Predictors of pressure ulcer development in adult critical care patients

The purpose of this study was to examine the relationships between theoretically- and empirically derived risk factors and pressure ulcer development in adult critical care patients. Theoretically-derived risk factors under investigation included mobility, activity, sensory perception, moisture, friction/shear, nutrition, age and arteriolar pressure. Empirically-derived risk factors under investigation included length of intensive care unit stay, severity of illness, vasopressor administration and comorbid conditions. The sample was comprised of 347 patients admitted into a medical surgical intensive care unit from October 2008 through May 2009. Data was abstracted from various sources within the patient’s computerized medical record. Hypotheses testing consisted of both correlational and logistic regression analysis. Significant correlations were found between the following theoretically-derived risk factors: total Braden scale score, representing cumulative risk, mobility, sensory perception, friction/shear, nutrition, age and arteriolar pressure. Empirically-derived risk factors significantly associated with pressure ulcer development were length of ICU stay, severity of illness, norepinephrine, vasopressin and the comorbid conditions of cardiovascular disease and infection. In logistic regression analysis, the variables mobility, age, intensive care unit length of stay and cardiovascular disease explained a significant portion of the variance in pressure ulcer development in this study sample. This study contributed to the body of knowledge regarding pressure ulcer risk factors that confront the critically ill, however, more empirical evidence is needed to further validate these risk factors in the ICU population. Development of an ICU pressure ulcer risk assessment model or refinement of the Braden and Bergstrom conceptual framework is warranted in order to appropriately and more fully explain pressure ulcer development in this population. This risk assessment model may then serve as the basis for the development of a risk assessment tool designed specifically to measure pressure ulcer risk in adult critical care patients.Ph.D.Includes bibliographical references, abstract, and vita.byby Jill Co