title: What Factors Are Associated With the Development of Pressure Ulcers in a Medical Intensive Care Unit?
abstract: BACKGROUND
  Instruments used to determine the risk of pressure ulcer development are universally applied to adult patients. These instruments do not differentiate between intensive and acute care patients.
  
  
  BACKGROUND
  Pressure ulcers contribute to negative outcomes such as increases in pain and discomfort, risk of infection, hospital length of stay and costs, and a decrease in quality of life. Appropriately identifying risk factors is paramount to implementing a targeted care plan to avoid pressure ulcer development as well as pinpointing appropriate treatments if an ulcer develops.
  
  
  OBJECTIVE
  The purpose of this nursing research study was to identify factors associated with pressure ulcer development in a medical intensive care unit.
  
  
  METHODS
  A 15-month retrospective chart review of patients with pressure ulcers in a medical intensive care unit was performed. Statistics were computed on demographics and variables of interest including: pressure ulcer stage, vasopressor infusion, oxygen requirement, comorbidities, primary diagnosis, length of stay, mortality, age, gender, weight, Braden scores, and albumin level.
  
  
  RESULTS
  The characteristics of 76 patients who developed pressure ulcers were evaluated. An equal number of men (n = 38) and women (n = 38) were included. Forty-seven percent had a stage II pressure ulcer. The presence of hemodynamic support with vasopressor administration (P = .016) and the length of stay (P = .021) were noted as the most significant factors in pressure ulcer development in this study.
  
  
  CONCLUSIONS
  Vasopressor use and length of stay are not factors that are accounted for in current pressure ulcer risk assessment instruments. The administration of vasopressor support and patient length of stay are potential contributory factors that need to be considered when assessing patients. Instruments specific to intensive care unit pressure ulcer risk stratification are warranted and should include the unique characteristics of a critically ill patient.
authors.affiliation: Inge Smit, MSN, RN, CCRN, is a clinician IV in the medical intensive care unit at the University of Virginia, Charlottesville. Lisa Harrison, MSN, RN, ACNP, CCRN, is a nurse practitioner at the University of Virginia, Charlottesville. Lisa Letzkus, MSN, RN, CPNP, CCRN, is the assistant director of the Professional Nursing Staffs' Nursing Research Program at the University of Virginia, Charlottesville. Beth Quatrara, DNP, RN, CMSRN, ACNS, is the director of Professional Nursing Staffs' Nursing Research Program at the University of Virginia, Charlottesville.
authors.forename: Inge
authors.initials: I
authors.lastname: Smit
authors.forename: Lisa
authors.initials: L
authors.lastname: Harrison
authors.forename: Lisa
authors.initials: L
authors.lastname: Letzkus
authors.forename: Beth
authors.initials: B
authors.lastname: Quatrara
mesh_terms: D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014662:Vasoconstrictor Agents / Q000009:adverse effects; D014768:Virginia / Q000453:epidemiology
chemical_list: D014662:Vasoconstrictor Agents