Pressure injury prevalence in critical care settings : An observational pre-post intervention study

Journal article


Alshahrani, Bassam, Middleton, Rebekkah, Rolls, Kaye and Sim, Jenny. (2024). Pressure injury prevalence in critical care settings : An observational pre-post intervention study. Nursing Open. 11(2), p. Article e2110. https://doi.org/10.1002/nop2.2110
AuthorsAlshahrani, Bassam, Middleton, Rebekkah, Rolls, Kaye and Sim, Jenny
Abstract

Aim
To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention.

Design
A multi-centre observational study.

Method
Data were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included.

Results
A total of 181 patients in critical care units were included at the two-time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital-acquired, 37.9% unit-acquired and 23.0% medical device-related. Post-intervention prevalence decreased significantly to 28.7%, including 21.3% hospital-acquired, 14.9% unit-acquired, and 8.5% medical device-related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries.

Conclusions
This study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence-based education strategies are implemented.

Patient Care Impact
Pressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries.

Reporting Method
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist.

Patient or Public Contribution
No patient or public contribution.

Keywordscritical care; nursing intervention; observation; pressure injury; pressure ulcer; prevalence
Year2024
JournalNursing Open
Journal citation11 (2), p. Article e2110
PublisherJohn Wiley & Sons Ltd
ISSN2054-1058
Digital Object Identifier (DOI)https://doi.org/10.1002/nop2.2110
PubMed ID38391102
Scopus EID2-s2.0-85184719571
PubMed Central IDPMC10847625
Open accessPublished as ‘gold’ (paid) open access
Page range1-10
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online06 Feb 2024
Publication process dates
Accepted16 Jan 2024
Deposited16 May 2025
Additional information

© 2024 The Authors. Nursing Open published by John Wiley & Sons Ltd.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), 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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