Medical Device-related Pressure Injuries Research Articles

Determination of the Knowledge Level of Surgical Intensive Care Nurses in Medical Device Induced Pressure Injury

Aim: The purpose of this study was to measure the level of knowledge and attitudes of nurses in surgical intensive care units (ICUs) about medical device-induced pressure injury. Method: The cross-sectional study was conducted with 227 surgical intensive care nurses in Turkey between November 2022 and June 2023. “Nurse Introduction Form” and “Pressure Ulcer Knowledge Level Assessment Tool Scale” were used as data collection tools. Since the scale score averages did not comply with normal distribution, Mann Whitney U and Kruskal Wallis tests were used in the statistical analysis of the data. Results: It was found that the majority of participants (n=227) were in the age range of 26-33 years (n=115), and 66.1% (n=113) had been working in the ICU for 1-5 years. 51.5% (n=117) of the participants reported having received training in medical device-related pressure injury. In the pressure ulcer knowledge level assessment tool, the mean of the "prevention of pressure ulcers" sub-dimension (mean: 4.74) was found to be the highest, while the total knowledge level score was 14.87±5.6 and it was found that the nurses had a moderate level of knowledge. Conclusion: The findings of the study indicated that nurses' knowledge of medical device-related pressure injuries was inadequate, but that their knowledge of pressure injury prevention increased with increasing levels of education.

Medical device-related pressure injuries in intensive care patients: A prospective and descriptive study

BackgroundTreatment and care of patients in intensive care units require the use of many medical and technological instruments. Pressure injuries occur when medical devices, which are used more in intensive care patients and are in direct or indirect contact with the skin, cause focal and localized forces on the superficial or deep tissues. ObjectiveIn this study, it was aimed to examine the risk factors, incidence and characteristics of medical device-related pressure injuries in intensive care patients. MethodsThis study has a prospective and descriptive design. The study was carried out in the adult intensive care unit of a healthcare institution located in the western Turkey. 138 intensive care patients treated in the level 3 adult intensive care unit were enrolled in the study. The first observations and evaluations of intensive care patients in terms of pressure injuries were made within the first 24 h after admission to the clinic. Observations continued daily during the hospitalization period of the patient. Data were collected with the Intensive Care Patient Information Form, Glasgow Coma Scale, Braden Pressure Ulcer Risk Assessment Scale and Identification Form for Medical device-related Pressure Ulcers. Analysis of data was performed with descriptive statistical methods, Shapiro-Wilk Test, Mann-Whitney U Test and Chi-Square analysis. ResultsMedical device-related pressure injury developed in 11.6% (n = 16) of intensive care patients. Anatomically, pressure injury occurred most frequently on the lip (37.5%) and most frequently due to the intubation tube (37.5%). Most of the developed wounds (75.0%) were found to be stage 2. Multinominal logistic regression analysis, which was performed to determine the effect of independent variables on medical device-related pressure injuries in intensive care patients, was found to be statistically significant (X2 = 37.098, p < 0.001). When the regression coefficients were examined, it was found that total hospitalization time in the intensive care unit (β = 0.948, p < 0.01) and PaCO2 level (β = 0.923, p < 0.01) had a positive, and duration of aerobic respiration with nasal cannula or mask (β = −0.920, p < 0.01) and Braden score (β = −0.948, p < 0.01) had a negative and significant effect on medical device-related pressure injuries. ConclusionsIn this study found that the MDRPIs development rate was lower than other studies. It was observed that pressure injuries due to medical devices developed more frequently in patients with longer hospitalization days, higher PaCO2 levels, shorter duration of oxygenated breathing with nasal cannula or mask, and lower Braden scores.

Iatrogenic skin injuries in infants admitted to neonatal intensive care units: An investigation in 22 Chinese units

