Risk Factors for Hospital-Acquired Pressure Injury in Surgical Critical Care Patients.

Autor:	Alderden J; Jenny Alderden is an assistant professor and Mollie Cummins is a professor, University of Utah College of Nursing, Salt Lake City., Cowan LJ; Linda J. Cowan is associate director, VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans' Hospital and Clinics, Tampa, Florida., Dimas JB; Jonathan B. Dimas is a PhD candidate, University of Utah College of Nursing, and a clinical nurse and analyst, University of Utah Health, Salt Lake City., Chen D; Danli Chen is a biostatistician II and Yue Zhang is an associate professor, Division of Epidemiology, University of Utah, Salt Lake City., Zhang Y; Danli Chen is a biostatistician II and Yue Zhang is an associate professor, Division of Epidemiology, University of Utah, Salt Lake City., Cummins M; Jenny Alderden is an assistant professor and Mollie Cummins is a professor, University of Utah College of Nursing, Salt Lake City., Yap TL; Tracey L. Yap is an associate professor, Duke University School of Nursing, Durham, North Carolina.
Jazyk:	angličtina
Zdroj:	American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2020 Nov 01; Vol. 29 (6), pp. e128-e134.
DOI:	10.4037/ajcc2020810
Abstrakt:	Background: Hospital-acquired pressure injuries disproportionately affect critical care patients. Although risk factors such as moisture, illness severity, and inadequate perfusion have been recognized, nursing skin assessment data remain unexamined in relation to the risk for hospital-acquired pressure injuries. Objective: To identify factors associated with hospital-acquired pressure injuries among surgical critical care patients. The specific aim was to analyze data obtained from routine nursing skin assessments alongside other potential risk factors identified in the literature. Methods: This retrospective cohort study included 5101 surgical critical care patients at a level I trauma center and academic medical center. Multivariate logistic regression using the least absolute shrinkage and selection operator method identified important predictors with parsimonious representation. Use of specialty pressure redistribution beds was included in the model as a known predictive factor because specialty beds are a common preventive intervention. Results: Independent risk factors identified by logistic regression were skin irritation (rash or diffuse, nonlocalized redness) (odds ratio, 1.788; 95% CI, 1.404-2.274; P < .001), minimum Braden Scale score (odds ratio, 0.858; 95% CI, 0.818-0.899; P < .001), and duration of intensive care unit stay before the hospital-acquired pressure injury developed (odds ratio, 1.003; 95% CI, 1.003-1.004; P < .001). Conclusions: The strongest predictor was irritated skin, a potentially modifiable risk factor. Irritated skin should be treated and closely monitored, and the cause should be eliminated to allow the skin to heal. (©2020 American Association of Critical-Care Nurses.)
Databáze:	MEDLINE
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