In this study about 40% of hospital acquired pressure injuries (HAPIs) are unavoidable, according to a study publish in the September issue of the American Journal of Critical Care. Joyce Pittman, Ph.D., R.N., from the University of South Alabama in Mobile, and colleagues conduct a descriptive, retrospective study to examine the proportion of HAPIs among patients in critical and progressive care units that are unavoidable and to determine risk factors that differentiate avoidable from unavoidable HAPIs. Data were include for 165 patients.
Health care organizations strive to minimize harm and provide safe environments for patients they serve. Despite a vast array of prevention strategies; hospital acquire pressure injuries (HAPIs) continue to occur, especially in critical care. Rates of such injuries have been report to range from 2.8% to 53.4% in critical care units, compare with 2.0% to 8.3% in medical surgical units.
Hospital acquired pressure injuries
Risk factors have associate with the development of hospital acquire pressure injuries; so yet those that best predict the development of HAPIs are not completely understood. Nonmodifiable risk factors such as age; also history of pressure injuries may tip the scale toward pressure injury development despite the best preventive interventions.
Unavoidable pressure injuries may occur when the magnitude; also severity of the risk factors are extremely high and preventive measures are either contraindicate or inadequate given the risk. Although new technology is available to provide quantitative assessment of turning and patient mobility; currently this technology is not widespread or integrate into most acute care settings.
An important finding of this study was the identification of 41% (n = 67) of the HAPIs as being unavoidable. Using a valid and reliable instrument (PUPI) provide an objective measure to identify unavoidable HAPIs. No other similar studies using such a tool were found in the literature. The odds of developing an unavoidable pressure injury increase; so with each one day increase in stay when length of stay was incorporate into the model (odds ratio, 1.04).
Knowledge for critical care
The likelihood of having an unavoidable HAPI was increase more than five fold; so for participants with a previous pressure injury (odds ratio, 5.27). “The findings of this study provide important information and new knowledge for critical care nurses and other health care providers and highlight the importance of pressure injury prevention documentation,” the authors write.
The findings of this study provide important information and new knowledge for critical care nurses; also other health care providers and highlight the importance of pressure injury prevention documentation. Attention to standard nursing care (preventive interventions) and accuracy of documentation is essential in the complex critical care setting.
In addition, this study objectively identify the occurrence of unavoidable pressure injuries; suggesting a possible etiology of acute skin failure rather than a lack of preventive nursing care. Further research particularly rigorous; control studies is need to investigate the occurrence of unavoidable HAPIs and acute skin failure in critically ill patients.