TY  - JOUR
T1  - Yoğun Bakım Hastalarında Basınç Yaralanmalarının Önlenmesinde Hemşirenin Rolü: Risk Faktörleri, Girişimler ve Klinik Uygulamalar
TT  - The Role Of The Nurse In The Preventıon Of Pressure Injurıes In Intensıve Care Unıt Patıents: Rısk Factors, Interventıons And Clınıcal Practıces
AU  - Bilik, Özlem
AU  - Dalkılıç, Mehmet
AU  - Kalayci Emek, Ferzan
PY  - 2025
DA  - August
Y2  - 2025
DO  - 10.58605/bingolsaglik.1694661
JF  - Bingöl Üniversitesi Sağlık Dergisi
JO  - BÜSAD
PB  - Bingöl Üniversitesi
WT  - DergiPark
SN  - 2717-7653
SP  - 273
EP  - 281
VL  - 6
IS  - 2
LA  - tr
AB  - Basınç yaralanmaları, özellikle yoğun bakım ünitesi (YBÜ)’nde  yatan hastalarda sık karşılaşılan, ciddi ve önlenebilir komplikasyonlardandır. Bu derleme çalışması, hemşirelerin basınç yaralanmalarının önlenmesindeki rolünü; risk faktörleri, girişimler ve klinik uygulamalar bağlamında ele almayı amaçlamaktadır. Literatür, basınç yaralarının etiyolojisinde içsel (immobilizasyon, yaş, malnütrisyon, kronik hastalıklar) ve dışsal (basınç, sürtünme, nem) faktörlerin etkili olduğunu göstermektedir. Hemşirelik bakımında en sık kullanılan risk değerlendirme aracı Braden Skalası’dır. Kanıta dayalı önleyici uygulamalar arasında destek yüzeylerinin kullanımı, düzenli pozisyon değişikliği, yeterli beslenme ve hidrasyon sağlanması, tıbbi cihazların neden olduğu basınca karşı önlem alınması yer almaktadır. Yoğun bakım hemşirelerinin bilgi düzeylerinin ve klinik uygulama becerilerinin yetersiz olması, basınç yarası gelişim oranlarını artıran temel faktörlerdendir. Eğitim eksiklikleri, iş yükü ve personel yetersizliği, önleyici stratejilerin uygulanmasını güçleştirmektedir. Türkiye'de basınç yarası prevalansı hastane genelinde %11,4–12,7 arasında değişmekte; YBÜ’nde bu oran %56,8’e kadar çıkmaktadır. Bu durum, basınç yaralarının bireysel sağlık ve sistem maliyeti üzerindeki yükünü ortaya koymaktadır. Sonuç olarak, hemşirelerin bu alandaki bilgi düzeylerinin artırılması, multidisipliner yaklaşımla desteklenmiş bakım protokollerinin uygulanması ve kanıta dayalı eğitimin yaygınlaştırılması, basınç yaralanmalarının önlenmesinde temel stratejiler olarak öne çıkmaktadır.
KW  - Basınç yarası
KW  - yoğun bakım
KW  - hemşirelik
KW  - risk değerlendirme
N2  - Pressure injuries are common, serious, and largely preventable complications, especially among intensive care unit (ICU) patients. This review highlights the critical role of nurses in preventing these injuries by examining risk factors, interventions, and clinical practices. Both intrinsic (e.g., immobilisation, age, malnutrition, chronic diseases) and extrinsic (e.g., pressure, friction, moisture) factors contribute to the development of pressure injuries. The Braden Scale is widely used by nurses for risk assessment. Evidence-based practices such as using support surfaces, frequent repositioning, ensuring proper nutrition and hydration, and protecting the skin from medical device-related pressure are essential preventive measures. However, many ICU nurses lack adequate knowledge and skills, which, along with heavy workloads, limited staff, and insufficient training, hinders effective prevention. In Turkey, the overall hospital prevalence of pressure injuries is between 11.4–12.7%, rising to 56.8% in ICUs. This highlights their significant impact on patient health and healthcare costs. To address this, it is vital to enhance nurses’ knowledge, promote the implementation of care protocols within a multidisciplinary framework, and support widespread, evidence-based education initiatives aimed at reducing the incidence of pressure injuries.