ObjectiveTo investigate the incidence of iatrogenic skin injuries in neonates across 22 neonatal intensive care units (NICUs) in China. DesignProspective study. Setting22 NICUs in China. PatientsInfants admitted to NICU. InterventionsNone. MeasurementsThe “Iatrogenic Skin Injuries Data Collection Form of infants” were used to collect the data during hospitalization. Main resultsA total of 8126 neonates who were hospitalized in 22 tertiary hospitals across 15 provinces, cities, and autonomous regions of China between December 1, 2019 and January 31, 2020 were analyzed. Five hundred and twenty-one infants had iatrogenic skin injuries, including 250 with diaper dermatitis (47.98%), 70 with physicochemical factor–related skin lesions (PCFRSIs) (13.44%), 81 with medical device–related pressure injuries (MDRPIs) (15.55%), and 69 with medical adhesive–related skin injuries (MARSIs) (13.24%), accounting for 91% of the total number of iatrogenic injuries. Among these, diaper dermatitis was closely related to the skin and feeding status. Furthermore, the risk was higher among neonates who had skin damage upon admission or were already fully fed orally. The influencing factors of MDRPIs and MARSIs were similar. They were negatively associated with gestational age and birth weight, and were closely related to the presence of various tubes. ConclusionsDiaper dermatitis, PCFRSIs, MDRPIs, and MARSIs were the four common types of iatrogenic skin injuries in newborns. The various types of iatrogenic skin injuries were influenced by varying factors. Specialized nursing measurements can reduce the likelihood of these injuries.

Medical device-related pressure injuries prevention practices of intensive care unit nurses: A cross‐sectional study in Turkey

AimMedical device-related pressure injuries (MDRPIs) are becoming increasingly common across all healthcare services and age groups in terms of both incidence and severity. It is crucial for nurses to be aware that MDRPI is a potential complication of healthcare services. This study aimed to assess the preventive practices of intensive care unit (ICU) nurses in relation to MDRPIs. Materials and methodsThis cross-sectional and descriptive study was conducted with 96 nurses between March 10 and April 31, 2021. The “Nurse Information Form” and the “MDRPIs Prevention Practices Questionnaire” form were used for the data collection. ResultsThe overall practice scores of ICU nurses in preventing MDRPIs were 50.83 ± 12.93. Out of the participants, 57.3% (n = 55) achieved a total practice score of 51 and above out of 68 (considered an acceptable score indicating proficiency in positive practice). The items with the most negative practice levels among nurses were related to statements such as ‘I apply hydrocolloid, thin foam, or a silicone-type dressing to prevent MDPRI’ (2.86 ± 0.85) and ‘I use the normal pressure injury staging when staging the MDRPI’ (2.88 ± 0.86). No significant difference was observed between the mean scores of MDRPI prevention practices and the characteristics of ICU nurses, such as education level, years working in the unit, and years of experience in the profession (p > 0.05). Furthermore, a positive correlation was found between age and practice levels in preventing MDRPIs (p < 0.05). ConclusionThe study results indicate that the practice levels of ICU nurses in preventing MDRPIs were insufficient. We believe that regular in-service training programs, grounded in clinical practice, are necessary to enhance nurses' awareness and management of MDRPIs.

Medical Device-Related Pressure Injury Care and Prevention Training Program (DevICeU): Effects on intensive care nurses' knowledge, prevention performance and point prevalence

ObjectiveTo determine the effect of the training given to intensive care unit (ICU) nurses to prevent medical device-related pressure injuries (MDRPIs) on nurses' knowledge levels, their prevention performance, and the point prevalence (PP) of MDRPIs. Research Methodology/DesignA pre-post test intervention study without a control group. SettingThe study was conducted between May and July 2023 with ICU nurses in three phases: pre-training phase (E0) (104 nurses, 116 patients), training implementation phase (E) and post-training phase (E1) (89 nurses, 120 patients). Main Outcome MeasuresThe data were collected by using the Patient (E0, E1) and Nurse (E0) Characteristic Forms, MDRPI Follow-up and Prevalence Form (E0, E1), D.E.V.I.C.E Performance Observation Checklist (E0, E1), MDRPI Knowledge Assessment Questionnaire (E0, E1), Braden Pressure Ulcer Risk Assessment Scale (E0, E1), Pressure Injury Grading Form (E0, E1), and Feedback Form about the Training Process (E). ResultsThe mean MDRPI knowledge score of the nurses increased significantly from E0 to E1 (13.23 ± 1.43 vs. 20.02 ± 1.30, p = 0.001), with the highest improvement in the staging and prevention themes. Nurses’ MDRPI prevention performance increased significantly from E0 to E1 (2.15 ± 1.01 vs. 11.17 ± 1.65, p = 0.001). There was a significant difference between the PP rate at E0 (61.2 %) and E1 (27.5 %) (p = 0.001). ConclusionThe study indicated that the training on MDRPIs given to ICU nurses increased their knowledge and prevention performance and decreased the prevalence of MDRPIs. However, further studies with a larger sample size are needed to confirm these findings. Implications for clinical practiceSince MDRPIs have more complex staging and prevention practices than conventional PIs, they require the adoption of a training approach that includes visual materials and practical methods in addition to theoretical knowledge. Accurate definitions of medical device dimensions and fixation, skin assessment, and prevention practices will lead to the desired outcome of reducing MDRPIs in ICUs.

