Characteristics And Influencing Factors Of Pressure Injury In ICU Patients Of Tertiary Hospitals In Gansu Province

Background Intensive care unit(ICU)patients are a high-risk group of pressure injury.Patients will suffer significant harm from concurrent pressure injury,and the disease burden will rise.To master the characteristics of pressure injury in ICU patients and explore its possible influencing factors is helpful to establish standardized management strategies,promote the prevention and treatment of pressure injury in ICU patients in Gansu Province,and continuously improve the quality of clinical nursing.Objectives To investigate the characteristics and influencing factors of pressure injury in ICU patients of tertiary hospitals in Gansu Province,and to provide scientific basis and theoretical guidance for promoting the formulation of risk prevention and management strategies for pressure injury in ICU patients in Gansu Province.Methods A non-experimental descriptive study was conducted.The “Long Hu Hui” pressure injury mobile information platform was used to collect the risk assessment and reported data of pressure injury of 4957 ICU patients from tertiary hospitals in Gansu Province from April 1,2021 to October 31,2022.Frequency,percentage,Mean ± standard deviation(Mean ± SD)or median and interquartile range(IQR)were used to describe the characteristics of pressure injury in ICU patients.Chi-square test,Fisher exact probability algorithm and Binary Logistic regression were used to analyze the influencing factors of pressure injury in ICU patients.Results 1.Characteristics of pressure injury in ICU patients(1)Prevalence and Incidence: Among 4957 ICU patients,185 patients suffered from pressure injury,of which 115 patients suffered from pressure injury before admission to ICU,and 70 patients suffered from pressure injury after admission to ICU.The prevalence of pressure injury was 3.7%,and the incidence was 1.4%.(2)Stage and Location: Stage 2 pressure injury accounted for the highest proportion of all pressure injury and ICU-acquired pressure injury,accounting for 51.9% and 63.3%,respectively.Followed by stage 1 pressure injury,accounting for 20.5% and 22.4%,respectively.A total of 297 pressure injury occurred in 185 patients.The most common site of pressure injury was sacral(127,42.8%),followed by hip and heel.(3)Demographic characteristics: Among all age groups of ICU patients with pressure injury,patients over 80 years old had the highest prevalence of pressure injury,which was 5.1%.Among the patients with pressure injury,there were 55 males with an incidence of 1.8% and 15 females with an incidence of 0.8%.There were 22 patients with overweight(24.00≤BMI<28.00),and the incidence of pressure injury was the highest(1.7%).The prevalence and incidence of pressure injury in patients with ICU stay of 8 days or more were higher than those with less than 8 days,which were 6.4% and 3.4%,respectively.2.Conditions of ICU pressure injury risk assessmentAmong 4842 patients without pressure injury at ICU admission,the average score of Braden scale was(14.59±3.08),and the average score of Waterlow scale was(19.61±6.00).According to the risk degree of Braden scale,88.6% of patients with ICUacquired pressure injury had the risk of pressure injury on the day of ICU admission;According to the Waterlow scale,97.1% of ICU-acquired pressure injury patients were at risk of pressure injury on the day of ICU admission.3.Conditions of implementation of preventive measures for pressure injuryMore than 80% of the patients at risk of pressure injury used nursing decompression devices,mainly water bags and air cushion beds,and more than 98% of the patients could ensure the frequency of turning over every 2 hours.4.Analysis of influencing factors of pressure injury in ICU patientsA total of 6 aspects including general data of patients,main disease diagnosis,physical assessment,laboratory index,treatment and nursing measures and medication of ICU patients were analyzed.A total of 13 variables entered the Binary Logistic regression model with the occurrence of pressure injury as the dependent variable.In general data of patients,gender,length of stay in ICU,ICU category,and season were the influencing factors of pressure injury.Neurological diseases and dysfunction in the main disease diagnosis of patients on admission are the influencing factors of pressure injury.In addition,patients with previous stroke and peripheral vascular disease will also increase the risk of pressure injury.Skin discolored and broken or spots are the influencing factors of pressure injury in physiological condition.The use of dobutamines and propofol in medication was the influencing factor of the occurrence of pressure injury,and the indwelling of tracheostomy tube and chest tube in treatment and nursing measures was the influencing factor of the occurrence of pressure injury.ConclusionsThe prevalence and incidence of pressure injury in ICU patients in this study are lower than the results of most studies at home and abroad.Stage 2 pressure injury is the most common stage,and the location and incidence are more common in sacral,hip and heel.Male,length of stay in ICU ≥ 8 days,specialized ICU,winter,neurological diseases and dysfunction,previous stroke,peripheral vascular disease,indwelling of tracheostomy tube and chest tube,use of dobutamine,propofol,Skin discolored and broken or spots were the influencing factors of pressure injury in ICU patients.This study provides data on the prevalence,incidence and influencing factors of pressure injury for clinical work and further research on pressure injury in ICU patients.In clinical nursing work,nurses should focus on the above factors affecting the occurrence of pressure injury in ICU patients,improve prevention awareness,and implement preventive measures.Nursing managers can strengthen nursing management strategies according to the results of this study,so as to reduce the risk of pressure injury in ICU patients.