Risk Factors And Prevention Among Patients With Hospital-Acquired And Pre-Existing Pressure Ulcers In Hospital

Abstract

Background: Hospital-acquired pressure injuries (HAPUs) remain a significant patient safety threat. Worldwide, pressure ulcers (PUs) have been implicated in costing billions annually, with 60,000 deaths out of 2.5 million hospitalized patients resulting from complications related to PU. The prevention of PU reduces the incidence of other illnesses, decreases the financial costs, and improves the quality of life for patients. A contemporary understanding of the risk factors predicting pressure injury in hospitalized patients will inform pressure injury prevention. This study aimed to describe and identify risk factors associated with hospital-acquired pressure ulcers (HAPUs) among adults in an acute care hospital compared with patients with pre-existing pressure ulcers present on admission. A further aim was to identify the preventive measures performed with both groups respectively. Method: A cross-sectional survey design was conducted at Irada Mental Health Complex in Riyadh and Al-Noor specialist hospital AT Makkah. Data on 535 patients were recorded using a modified version of the protocol developed and tested by the Pressure Ulcer Advisory Panel, including the Braden scale for risk assessment. Results: The prevalence of pressure ulcers was 27% (95% confidence interval, 23– 31%). Higher age and a total Braden score below 17 were significantly associated with the presence of pressure ulcers. Among individual risk factors higher age, limited activity level and friction and shear while seated or lying[1] down were associated with HAPUs, whereas only higher age and friction and shear were associated with the presence of PUs in the overall sample. There was an overall sparse use of preventive measures to relieve pressure. Conclusion: The findings of the present study revealed that PUs and the insufficient use of preventive measure to relieve pressure is still a problem in acute care settings. A continued focus must be placed on staff training in identifying patients at risk for PUs development. Implication to clinical practice: Increasing the ability to identify patients who are at risk for pressure ulcer development can assist in preventing unnecessary complications and suffering as well as reduce costs.