Pressure Ulcer Risk and Prevention Practices in Pediatric Patients

Abstract

Purpose: Little is known about pressure ulcer risk and prevention practices in hospitalized pediatric patients. The purpose of this study was 1) to describe the frequency of pressure ulcer risk assessment among pediatric acute care patients, as well as methods, and 2) to examine the frequency of pressure ulcer prevention interventions among those at risk overall and by hospital unit type.

Design: This was a descriptive secondary analysis of 2012 data on pressure ulcers among pediatric patients from the National Database for Nursing Quality Indicators^® (NDNQI^®).

Subjects and Setting:  The sample include 39,984 pediatric patients ages 1 day to 18 years of age from 678 pediatric acute care units (general pediatrics, pediatric critical care units, neonatal intensive care units, pediatric step down and pediatric rehabilitation units) in 271 United States (US) hospitals that submitted pressure ulcer data for at least three quarters during 2012.

Results: Most pediatric patients (n = 33,644; 89.2%) received a pressure ulcer risk assessment within 24 hours of admission. The Braden Q Scale was frequently used (56-86%) to assess pressure ulcer risk on most pediatric units except for NICUs where other scales or other methods were commonly used (55-60%). Overall, 30% of the pediatric patients (n=11,203) were at risk for pressure ulcers. The majority (n= 10,741, 95.8%) received some kind of pressure ulcer prevention. Across unit types, nearly all at risk patients (99.2%) received a skin assessment within the previous 24 hours; 89.5%were repositioned as prescribed, 88.6% had received nutritional support, and moisture was managed for 84.6% of at risk patients.  A pressure redistribution surface was in use for only 70.7% of at risk patients.

Conclusion:  Most pediatric patients are being assessed for pressure ulcer risk but there is room for improvement in pressure ulcer prevention among pediatric patients.