Predictive and Protective Factors Related to the Occurrence of Pressure Injuries Among Critically-ill Surgery Patients: A Retrospective, Case-Control Study
Keywords:
risk factors, pressure injury, critical surgical care patientsAbstract
Critically-ill surgical patients are at risk for developing pressure injuries. This retrospective, case-control design study was aimed to explore predictive and protective factors associated with the occurrence of pressure injuries among critically-ill surgical patients. The data of 285 critically-ill surgical patients were collected between 2015 and 2020 in a hospital in Ubon Ratchathani Province, Thailand. They were purposively recruited based on having (n = 95), or not having (n = 190), a pressure injury. The data were collected using the Factors Related to the Occurrence of Pressure Injury Record Form. The instrument’s content validity was approved by three clinical experts and its content validity index was 1.0. Data were analyzed using descriptive statistics and multiple logistic regressions. Results showed that most of the participants were male (61.8%) with an average age of 65.83 years (SD =14.53). The predictive factor of developing a pressure injury was higher Body Mass Indexes (BMI). Those who had higher BMI were at 1.37 times (OR = 1.37, 95 % Cl [1.06, 1.77]) greater risk for developing a pressure injury than those who had a normal BMI. It also revealed that moisture (OR = 0.51, 95 % Cl [0.27, 0.98]), mobility (OR = 0.11, 95 % Cl [ 0.04, 0.25]), and friction or shearing (OR = 0.42, 95 % Cl [0.19, 0.91]) were protective factors preventing pressure injuries. When the score for any one of these three factors increase 1 point, the potential to develop a pressure injury is likely to decrease. Therefore, care for critically-ill surgical patients with a high BMI, decreasing level of consciousness, immobilization, and having moist skin or poor skin sensation should be more focus.
References
ผกามาศ พีธรากร. (2564). การพยาบาลผู้ป่วยที่มีแผลกดทับโดยใช้หลักฐานเชิงประจักษ์: บทบาทพยาบาล. หัวหินเวชสาร, 1(1), 33-48.
ช่อผกา สิทธิพงศ์, และศิริอร สินธุ. (2554). ปัจจัยทำนายการเกิดแผลกดทับในผู้สูงอายุที่ไม่มีโรคเบาหวานร่วมด้วย. วารสารพยาบาลศาสตร์, 29(Suppl2), 113-123.
ฝ่ายการพยาบาล โรงพยาบาลศิริราช. (2556). แบบประเมินของบราเดน (The Braden Scale for Predicting Pressure Sore Risk). Retrieved from https://www.si.mahidol.ac.th/Th/division/nursing/NDivision/N_qd/admin/news_files/51_72_2.pdf
ประภาพร ดองโพธิ์. (2562). ประสิทธิผลของการใช้แนวปฏิบัติทางคลินิกสำหรับป้องกันการเกิดแผลกดทับ. ธรรมศาสตร์เวชสาร, 19(2), 315-323.
วาสนา ฬาวิน, พรทิพย์ อยู่ญาติมาก, และรภัสศา แพรภัทรประสิทธิ์. (2563). ภาวะโภชนาการและความสัมพันธ์กับการเกิดแผลกดทับใหม่ในผู้ป่วยที่รับย้ายจากหอผู้ป่วย ในเข้ารักษาต่อในหอผู้ป่วยวิกฤต. วารสารพยาบาลศาสตร์และสุขภาพ, 4(33), 161-171.
สุชาดา นิลบรรพต, อัมพรพรรณ ธีราบุตร, และปณิตา ลิมปะวัฒนะ. (2562). ปัจจัยทำนายการเกิดแผลกดทับในผู้ป่วยวิกฤติ. วารสารพยาบาลศาสตร์และสุขภาพ, 42(3), 1-10.
Akbari Sari, A., Doshmanghir, L., Neghahban, Z., Ghiasipour, M., & Beheshtizavareh, Z. (2014). Rate of pressure ulcers in intensive units and general wards of Iranian hospitals and methods for their detection. Iranian Journal of Public Health, 43, 787–792.
Alderden, J., Rondinelli, J., Pepper, G., Cummins, M., & Whitney, J. (2017). Risk factors for pressure injuries among critical care patients: A systematic review. International Journal of Nursing Studies, 71, 97–114. https://doi.org/10.1016/j.ijnurstu.2017.03.012
Alderden, J., Drake, K. P., Wilson, A., Dimas, J., Cummins, M. R., & Yap, T. L. (2021). Hospital acquired pressure injury prediction in surgical critical care patients. BMC Medical Informatics and Decision Making, 21(1), 12. https://doi.org/10.1186/s12911-020-01371-z
Coleman, S., Nixon, J., Keen, J., Wilson, L., McGinnis, E., Dealey, C., . . . Nelson, E. A. (2014). A new pressure ulcer conceptual framework. Journal of Advance Nursing, 70(10), 2222–2234. https://doi.org/10.1111/jan.12405
Cox, J. (2011). Predictors of pressure ulcers in adult critical care patients. American Journal of Critical Care, 20(5), 364-375.
Dorsey, I. E. (2021). Evidence based repositioning strategies to improve pressure injury rates. Master's Projects and Capstones. 1287. https://repository.usfca.edu/capstone/1287
Grada, A., & Phillips, T. J. (2021). Pressure injuries. Retrieved from https://www.msdmanuals.com/professional/dermatologic-disorders/pressure-injury/pressure-injuries
Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. Journal of the American Academy of Dermatology, 81(4), 881–890. https://doi.org/10.1016/j.jaad.2018.12.069
Schlesselman, J. J. (1982). Case-control studies: Design, conduct, analysis. New York: Oxford University Press.
Ulker, E. E., & Yapucu, G. U. (2013). A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units. Ostomy/Wound Management, 59(7), 22–27.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Journal of Health and Nursing Education
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The published articles are copyrighted by Journal of Health and Nursing Education.
The statements that appear in each article in this academic journal are the personal opinions of each author and are not related to the editorial team of the Journal of Health and Nursing Education or Boromarajonani College of Nursing, Nakhon Ratchasima.
Responsibility for all elements of each article belongs to the individual author. If there is any mistake each author is solely responsible for his or her own article.
