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Independent Hospital Pricing Association. National Hospital Cost Data Collection, Public Hospitals Cost Report, Round 20 (Financial year 2015-16). 2018. https://tinyurl.com/y3xhsstg (accessed 18 July 2019)

Barakat-Johnson M, Lai M, Wand T The cost and consequences of an intervention-based programme to reduce hospital-acquired pressure injuries in one health district in Australia. Aust Health Rev. 2019; https://doi.org/10.1071/AH18131

Bale S, Dealey C, Defloor T The experience of living with a pressure ulcer. Nurs Times. 2007; 103:(15)42-43

Coyer F, Miles S, Gosley S, Fulbrook P Pressure injury prevalence in intensive care versus non-intensive care patients: A state-wide comparison. Aust Crit Care. 2017; 30:(5)244-250 https://doi.org/10.1016/j.aucc.2016.12.003

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Coyer FM, Stotts NA, Blackman VS. A prospective window into medical device-related pressure ulcers in intensive care. Int Wound J. 2014; 11:(6)656-664 https://doi.org/10.1111/iwj.12026

Arnold-Long M, Ayer M, Borchert K. Medical Device–Related Pressure Injuries in Long-term Acute Care Hospital Setting. J Wound Ostomy Continence Nurs. 2017; 44:(4)325-330 https://doi.org/10.1097/WON.0000000000000347

Hanonu S, Karadag A. A Prospective, Descriptive Study to Determine the Rate and Characteristics of and Risk Factors for the Development of Medical Device-related Pressure Ulcers in Intensive Care Units. Ostomy Wound Manage. 2016; 62:(2)12-22

Hobson DB, Chang TY, Aboagye JK Prevalence of graduated compression stocking–associated pressure injuries in surgical intensive care units. J Crit Care. 2017; 40:1-6 https://doi.org/10.1016/j.jcrc.2017.02.016

Seyedhejazi M, Hamidi M, Sheikhzadeh D, Aliakbari Sharabiani B Nasogastric tube placement errors and complications in pediatric intensive care unit: a case report. J Cardiovasc Thorac Res. 2011; 3:(4)133-134

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Boesch RP, Myers C, Garrett T Prevention of tracheostomyrelated pressure ulcers in children. Pediatrics. 2012; 129:(3)e792-e797 https://doi.org/10.1542/peds.2011-0649

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Pressure ulcers

The incidence and prevalence of medical device-related pressure ulcers in intensive care: a systematic review

02 May 2020
Review
02 May 2020
Volume 4 · Issue 2

Abstract

Objective:

The objective of this review was to synthesise the literature and evaluate the incidence, prevalence and severity of medical device-related pressure ulcers (MDRPU) in adult intensive care patients.

Method:

Electronic databases and additional grey literature were searched for publications between 2000 and 2017. Outcome measures included cumulative incidence or incidence rate, point prevalence or period prevalence as a primary outcome and the severity and location of the pressure ulcer (PU) as secondary outcome measures. Included studies were assessed for risk of bias using a nine-item checklist for prevalence studies. The heterogeneity was evaluated using 12 statistic.

Results:

We included 13 studies in this review. Prevalence was reported more frequently than incidence. Pooled data demonstrated a high variation in the incidence and prevalence rates ranging from 0.9% to 41.2% in incidence and 1.4% to 121% in prevalence. Heterogeneity was high. Mucosal pressure injuries were the most common stage reported in the incidence studies whereas category II followed by category I were most commonly reported in the prevalence studies. In the incidence studies, the most common location was the ear and in the prevalence studies it was the nose.

Conclusion:

While MDRPU are common in intensive care patients, it is an understudied area. Inconsistency in the staging of MDRPU, along with variations in data collection methods, study design and reporting affect the reported incidence and prevalence rates. Standardisation of data reporting and collection method is essential for pooling of future studies.

Pressure ulcers (PU), also referred to as pressure injuries, are a serious clinical problem and pose a significant burden on the individual and the health-care system.1,2,3 Evidence shows that PUs account for 1.9% of public health expenditure in Australia, totalling $983 million per annum related to treatment costs and prolonged hospital stays.3 In the US, PUs cost $2.1 billion per year4 and in the UK, £2.1 billion per year.5 Patients who develop a PU in hospital are more likely to have a longer stay than those who do not.3,6,7 PUs cause pain, physical disability such as immobility, and impact on an individual psychologically.1,2,8

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critical care
device-related
incidence
pressure injury
pressure ulcer
prevalence