Medical device-related pressure injuries in paediatric patients: An incidence study in a children's hospital.

To determine the incidence of pressure injuries from medical devices in children. Medical devices can cause pressure injuries on skin and soft tissues. A prospective, descriptive study adhering to STROBE guidelines. This study was conducted in the third-level Paediatric Intensive Care Unit of Ege University Hospital in İzmir, Türkiye between April 2019 and October 2019 in Türkiye. Patients aged between 1 month and 18 years with medical devices were observed for pressure injuries using Braden scales and a specific monitoring form. In this study, we followed 522 medical devices applied to 96 patients. The three most commonly used medical devices were the ECG probe (21%), the blood pressure cuff (16%) and the saturation probe. Out of the 522 medical devices followed, 36 caused pressure injuries (6.8%). The incidence of medical device-related pressure injuries was found to be high. Effective training and implementation strategies need to be devised for paediatric nurses to prevent pressure injuries associated with medical devices. The results of this study reveal that pressure injuries related to medical devices are an important health problem in paediatric hospitals. Therefore, awareness-raising and educational activities among health professionals and nurses should be accelerated. No patient or public contribution in the study.

Incidence, characteristics, and associated factors of pressure injuries acquired in intensive care units over a 12-month period: A secondary analysis of a quality improvement project

ObjectivesTo determine the 12-month cumulative incidence, characteristics, and associated factors of pressure injuries acquired in Intensive Care Units. SettingFour intensive care units in a Norwegian University Hospital. Research methodologyA prospective observational cohort study using data from daily skin inspections during a quality improvement project. We used descriptive statistics and logistic regression. Variables associated with the development of intensive care unit-acquired pressure injuries are presented with odds ratios (OR), and 95% confidence intervals. ResultsThe 12-month cumulative incidence of patients (N = 594) developing intensive care unit-acquired pressure injuries was 29 % (172/594) for all categories and 16 % (95/594) when excluding category I pressure injuries (no skin loss). Cumulative incidence for patients acquiring medical device-related pressure injuries was 15 % (91/594) and 11 % (64/594) for category II or worse. Compression stockings (n = 51) and nasogastric tubes (n = 22) were the most frequent documented medical devices related to pressure injuries. Development of pressure injuries category II or worse was significantly associated with vasoactive drug infusions (OR 11.84, 95 % CI [1.59; 88.13]) and longer intensive care unit length of stay (OR 1.06, 95 % CI [1.04; 1.08]). ConclusionThe 12-month cumulative incidence of intensive care unit-acquired pressure injuries was relatively high when category I pressure injuries were included, but comparable to other studies when category I was excluded. Some medical device-related pressure injuries were surprisingly frequent, and these may be prevented. However, associated factors of developing pressure injuries were present and deemed non-modifiable. Implications for clinical practiceAwareness about pressure injury prevention is needed in the intensive care unit considering high incidences. Nurses can detect category I pressure injuries early, which may be reversed. Our findings show several factors that clinicians can control to reduce the risk of pressure injuries in the intensive care unit.

The current status and future of dressings to prevent pressure injuries: Focus on the prophylaxis of medical device-related pressure injuries

The current status and future of dressings to prevent pressure injuries: Focus on the prophylaxis of medical device-related pressure injuries

Feasibility, acceptability, and usability of implementing a medical device-related pressure injury algorithm for critically ill patients using non-invasive ventilation

