Faculty Collaboration Database

Protecting fragile skin: nursing interventions to decrease development of pressure ulcers in pediatric intensive care. Am J Crit Care 2011 Jan;20(1):26-34; quiz 35

Date

01/05/2011

Pubmed ID

21196569

DOI

10.4037/ajcc2011754

Scopus ID

2-s2.0-78751503806 (requires institutional sign-in at Scopus site)   107 Citations

Abstract

BACKGROUND: The reported incidence of pressure ulcers in critically ill infants and children is 18% to 27%. Patients at risk for pressure ulcers and nursing interventions to prevent the development of the ulcers have not been established.

OBJECTIVES: To determine the incidence of pressure ulcers in critically ill children, to compare the characteristics of patients in whom pressure ulcers do and do not develop, and to identify prevention strategies associated with less frequent development of pressure ulcers.

METHODS: Characteristics of 5346 patients in pediatric intensive care units in whom pressure ulcers did and did not develop were compared. Multiple logistic regression was used to determine which prevention strategies were associated with less frequent development of pressure ulcers.

RESULTS: The overall incidence of pressure ulcers was 10.2%. Patients at greatest risk were those who were more than 2 years old; who were in the intensive care unit 4 days or longer; or who required mechanical ventilation, noninvasive ventilation, or extracorporeal membrane oxygenation. Strategies associated with less frequent development of pressure ulcers included use of specialty beds, egg crates, foam overlays, gel pads, dry-weave diapers, urinary catheters, disposable under-pads, body lotion, nutrition consultations, change in body position every 2 to 4 hours, blanket rolls, foam wedges, pillows, and draw sheets.

CONCLUSIONS: The overall incidence of pressure ulcers among critically ill infants and children is greater than 10%. Nursing interventions play an important role in the prevention of pressure ulcers.

Author List

Schindler CA, Mikhailov TA, Kuhn EM, Christopher J, Conway P, Ridling D, Scott AM, Simpson VS

Authors

Theresa A. Mikhailov MD, PhD Professor in the Pediatrics department at Medical College of Wisconsin
Christine Schindler Ph.D., RN, CPNP, AC/PC Nurse Practitioner in the Nursing department at Marquette University

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Education, Nursing, Continuing
Focus Groups
Humans
Infant
Intensive Care Units, Pediatric
Logistic Models
Medical Audit
Nurse's Role
Nursing Care
Pressure Ulcer
Retrospective Studies
Risk Assessment
United States