BMJ Open (Nov 2022)

Prevalence of skin pressure injury in critical care patients in the UK: results of a single-day point prevalence evaluation in adult critically ill patients

  • ,
  • Daniel Horner,
  • Paul Hayden,
  • Catherine Smith,
  • Egidija Bielskute,
  • Monica Popescu,
  • Bronagh Blackwood,
  • Tamas Szakmany,
  • Una Gunter,
  • Matthew Jackson,
  • Joanne White,
  • David Shaw,
  • Stephen Brett,
  • Neil Smith,
  • Sarah Buckley,
  • Tomas Jovaisa,
  • Jason Cupitt,
  • Karen Burns,
  • Francesca Rubulotta,
  • Justin Woods,
  • Mark Pulletz,
  • Jonathan Paddle,
  • Tomasz Torlinski,
  • Helen Williams,
  • Julie Camsooksai,
  • Lynne Williams,
  • Karen Williams,
  • Nicola McCann,
  • David Higgins,
  • Ian Kerslake,
  • Ascanio Tridente,
  • Natalie Fox,
  • Ahmed Zaki,
  • Rachel Baumber,
  • JOHN ADAMS,
  • Suzanne Bench,
  • Rhian Bull,
  • Michele Clark,
  • Beverley Thomas,
  • John Prowle,
  • Carole Boulanger,
  • Anne Williams,
  • Helen Baker,
  • Sarah Bean,
  • Stephanie Harris,
  • Charlotte Young,
  • Agnieszka Kubisz-Pudelko,
  • Amy Collins,
  • Christian Frey,
  • Ingeborg D Welters,
  • Jenny Lord,
  • Marcela Vizcaychipi,
  • Nigel White,
  • Reni Jacob,
  • Ritoo Kapoor,
  • Vongayi Ogbeide,
  • Jayne Craig,
  • Rajnish Saha,
  • Rosaleen Baruah,
  • Santhana Kannan,
  • Sophie Liu,
  • Mieke Deschepper,
  • Sonia O Labeau,
  • Stijn Blot,
  • Aberdeen Royal Infirmary,
  • Faye Morren,
  • Nicola Vaughan-Jones,
  • Carmel Georgiev,
  • Rosina Shayamano,
  • Peter Creber,
  • Ana Vochin,
  • Catherine O’Brien,
  • Paul Caddell,
  • Samantha Hagan,
  • Mandy Hughes,
  • James Sherwin,
  • Amber Markham,
  • Richard Lebon,
  • Julius Cranshaw,
  • Victoria Marriott,
  • Wendy Milner,
  • Casiano Barrera Groba,
  • Joao Azoia,
  • Petra Polgarova,
  • Shaly George,
  • Ceri Lynch,
  • Nathalie Fox,
  • Karen Cranmer,
  • Thomas Llewellym,
  • Kelly Matthews,
  • Louise Maltby,
  • Karen Boulton,
  • Rachel Jarman,
  • Karen Baxter,
  • Ashok Sundai Raj,
  • Arif Moghal,
  • Suzanne Barrowcliffe,
  • Vaarisan Ganeshalingam,
  • Poe Poe Ei,
  • Jennifer Hughes,
  • Madhu Balasubramanian,
  • Armorel Salberg,
  • Dagmar Holmquist,
  • Claire Derbyshire,
  • Elizabeth Stones,
  • Jane Ademokun,
  • Maria Schofield Legorburo,
  • Samantha North,
  • Carole Brett,
  • Helen Jaundoo,
  • Simon Whiteley,
  • Clare Howcroft,
  • Liz Wilby,
  • Peter Delve,
  • Jane McMullen,
  • Leah Flores,
  • Mae Templeton,
  • Heather Byers,
  • Andrea McDonnell,
  • Bernd Oliver Rose,
  • Rosie Reece-Anthony,
  • Luis Mendes,
  • Grace Lacaden,
  • Eleanor Santiago,
  • Carlos Castro Delgado,
  • Sarah Farnell-Ward,
  • Elaine Thorpe,
  • Justine Somerville,
  • Donna Cummings,
  • Helen Derrick,
  • Sarah Brumwell,
  • Claire Randell,
  • Emma Aves,
  • Gillian Berry,
  • Paul Pulak,
  • Nikki Sarkar,
  • Kerry Wright,
  • Vitor Gomes,
  • Jo Jones,
  • Ruth Palfrey,
  • Abby Lewis,
  • Antony Eneas,
  • Louise Barr,
  • Emma Parkin,
  • Phil Broadhurst,
  • Christopher Palfreeman,
  • Nicola Allison,
  • Penny Parsons,
  • Victoria Houghton,
  • Sarah Jane Turner,
  • Nicola Horrigan,
  • Karen Habgood,
  • Charalice Ramiro,
  • Michelle Kotze,
  • Jowena Ibao,
  • Treiza Trueman-Dawkins,
  • Ben Attwood

DOI
https://doi.org/10.1136/bmjopen-2021-057010
Journal volume & issue
Vol. 12, no. 11

Abstract

Read online

Objectives Hospital-acquired pressure injuries (PIs) are a source of morbidity and mortality, and many are potentially preventable.Design This study prospectively evaluated the prevalence and the associated factors of PIs in adult critical care patients admitted to intensive care units (ICU) in the UK.Setting This service evaluation was part of a larger, international, single-day point prevalence study of PIs in adult ICU patients. Training was provided to healthcare givers using an electronic platform to ensure standardised recognition and staging of PIs across all sites.Participants The characteristics of the ICUs were recorded before the survey; deidentified patient data were collected using a case report form and uploaded onto a secure online platform.Primary and secondary outcome measures Factors associated with ICU-acquired PIs in the UK were analysed descriptively and using mixed multiple logistic regression analysis.Results Data from 1312 adult patients admitted to 94 UK ICUs were collected. The proportion of individuals with at least one PI was 16% (211 out of 1312 patients), of whom 8.8% (n=115/1312) acquired one or more PIs in the ICU and 7.3% (n=96/1312) prior to ICU admission. The total number of PIs was 311, of which 148 (47.6%) were acquired in the ICU. The location of majority of these PIs was the sacral area, followed by the heels. Braden score and prior length of ICU stay were associated with PI development.Conclusions The prevalence and the stage of severity of PIs were generally low in adult critically ill patients admitted to participating UK ICUs during the study period. However, PIs are a problem in an important minority of patients. Lower Braden score and longer length of ICU stay were associated with the development of injuries; most ICUs assess risk using tools which do not account for this.Trial registration number NCT03270345.