Prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units - Results of a cross-sectional survey
Prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units - Results of a cross-sectional survey
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DOI：
10.1007/s001340101061
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发表时间：
2001-10-01
影响因子：
38.9
通讯作者：
Lubbers, M
中科院分区：
文献类型：
--
作者：
Bours, GJJW;De Laat, E;Lubbers, M
目的：评价荷兰重症监护病房（icu）压疮的患病率、危险因素及预防措施。设计：横断面设计。环境：参加1998年和1999年全国流行病学调查的急症护理医院的icu。每年1天采集数据。患者：荷兰icu收治了850例患者。干预措施:没有。测量和主要结果：收集了六类数据：(1)机构特征，(2)病房特征，(3)患者特征（年龄、性别、入院日期、入院原因），(4)使用Braden量表和两个附加危险因素（营养不良和尿失禁）进行风险评估，(5)压疮严重程度，(6)使用的支撑面。压疮患病率为28.7%。在前瞻性logistic回归分析中，四个危险因素与压疮的存在显著相关：感染、年龄、住院时间和总Braden评分。在发生压力性溃疡的高风险但没有实际压力性溃疡的患者中，60.5%的患者被安置在支持系统上。只有36.8%确定需要重新定位的患者实际上被翻转了。结论：荷兰icu压疮患病率高，其预防存在缺陷，特别是在支持系统的使用方面。指示转诊的病人没有转诊。预测ICU患者的压疮是困难的，需要进一步的研究。
Objective: Evaluating the prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units (ICUs).Design: Cross-sectional design.Setting: ICUs of acute care hospitals that participated in the 1998 and 1999 national prevalence surveys. Data were collected on 1 day in each year.Patients: Eight hundred fifty patients admitted to Dutch ICUs.Interventions: None.Measurements and main results: Six categories of data were collected: (1) characteristics of the institution, (2) characteristics of the ward, (3) characteristics of the patients (age, sex, date of admission, reason for admission), (4) risk assessment using the Braden scale and two additional risk factors (malnutrition and incontinence), (5) severity of the pressure ulcers and (6) supportive surface used. The prevalence of pressure ulcers was 28.7 %. In a forward logistic regression analysis, four risk factors were significantly associated with the presence of pressure ulcers: infection, age, length of stay and total Braden score. Of the patients at high risk of developing pressure ulcers but without actual pressure ulcers, 60.5 % were positioned on a support system. Only 36.8 % of the patients who were determined to need repositioning were actually being turned.Conclusions: The prevalence of pressure ulcers in Dutch ICUs is high and their prevention is flawed, especially as regards the use of support systems. Patients for whom turning is indicated are not being turned. Predicting pressure ulcers in ICU patients is difficult and needs further investigation.