title: Prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units. Results of a cross-sectional survey.
abstract: OBJECTIVE
  Evaluating the prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units (ICUs).
  
  
  METHODS
  Cross-sectional design.
  
  
  METHODS
  ICUs of acute care hospitals that participated in the 1998 and 1999 national prevalence surveys. Data were collected on 1 day in each year.
  
  
  METHODS
  Eight hundred fifty patients admitted to Dutch ICUs.
  
  
  METHODS
  None.
  
  
  RESULTS
  Six categories of data were collected: (1) characteristics of the institution, (2) characteristics of the ward, (3) characteristics of the patients (age, sex, date of admission, reason for admission), (4) risk assessment using the Braden scale and two additional risk factors (malnutrition and incontinence), (5) severity of the pressure ulcers and (6) supportive surface used. The prevalence of pressure ulcers was 28.7%. In a forward logistic regression analysis, four risk factors were significantly associated with the presence of pressure ulcers: infection, age, length of stay and total Braden score. Of the patients at high risk of developing pressure ulcers but without actual pressure ulcers, 60.5% were positioned on a support system. Only 36.8% of the patients who were determined to need repositioning were actually being turned.
  
  
  CONCLUSIONS
  The prevalence of pressure ulcers in Dutch ICUs is high and their prevention is flawed, especially as regards the use of support systems. Patients for whom turning is indicated are not being turned. Predicting pressure ulcers in ICU patients is difficult and needs further investigation.
authors.affiliation: Maastricht University, Department of Health Care Studies, Section of Nursing Science, PO Box 616, 6200 MD Maastricht, The Netherlands. G.Bours@zw.unimaas.nl
authors.forename: G J
authors.initials: GJ
authors.lastname: Bours
authors.forename: E
authors.initials: E
authors.lastname: De Laat
authors.forename: R J
authors.initials: RJ
authors.lastname: Halfens
authors.forename: M
authors.initials: M
authors.lastname: Lubbers
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001510:Bed Rest / Q000009:adverse effects / Q000451:nursing; D001513:Beds / Q000706:statistics & numerical data; D003422:Critical Care / Q000379:methods / Q000592:standards; D003430:Cross-Sectional Studies; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009748:Nutrition Disorders / Q000150:complications; D011159:Population Surveillance; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors; D014549:Urinary Incontinence / Q000150:complications