The Occurrence And Influencing Factors Of Pressure Injury In ICU Patients Based On Mobile Information Platform

ObjectivesTo investigate the number,location,stage,prevalence and incidence of pressure injury in ICU patients,and explore the influencing factors of pressure injury.MethodsObservational studies are used.Using a mobile information platform embedded in the questionnaire on the occurrence and influencing factors of pressure injury as a research tool,1 051 adult patients admitted to the comprehensive ICU and specialty ICU wards of a tertiary general hospital from January 2021 to December 2021 were investigated.Frequency,percentage,mean,and standard deviation were used to describe the disease and incidence of pressure injury in ICU patients,and chi-square test,Fisher exact probability algorithm,and Binary Logistic regression were used to analyze the influencing factors for pressure injury in ICU patients.Results1.Occurrence of pressure injury in ICU patients（1）Prevalence and morbidity: The overall prevalence of pressure injury in 1051 ICU patients was 11.2%,and the prevalence of stage 2 or above pressure injury was9.1%;The overall incidence of pressure injury was 6.4% in 997 ICU patients（excluding54 patients with pressure injury when admitted to ICU）,and the incidence of stage 2 or above pressure injury was 5.1%.（2）Stage and location: Among the 64 patients with new pressure injury,28.1%had ≥2 pressure injury sites;most were stage 2 pressure injuries,accounting for 58.9%（53/90）;the second were stage 1 pressure injuries,accounting for 21.1%（19/90）.New pressure injuries occurred most frequently in the sacrococcygeal region,accounting for44.4%（40/90）,followed by the heel,accounting for 12.2%（11/90）,and the hip,accounting for 6.7%（6/90）.（3）Characteristics of hospitalization distribution: The time from admission to pressure injury in patients with pressure injury was（10.95±10.57）days,and the total number of days in hospital was（31.58±24.90）days;The length of time was（7.33±11.03）days,and the length of ICU stay was（17.56±23.77）days.2.Risk assessment of pressure injury in ICU patientsThe predictive power of the Waterlow scale in ICU patients was moderate,the area under the ROC curve was 0.78,the sensitivity was 0.95,and the specificity was 0.17,which would overestimate the risk of pressure injury in ICU patients;when its critical value was 20 points,the Youden index was only 0.47 at the maximum,and the predictive power was limited.3.Univariate analysis results of influencing factors of pressure injury in ICU patientsInfluencing factors of pressure injury in ICU patients（P<0.05）included:（1）General information: gender,direct admission to ICU,season,ICU type,ICU length of stay,total length of stay,and motor system disease,etc.7 independent variables;（2）Physical assessment: bedridden,perception,mobility,friction and shear,nutritional problems,high lactate,mean arterial pressure,low albumin,low hemoglobin,high temperature,diastolic blood pressure,skin moisture,abnormal skin color,skin ulceration/erythema,unconsciousness,and forced posture,etc.16 independent variables;（3）Treatment measures: mechanical ventilation,restraint,use of nasogastric/small intestine tube,tracheal intubation,tracheostomy tube,CVC,peritoneal catheter,urinary catheter,vasoactive drugs,sedation analgesic drugs,anti-tumor drugs,hormone,antiarrhythmic,anti-asthmatic,antibacterial,muscle relaxants,surgery,and surgery time,etc.18 independent variables;（4）Nursing measures: nursing pads,water bags,soft pillows and other three independent variables.4.Results of multivariate analysis on the influencing factors of pressure injury in ICU patientsThe results of Binary Logistic regression analysis showed that the total length of hospital stay,ICU length of stay,ICU type,season,skin moisture,abnormal skin color,skin ulceration/erythema,hormone,antibiotics,peritoneal catheter,surgery time,fever,the existence of friction and shear force,and the use of nursing pads were the influencing factors of pressure injury in ICU patients（P<0.05）.ConclusionsThe prevalence and the morbidity of pressure injury in ICU patients in this study,lower than those reported in most regions at domestic and overseas.The injury locations were more common in the sacral tail,heel and hip.Total length of hospital stay,ICU length of stay,ICU type,season,skin moisture,abnormal skin color,skin ulceration/erythema,hormone,antibiotics,peritoneal catheter,surgery time,fever,the existence of friction and shear force,and the use of nursing pads were the influencing factors for pressure injury in ICU patients.Develop effective risk assessment tools for ICU patients with pressure injury according to China’s national conditions and regional characteristics.To help nurses identify the risk and influencing factors of pressure injury in ICU patients at an early stage,implement scientific and reasonable intervention measures as soon as possible,and reduce the incidence of pressure injury in ICU patients.