CR  - Al-Dorzi HM. Prevention of pressure injury in the intensive care unit. Saudi Crit Care J. 2019;3(1):24–28. doi:10.4103/2543-1854.259474
CR  - European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers: Clinical practice guideline. EPUAP/NPIAP/PPPIA; 2019.
CR  - Cox J, Edsberg LE, Koloms K, VanGilder C. Pressure injuries in critical care patients in US hospitals. J Wound Ostomy Continence Nurs. 2022;49(1):21–28. doi:10.1097/WON.000000000000083
CR  - Lee SY, Oh DK, Hong S, Lim C, Huh JW. Neuromuscular blocking agents and opioids are major risk factors for developing pressure injuries in patients in the intensive care unit. Korean J Intern Med. 2022;37(6):1186–1194. doi:10.3904/kjim.2021.546
CR  - Coyer F, Gardner A, Doubrovsky A, Cole R, Ryan FM, Allen C, McNamara G. Reducing pressure injuries in critically ill patients by using a patient skin integrity care bundle (InSPiRE). Am J Crit Care. 2015;24(3):199–209. doi:10.4037/ajcc2015930
CR  - Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016;43(6):585–597. doi:10.1097/WON.0000000000000281
CR  - Coyer F, Cook JL, Doubrovsky A, Campbell J, Vann A, McNamara G. Understanding contextual barriers and enablers to pressure injury prevention practice in an Australian intensive care unit: An exploratory study. Aust Crit Care. 2019;32(2):122–130. doi:10.1016/j.aucc.2018.02.008
CR  - Jacq G, Valera S, Muller G, Decormeille G, Youssoufa A, Poiroux L, et al. Prevalence of pressure injuries among critically ill patients and factors associated with their occurrence in the intensive care unit: The Pressure study. Aust Crit Care. 2021;34(5):411–418. doi:10.1016/j.aucc.2020.12.001
CR  - Makic BFM. [Editorial]. J PeriAnesth Nurs. 2015;30(4):336–337. doi:10.1016/j.jopan.2015.05.004
CR  - Labeau SO, Afonso E, Benbenishty J, Blackwood B, Boulanger C, Brett SJ, et al. Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: The DecubICUs study. Intensive Care Med. 2021;47(4):503–520. doi:10.1007/s00134-020-06234-9
CR  - Gefen A, Alves P, Ciprandi G, Coyer F, Milne CT, Ousey K, et al. Device-related pressure ulcers: SECURE prevention. J Wound Care. 2022;31(Sup3a):S1–S72
CR  - Chaboyer WP, Thalib L, Harbeck EL, Coyer FM, Blot S, Bull CF, et al. Incidence and prevalence of pressure injuries in adult intensive care patients: A systematic review and meta-analysis. Crit Care Med. 2018;46:e1074–e1081. doi:10.1097/CCM.0000000000003366
CR  - Çavuşoğlu A, Yeni K, İncekara H, Acun A, Polat Dünya C, Tülek Z. Bir yoğun bakım ünitesinde basınç yarası prevalansı: Retrospektif bir çalışma. J Acad Res Nurs (JAREN). 2020;6(2).