ObjectivesDescribe the feasibility, acceptability, and usability of implementing a nurse-led intervention to prevent medical device-related pressure injury in critical care patients using non-invasive ventilation during hospitalization. Study designA quality improvement project, using a descriptive single-arm study design with convenience sampling. Setting and participantsThis study was conducted at a Midwestern medical center with 640 beds (two hospital campuses). After an educational session, the nurse-led algorithm for non-invasive ventilation medical device-related pressure injury prevention was implemented in two critical care nursing units (cardiac medical progressive care and neurotrauma intensive care unit). Nursing staff were full or part-time critical care nurses. Main outcome measuresFeasibility, acceptability, and usability of the non-invasive ventilation medical device-related pressure injury algorithm were measured (bedside rounding and pre/post System Usability Scale). ResultsThirty-five nurses (52.2 %) completed a pre-educational survey; 8 (11.2 %) completed a post-survey. The total mean pre-survey score was 70.7 (SD ± 13.6) and the post-survey mean score was 71.3(SD ± 19.6). There was a statistically significant increase in the post-survey mean score {Χ2 (1, N = 43) = 43.5, p <.05}, however, the 0.06 increase was not clinically meaningful. Bedside rounding interviews (n = 22) indicated 82 % (n = 18) of the nurses used the algorithm. The SUS tool mean score was 83.3 (10.73) pre-implementation (n = 21); and 85.63 (8.26) post-implementation (n = 5), indicating clinical usability of the algorithm pre- and post-implementation. ConclusionThe feasibility, acceptability, and usability of implementing a medical device-related pressure injury algorithm for critically ill patients using non-invasive ventilation were demonstrated during this study. More nursing research is needed to develop scalable interdisciplinary clinical algorithms to reduce medical device-related pressure injuries in patients using non-invasive ventilation. Implications for clinical practiceThis study focused on the bedside usability of the algorithm in a clinical setting. Implementing this nursing-developed algorithm created an interdisciplinary framework in which nursing assessment may guide clinical care.

Tıbbi Cihaza Bağlı Basınç Yarası Gelişme Riski

Son yıllarda, tıbbi cihazlara bağlı basınç yarası gelişimi hem hastalar hem de sağlık profesyonelleri için önemli bir yük oluşturmaya devam etmektedir. Tıbbi cihazlar, yeni doğanlardan yaşlılara kadar her yaştan hastada meydana gelebilen basınç yarasına neden olabilmektedir. Deri, mukoza ve bu yapıların altındaki yumuşak dokularla etkileşime giren tıbbi cihazlar, oluşturdukları basınç nedeniyle önemli hasarlara yol açmaktadır. Sağlık bakım hizmeti verenler; hastanede yatarak tedavi gören hasta bireylerin basınç yarasının tespiti, önlenmesi, riskinin değerlendirilmesi ve iyileştirilmesi konusunda önemli roller üstlenirler. Tıbbi cihaza bağlı basınç yarası, hasta bireyin tedavisinin neden olduğu istenmeyen bir durumdur. Buradan anlaşıldığı üzere tıbbi cihaz kaynaklı oluşan basınç yarası aynı zamanda bir sağlık hizmeti komplikasyonu olarak değerlendirilebilir. Tıbbi cihaza bağlı basınç yarasının oluşmaması için iyi bir risk değerlendirmesinin yapılması oldukça önemlidir. Hastanın bakımından ve sürekli takibinden sorumlu hemşireler uzun süreli tıbbi cihaz uygulanan hastaların basınç yarası riskini ölçebilmeli, tıbbi cihazın yaptığı basınca yönelik bütüncül bir yaklaşım sergileyerek değerlendirebilmelidir. &#x0D; Bu derleme tıbbi cihaza bağlı basınç yarası gelişimine neden olabilecek risk faktörlerinin belirlenmesi ve önlenmesi ile ilgili yeterli çalışma olmamasından aynı zamanda tıbbi cihaza bağlı basınç yarası gelişen hastaların bakımında kapsamlı analiz yapabilmeyi sağlayacağı düşüncesiyle yola çıkılarak konuya dikkat çekmek amacıyla hazırlanmıştır.

