Incidence of medical device-related pressure injuries in the intensive care unit and related risk factors

Abstract

Aim: At present, physicians employ medical devices extensively in the treatment of numerous diseases and in the care and follow-up of patients. However, these medical devices are a potential cause of pressure injuries.The study aimed to investigate the incidence and affecting risk factors of medical device-related pressure injuries (MDRPIs) in an adult intensive care unit.Materials and methods: This is a longitudinal descriptive/analytical and cross-sectional study. The researchers conducted this study with 213 intensive care patients between 15.06.2021 and 15.12.2021. The skin and mucosa under and around each medical device were observed once a day for MDRPIs during the stay of patients who had been hospitalized in the intensive care unit for at least 24 h. The data were collected using Patient Information Form developed by the researchers based on the literature, Medical Device-Related Pressure Injury Monitoring Form, the Jackson/Cubbin Pressure Area Risk Calculator (Jackson/Cubbin BARHATr)-Turkish Version, the National Pressure Injury Advisory Panel (NPIAP) Pressure Injury Staging System and the Glasgow Coma Scale.Results: The incidence of MDRPIs was 28.6% (61/213). The study revealed that 48.4% (46/95) of these injuries were caused by medical devices for respiratory system, 26.3% (25/95) by devices for gastrointestinal and genitourinary system. The study also revealed that 70.5% of MDRPIs occurred on the skin and 29.5% on the mucosal membrane, and that 82.1% of the MDRPIs occurring on the skin were at Stage 1. In terms of anatomical location, 21.1% of these injuries developed on the fingers and 13.7% on the mouth/lip. In multivariate analysis, parenteral + enteral (p = 0.006, OR = 0.083, 95%CI = [0.014-0.497]) and oral nutrition (p = 0.037, OR = 0.210, 95%CI = [0.049-0.908]), a higher number of devices (nine or more) (p = 0.002, OR = 5.387, 95%CI = [1.840-15.772]) and the duration of device wear (p < 0.05) were identified as independent risk factors for the occurrence of MDRPIs.Conclusions: The study showed that the incidence of MDRPIs was relatively high and was associated with various factors. It is critical for intensive care nurses, who encounter MDRPIs more frequently, to consider these factors while caring for their patients and to take appropriate preventive measures to reduce the incidence of these injuries.