Pressure injuries in critical patients: Incidence, patient-associated factors, and nursing workload

Abstract

AIM: To estimate the incidence of pressure injury and its predictors including nursing workload in critical patients. BACKGROUND: There is controversy about the influence of the nursing workload on the occurrence of pressure injury in intensive care units. METHODS: A retrospective cohort of 766 patients in nine intensive care units of two university hospitals was studied. The nursing workload was measured using the Nursing Activities Score. The predictors were identified by logistic regression. RESULTS: The pressure injury incidence was 18.7%. The odds ratio of the development of pressure injury, increased 3.5 times in mechanical ventilation (p < 0.001), 7.8 times in palliative care (p = 0.004), 2.3 times in the 60-84 years old group (p = 0.005); it also increased 10% for each day of hospitalization (p < 0.001), and 1.5% for each registered point of the Nursing Activities Score (p = 0.016). CONCLUSION: Existing risks for the development of pressure injury have been confirmed and nursing workload identified as a new predictor. Much still needs to be done in the area of prevention, especially in groups at risk. IMPLICATIONS FOR NURSING MANAGEMENT: Increasing nursing resources in the intensive care unit may assist in reducing the pressure injury rate.