Factors Affecting Medical Device-Related Pressure Injuries in Intensive Care Units

Context: Medical device-related pressure injuries (MDRPI) are a common complication that can occur in critically ill patients and require medical devices in the intensive care unit. MDRPI can occur when pressure from a medical device, such as a ventilator, catheter, or feeding tube, is exerted on the patient's skin for prolonged periods, causing tissue damage and leading to pressure injuries. MDRPI can result in pain, discomfort, prolonged hospital stays, and increased healthcare costs. Therefore, preventing and managing MDRPI in ICU patients is crucial to improving patient outcomes.&#x0D; Aim: The study aimed to assess factors affecting medical devices related to pressure injury in intensive care units.&#x0D; Methods: A descriptive and exploratory research design was employed to fulfill the objectives of this study. The study included two distinct samples: a purposive sample of 157 adult patients admitted to the intensive care unit and connected to various medical devices such as NGT, EET, CVC, UC, and CPAP masks, as well as a convenience sample of 50 nurses working in the intensive care unit who provided care to the same group of patients. Data were collected through a self-administered questionnaire, nurses' practice observational checklists, patient assessment records, and medical device assessment records.&#x0D; Results: The findings from this study reveal that 40% of the nurses under investigation demonstrated a moderate level of knowledge concerning Medical Device-Related Pressure Injuries (MDRPI). In comparison, 68.8% exhibited unsatisfactory practice in this area. Moreover, 56% of the nurses displayed a negative attitude towards factors associated with pressure injuries caused by medical devices in intensive care units. Concurrently, 58% of the patients in the study were found to have pressure injuries linked to medical devices, with 48% of these cases being attributed to CPAP masks. Furthermore, a highly significant statistical correlation was identified between the total knowledge scores of the nurses and their overall practice.&#x0D; Conclusion: The current study's conclusions indicate that the highest percentage of the participating nurses possessed an average level of knowledge, displayed inadequate practice, and harbored negative attitudes regarding factors contributing to medical device-related pressure injuries in intensive care units. Consequently, it is recommended that an educational training program be implemented to enhance nurses' competence in preventing medical device-related pressure injuries in intensive care units.

Medical Device Testing: Methods, Significance, and Clinical Applications.

To present a study conducting objective biomechanical testing of medical devices known to cause medical device-related pressure injuries (MDRPIs) in critically ill adults and comparing those results with clinical outcomes associated with each device. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Explain the results of the study of the relationships between objective biomechanical tests of medical devices and clinical outcomes that help inform clinicians using these devices.2. Synthesize the background information that informed the study.

A point prevalence study of medical device-associated pressure injuries: A cross-sectional study.

The aim of this cross-sectional study was to determine the point prevalence and associated risk factors of medical device-related pressure injuries (MDRPI) in intensive care patients in Turkey. MDRPI remain a clinical problem that has garnered the attention of healthcare professionals. This study used a cross-sectional design and was conducted over a single day in all intensive care units. Data were collected through face-to-face interviews, observation, skin examination and detailed diagnosis of MDRPI development and influencing factors. Presence of pressure injuries on the skin in the areas where the patient's medical device was placed was defined. The study was reported according to the STROBE declaration. MDRPI developed in 65 out of 200 patients included in the study (32.5%). The most frequent locations were on the face (71%). The MDRPIs were commonly associated with nasogastric tube (29.2%), endotracheal tube (18.5%) and CPAP mask (15.4%). A significant proportion of these injuries were mucosal (53.8%, n = 35). The majority of the skin pressure injuries were classified as Stage II (18.5%, n = 12). The risk increased 14 times in patients who were hospitalised for 9-16 days and 13 times in those who received mechanical ventilator support. The study findings suggest that MDRPI developed in approximately one of three patients hospitalised in the intensive care unit, and the length of hospital stay and mechanical ventilator support were important determining risk factors. The high prevalence of MDRPI may indicate inadequate nursing care quality. Therefore, it is recommended that nurses be aware of risk factors and evaluate the suitability and safety of medical devices. No patient or public contribution was involved in this study.

Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study.

Although the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking. To conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit. The study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method. After two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall's coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall's coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision). In addition, we also developed a strategy framework to clarify our strategies. According to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.

Replacing Monitoring Electrodes on Infant Skin Every 12 Versus 24 Hours.

