Medical device related pressure ulcers in hospitalized patients

TLDR

Pressure ulcers typically arise over bony prominences but can also develop beneath medical devices, as recognized by the National Pressure Ulcer Advisory Panel. This study aimed to quantify the prevalence of medical device–related pressure ulcers in hospitalized patients and identify associated risk factors. The authors performed a secondary analysis of data from eight quarterly pressure‑ulcer incidence and prevalence studies (N = 2178) conducted by the Nebraska Medical Center. Among 2079 patients, 5.4 % developed hospital‑acquired pressure ulcers, 34.5 % of which were device‑related, and patients with a device were 2.4 times more likely to develop any ulcer, though no distinct risk factors separated device‑related from traditional ulcers.

Abstract

Most pressure ulcers occur over bony prominences such as heels and the sacrum. However, the National Pressure Ulcer Advisory Panel recognises that pressure ulcers can also occur on any tissue under pressure and thereby can develop beneath medical devices. This article reports on results from a secondary analysis of existing data collected by The Nebraska Medical Center on pressure ulcer quality improvement initiatives and outcomes. The purpose of this study was to quantify the extent of the problem and identify risk factors for medical device related (MDR) pressure ulcer development in hospitalised patients. A subset of data collected during eight quarterly pressure ulcer incidence and prevalence studies (N = 2178) was created and analysed. The overall rate of hospital-acquired pressure ulcers was 5·4% (113 of 2079). The proportion of patients with hospital-acquired ulcers related to medical devices was 34·5% (39 of 113). Findings indicate that if a patient had a medical device, they were 2·4 times more likely to develop a pressure ulcer of any kind. Numerous risk factors for pressure ulcer development were identified; however, none differentiated between those with MDR and traditional pressure ulcers.