. https://doi.org/10.1111/j.1362-1017.2003.00039.x