Protecting Fragile Skin: Nursing Interventions to Decrease Development of Pressure Ulcers in Pediatric Intensive Care

Authors

Christine A. Schindler, Marquette UniversityFollow
Theresa Mikhailov, Medical College of Wisconsin
Jean Christopher, Medical Center of Akron
Pat Conway, National Association of Children's Hospitals and Related Institutions
Debra Ridling, Seattle Children's Hospital
Annette M. Scott, University of Michigan Hospital Systems
Vickie S. Simpson, Dell Children's Medical Center

Document Type

Article

Publication Date

1-2011

Publisher

American Association of Critical-Care Nurses

Source Publication

American Journal of Critical Care

Source ISSN

1062-3264

Abstract

Background

The reported incidence of pressure ulcers in critically ill infants and children is 18% to 27%. Patients at risk for pressure ulcers and nursing interventions to prevent the development of the ulcers have not been established.

Objectives

To determine the incidence of pressure ulcers in critically ill children, to compare the characteristics of patients in whom pressure ulcers do and do not develop, and to identify prevention strategies associated with less frequent development of pressure ulcers.

Methods

Characteristics of 5346 patients in pediatric intensive care units in whom pressure ulcers did and did not develop were compared. Multiple logistic regression was used to determine which prevention strategies were associated with less frequent development of pressure ulcers.

Results

The overall incidence of pressure ulcers was 10.2%. Patients at greatest risk were those who were more than 2 years old; who were in the intensive care unit 4 days or longer; or who required mechanical ventilation, noninvasive ventilation, or extracorporeal membrane oxygenation. Strategies associated with less frequent development of pressure ulcers included use of specialty beds, egg crates, foam overlays, gel pads, dry-weave diapers, urinary catheters, disposable under-pads, body lotion, nutrition consultations, change in body position every 2 to 4 hours, blanket rolls, foam wedges, pillows, and draw sheets.

Conclusions

The overall incidence of pressure ulcers among critically ill infants and children is greater than 10%. Nursing interventions play an important role in the prevention of pressure ulcers.

Comments

American Journal of Critical Care, Vol. 20, No. 1 (2011): 26-35. DOI.

Recommended Citation

Schindler, Christine A.; Mikhailov, Theresa; Christopher, Jean; Conway, Pat; Ridling, Debra; Scott, Annette M.; and Simpson, Vickie S., "Protecting Fragile Skin: Nursing Interventions to Decrease Development of Pressure Ulcers in Pediatric Intensive Care" (2011). College of Nursing Faculty Research and Publications. 751.
https://epublications.marquette.edu/nursing_fac/751