To examine the effect of varying the frequency of monitoring electrode replacement on skin moisture and condition of infants hospitalized in the pediatric ICU. The population of the study consisted of 1- to 12-month-old infants receiving treatment in the pediatric ICU. The control group of the study (n = 33) included infants whose monitoring electrodes were replaced every 24 hours during monitoring, and the experimental group (n = 33) included infants whose monitoring electrodes were replaced every 12 and 24 hours during monitoring. Before assessment, the skin moisture of the monitoring areas was measured and evaluated with the Skin Condition Assessment Scale. When the difference in skin moisture was compared for all measurement areas of the infants before monitoring and at the 24-hour mark, an increase in moisture was seen in both groups, and the difference in the experimental group was greater than that in the control group. Increased moisture is a risk factor for medical device-related pressure injuries. When comparing between-group differences in skin condition, the researchers noted a greater increase in skin condition score in the experimental group. An increased score indicates that the infant's skin condition is worsening. Replacing the monitoring electrodes every 24 hours positively affected skin moisture and condition, whereas replacing them every 12 hours negatively affected skin moisture and condition.

Pressure Injury Prevalence and Risk Factors: A National Multicenter Analytical Study.

The purpose of this study was to determine the point prevalence (PP) of general pressure injuries (PIs), hospital-acquired PIs, PI-related risk factors, and PI preventive interventions performed by nurses. Descriptive, multicenter, prospective, analytical study. The sample comprised 5088 patients cared for in 13 hospitals in 12 geographic regions of Turkey. Data were collected between November 5, 2018, and July 17, 2019. The study was carried out in 2 stages. First, nurses who collected data were trained in the diagnosis of PI, risk assessment, staging, and prevalence studies, and informed about the purpose and methods of the study, including data collection. Second, nurses and researchers who had received training related to data collection for this study conducted a PP study for PIs in their inpatient clinics using the ASSIST II method. The PI Prevalence Study Tool and the Braden Scale for Predicting Pressure Sore Risk were also used during data collection. The PP of general PIs was 9.5%; the prevalence of PIs with hospitalization in intensive care units was 43.2%; medical device-related pressure injuries prevalence was 10.7%. We found that 65.1% of the PIs were acquired after hospital admission. Similarities exist between PI prevalence in Turkey and reported PI prevalence rates worldwide. However, the prevalence of nosocomial PIs related to intensive care units and the prevalence of all nosocomial injuries were higher than rates previously reported. Based on results, there is a need to develop strategies to reduce the prevalence of nosocomial PIs.

The Characteristics and Risk Factors of Medical Device Related Pressure Injury in Intensive Care Unit Patients

Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU).Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher’s exact tests, and logistic regression were performed to analyze the data.Results : Among the 154 subjects, there were a total of 198 medical device–related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45).Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.

The incidence and prevalence of medical device-related pressure injuries in pediatric patients: Systematic review and meta-analysis

ProblemTo determine the pooled incidence and prevalence rate of medical device-related pressure injuries(MDRPIs) using the Braden QD scale, medical devices that frequently cause MDRPIs, and anatomical locations that are vulnerable to them. Eligibility criteriaUsing the Braden QD scale, being published in English between 01/01/2018-and 01/03/2023. MethodsThis study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations and registered in the International Prospective Register of Systematic Reviews database (No: CRD42021276501). SampleA total of 7 studies with 25,742 pediatric patients were included. ResultsThe pooled prevalence and cumulative incidence of hospital-acquired pressure injuries(HAPIs) were 7.8% (95% CI: 5.2–11.4%) and 3.9% (95% CI: 0.5–24.6%) respectively, and the incidence rate was 8.2/1000 person-days (95% CI: 2.4–14.2/1000 person-days). The pooled prevalence and cumulative incidence of MDRPIs were 7% (95% CI: 5.5–8.8%) and 5% (95% CI: 3.2–7.8%) respectively, and the incidence rate was 6.7/1000 person-days (95% CI, 0.11–13.4/1000 person-days). The most affected anatomical locations were the face (29.1%), ankle/foot (20.1%), and head (15.7%). Medical devices that frequently caused MDRPIs were external monitoring devices (24.5%), respiratory devices (22.8%), and supportive/securing devices (14.9%). ConclusionsAccording to the current systematic review and meta-analyses, the incidence and prevalence of HAPIs and MDRPIs are moderate to high. ImplicationsThe findings suggested that healthcare providers should pay more attention to reducing HAPIs and MDRPIs and future studies should be conducted to understand their characteristics and risk factors.

