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Pressure Injury in the Pediatric Population

Cohort Study Using the Braden Q Scale

Vocci, Marcelli Cristine, MSN; Fontes, Cassiana Mendes Bertoncello, PhD; Abbade, Luciana Patricia Fernandes, PhD

doi: 10.1097/01.ASW.0000542529.94557.0a

OBJECTIVE: To identify the risk and incidence of pressure injuries in bedridden pediatric patients to determine the most prevalent risk factors and preventive measures and to define the sociodemographic, clinical, and therapeutic profiles in this group.

METHODS: Prospective cohort study performed between March 2015 and March 2016 in the intensive care unit and the pediatric ward of a public teaching hospital. The study included 85 pediatric patients (45 intensive care unit and 40 pediatric ward patients).

MAIN OUTCOME MEASURE: Patients’ Braden Q Scale score was assessed at 48-hour intervals until discharge from the aforementioned units, discharge from the hospital, and/or death.

MAIN RESULTS: Researchers observed that 93.3% of intensive care unit patients and 87.5% of pediatric ward patients were categorized as high-risk patients, and 12 patients presented with 24 pressure injuries with an incidence of 14.1% and a mean of 4 days before pressure injury occurrence. Patients with pressure injuries in the cohort averaged a hospital length of stay of 7.7 days. Of these, the mean age was 4.1 years and most were female, receiving enteral nutrition, and had diagnoses related to neurological and respiratory diseases." Vasopressor use had a statistically significant association (P < .05) with the development of pressure injuries. The primary risk factor identified on the Braden Q Scale for the development pressure injury was a “mobility and activity” deficit.

CONCLUSIONS: Most patients (hospitalized in either unit) were at high risk of developing pressure injuries. No specific preventive guidelines were in place in this hospital prior to this study; therefore, the authors aimed to develop a protocol for the prevention and reduction of pressure injuries in pediatric patients.

At the Medical School of São Paolo State University, in Botucatu, São Paolo, Brazil, Marcelli Cristine Vocci, MSN, is a PhD student; Cassiana Mendes Bertoncello Fontes, PhD, is Professor, Nursing Department; and Luciana Patricia Fernandes Abbade, PhD, is Professor, Dermatology and Radiotherapy Department.

Acknowledgments: This research was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) Foundation. The authors have disclosed no other financial relationships related to this article. Submitted December 6, 2017; accepted in revised form April 17, 2018.

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