Risk factors and prevalence of medical device-related pressure injuries in pediatric intensive care

Abstract

Objectives: This study aimed to determine the incidence of pressure injuries (PI) in patients connected to medical devices during their treatment in the pediatric intensive care unit (PICU), the risk factors, and the most accurate scale that assesses PI.

Methods: A cross-sectional study adhering to STROBE guidelines. It was carried out with 70 children connected to medical devices during their treatment in the PICU between 12.01.2023 and 06.30.2024. The PI development risk statuses of the patients associated with medical devices were evaluated using the Braden Q Scale, the BUCH Scale, the Glamorgan Pediatric PI Risk Assessment Scale, and an Injury Monitoring Form.

Results: The incidence of medical device-related pressure injuries (MDPI) in the PICU was 12.8 %. MDPI developed the most frequently in the nasal and oral regions, and 61.5 % of these injuries were Stage 1. The equipment with the highest rates of contribution to PI included nasogastric tubes, orogastric feeding equipment, and oral intubation tubes. The Braden Q, BUCH, and Glamorgan Scales had AUC values of 0.91, 0.83, and 0.80, sensitivity values of 77 %, 77 %, and 66 %, and specificity values of 82 %, 69 %, and 62 %, respectively.

Conclusions: The results of this study highlight that medical devices used to support the recovery of critically ill children in the PICU pose a significant risk for PI development.

Implications for clinical practice: Determining incidence and risk factors is important to prevent PI. Appropriate protocols, interventions, and strategies can be developed to manage the identified MDPI risk factors.

Keywords: BUCH; Braden Q; Glamorgan; Medical device-related pressure injuries; Pediatric intensive care unit.