Incidence of medical device-related pressure injuries in the intensive care unit and related risk factors

AimAt present, physicians employ medical devices extensively in the treatment of numerous diseases and in the care and follow-up of patients. However, these medical devices are a potential cause of pressure injuries.The study aimed to investigate the incidence and affecting risk factors of medical device-related pressure injuries (MDRPIs) in an adult intensive care unit. Materials and methodsThis is a longitudinal descriptive/analytical and cross-sectional study. The researchers conducted this study with 213 intensive care patients between 15.06.2021 and 15.12.2021. The skin and mucosa under and around each medical device were observed once a day for MDRPIs during the stay of patients who had been hospitalized in the intensive care unit for at least 24 h. The data were collected using Patient Information Form developed by the researchers based on the literature, Medical Device-Related Pressure Injury Monitoring Form, the Jackson/Cubbin Pressure Area Risk Calculator (Jackson/Cubbin BARHATr)-Turkish Version, the National Pressure Injury Advisory Panel (NPIAP) Pressure Injury Staging System and the Glasgow Coma Scale. ResultsThe incidence of MDRPIs was 28.6% (61/213). The study revealed that 48.4% (46/95) of these injuries were caused by medical devices for respiratory system, 26.3% (25/95) by devices for gastrointestinal and genitourinary system. The study also revealed that 70.5% of MDRPIs occurred on the skin and 29.5% on the mucosal membrane, and that 82.1% of the MDRPIs occurring on the skin were at Stage 1. In terms of anatomical location, 21.1% of these injuries developed on the fingers and 13.7% on the mouth/lip. In multivariate analysis, parenteral + enteral (p = 0.006, OR = 0.083, 95%CI = [0.014–0.497]) and oral nutrition (p = 0.037, OR = 0.210, 95%CI = [0.049–0.908]), a higher number of devices (nine or more) (p = 0.002, OR = 5.387, 95%CI = [1.840–15.772]) and the duration of device wear (p < 0.05) were identified as independent risk factors for the occurrence of MDRPIs. ConclusionsThe study showed that the incidence of MDRPIs was relatively high and was associated with various factors. It is critical for intensive care nurses, who encounter MDRPIs more frequently, to consider these factors while caring for their patients and to take appropriate preventive measures to reduce the incidence of these injuries.

Preventing Medical Device-Related Pressure Injuries

Pressure injuries (PIs) are a common, yet preventable complication of patient care. 1 Dang W Liu Y Zhou Q et al. Risk factors of medical device-related pressure injury in intensive care units. J Clin Nurs. 2022; 31: 1174-1183https://doi.org/10.1111/jocn.15974 Crossref Scopus (14) Google Scholar ,2 Hajhosseini B Longaker MT Gurtner GC Pressure injury. Ann Surg. 2020; 271: 671-679https://doi.org/10.1097/sla.0000000000003567 Crossref PubMed Scopus (0) Google Scholar Regulatory, quality, and health care bodies view the frequency of hospital-acquired pressure injuries (HAPIs) as indicative of the quality of nursing care and take the issue of HAPIs very seriously in terms of patient safety. 3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar Every year, approximately 2.5 million people develop HAPIs, and approximately 60,000 people die as a result of these injuries. 3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar ,4 Padula WV Delarmente BA The national cost of hospital-acquired pressure injuries in the United States. Int Wound J. 2019; 16: 634-640https://doi.org/10.1111/iwj.13071 Crossref PubMed Scopus (207) Google Scholar The total cost of HAPI care per patient ranges from $29,900 to $151,700, resulting in an estimated annual cost of $26.8 billion. 3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar ,5 Tschannen D Anderson C The pressure injury predictive model: a framework for hospital-acquired pressure injuries. J Clin Nurs. 2020; 29: 1398-1421https://doi.org/10.1111/jocn.15171 Crossref Scopus (14) Google Scholar Despite the introduction of new technology and HAPI prevention strategies, the occurrence of HAPI is still on the rise. 2 Hajhosseini B Longaker MT Gurtner GC Pressure injury. Ann Surg. 2020; 271: 671-679https://doi.org/10.1097/sla.0000000000003567 Crossref PubMed Scopus (0) Google Scholar ,3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar People suffering from this injury can experience severe discomfort, a decrease in their overall quality of life, reduced activity, decreased productivity, social alienation, depression, and increased length of stay. 2 Hajhosseini B Longaker MT Gurtner GC Pressure injury. Ann Surg. 2020; 271: 671-679https://doi.org/10.1097/sla.0000000000003567 Crossref PubMed Scopus (0) Google Scholar