Incidence and associated factors of pressure ulcer Among patients admitted to adult intensive care unit Jimma university medical center, jimma town, ethiopia

Abstract

Background: Pressure ulcer is defined as a localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in with shear and/or friction. People most at risk of pressure ulcers are those with a medical condition that limits their ability to change positions or co-morbidity confines them to a bed for a long time. Once it developed pressure ulcer is a common cause of morbidity and mortality in hospitalized patients, and also require high cost for treatment. Objectives; The main objective of the study was to assess the incidence and associated factors of pressure ulcers among patients admitted to the adult Intensive care unit of Jimma Medical Center, southwest Ethiopia. Methods: Institutional-based cross-sectional study was conducted from August 1 to December 31, 2021. A pre-designed structured questionnaire was used to collect socio-demographic and some clinical data. In addition to these, the Braden scale risk assessment tool was used to evaluate for pressure ulcer risk during admission. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version 20. Descriptive analysis, bivariate, and multivariate logistic regression were applied to see the association between dependent and independent factors. Results: The overall incidence of pressure ulcers among adult intensive critical care admitted patients was 16.2%(22). Based on the EPUAP grading scale 11(50%) developed stage II pressure ulcers (PU) and the sacral anatomical site was the main one. length of stay≥21 days [OR 6.53(OR 1.02-41.9), P=0.048], not position change [OR 3.94(1.05-14.8), P=0.043], sedation [5.07(OR 1.32-19.51), P=0.018], vasopressor[OR 5.06(1.29-19.92), P=0.02], and friction problem[OR 6.32(1.1-36.37),95%CI, p=0.039] had significant association with pressure ulcer. Conclusion: In this study incidence of pressure ulcers was high. Prolonged length of stay in the ICU, the problem of friction and shearing forces, change of patient’s position by nurses, use of vasopressors, and sedatives were significantly associated with the presence of pressure ulcers. Healthcare providers’ particularly nurse’s contribution is vital in the prevention of PU for ICU admitted patients by frequent positioning and maintaining head of the bed at lower possible level. Also decreasing depth or duration of sedation, decrease LOS in ICU, and appropriate use of vasopressors are.