CR  - Dang W, Liu Y, Zhou Q, Duan Y, Gan H, Wang L, et al. Risk factors of medical device‐related pressure injury in intensive care units. J Clin Nurs. 2021;31(9-10):1174–1183. doi:10.1111/jocn.15974
CR  - Fulbrook P, Lovegrove J, Hay K, Coyer F. State‐wide prevalence of pressure injury in intensive care versus acute general patients: a five‐year analysis. J Clin Nurs. 2023;32(15-16):4947–4961. doi:10.1111/jocn.16687
CR  - Lien R, Wang C, Hung S, Lu S, Yang W, Chin S, et al. Reduction in the incidence density of pressure injuries in intensive care units after advance preventive protocols. Healthcare (Basel). 2023;11(15):2116. doi:10.3390/healthcare11152116
CR  - Çor Z, Soysal GE. Basınç yarası önleme çalışmaları: Güncel bakış. Ahi Evran Med J. 2024;8(2):242–250.
CR  - Esen H, Özbek C. Root Cause Analysis and Prevalence of Pressure Injuries a Neurointensive Care Unit. Turk J Intensive Care. 2023;21(2).
CR  - Gencer ZE, Ünal E, Özkan Ö. Basınç ülserleri tedavi maliyetleri etkililik analizi: Konvansiyonel ve modern yara bakım tedavi maliyetlerinin karşılaştırılması. Akdeniz Tıp Derg. 2019;5(2):201–208.
CR  - Padula WV, Delarmente BA. The national cost of hospital‐acquired pressure injuries in the United States. Int Wound J. 2019;16(3):634–640. doi:10.1111/iwj.13071
CR  - Teixeira-Vaz A, Rocha JA, Oliveira M, Reis DA, Moreira TS, Silva AI, Paiva JA. The PRINCOVID retrospective study: A predictive model of pressure injuries for critical COVID-19 patients. Am J Phys Med Rehabil. 2023;102(8):707–714.
CR  - Roussou E, Fasoi G, Stavropoulou A, Kelesi M, Vasilopoulos G, Gerogianni G, Alikari V. Quality of life of patients with pressure ulcers: A systematic review. Med Pharm Rep. 2023;96:123–130. doi:10.15386/mpr-2531
CR  - Han Y, Jin Y, Jin T, Lee SM, Lee JY. Impact of pressure injuries on patient outcomes in a Korean hospital: A case-control study. J Wound Ostomy Continence Nurs. 2019;46:194–200. doi:10.1097/WON.0000000000000528
CR  - Alderden J, Drake KP, Wilson A, Dimas J, Cummins M, Yap TL. Hospital acquired pressure injury prediction in surgical critical care patients. BMC Med Inform Decis Mak. 2021;21(1):1. doi:10.1186/s12911-020-01371-z
CR  - Cambaz C, Köken ZÖ, Sayın MM. Incidence, characteristics and risk factors of endotracheal tube‐related pressure injuries in intensive care units. Nurs Crit Care. 2024;29(6):1610–1618. doi:10.1111/nicc.13164
CR  - Özlüer YE, Doğruyol S, Karaman K, Doğruyol T. Victims of terrorism-related disasters: Experience of a hospital on the border of Iraq. Disaster Emerg Med J. 2021;6(1):26–32. doi:10.5603/demj.a2021.0005
CR  - Waladani B, Suwaryo PAW, Yuniar I, Yuwono P, Setianingsih E. Predictive value of non-invasive intracranial pressure monitoring in profoundly impaired traumatic brain injury patients. Babali Nurs Res. 2023;4(4):714–722. doi:10.37363/bnr.2023.44281
CR  - Borojeny LA, Albatineh AN, Dehkordi AH, Gheshlagh RG. The incidence of pressure ulcers and its associations in different wards of the hospital: A systematic review and meta-analysis. Int J Prev Med. 2020;11. doi:10.4103/ijpvm.IJPVM_182_19
CR  - Kalkavan EB, Şendir M. Braden ölçeği ile basınç yarası riski belirlenen hastalarda risk faktörleri ile basınç yarası arasındaki ilişkinin incelenmesi. Sağlık ve Spor Bilimleri Dergisi. 2024;7(1):28–54.
CR  - Konateke S. Ameliyathanede önlenmesi gereken önemli bir risk: basınç yaralanması. J Anatolia Nurs Health Sci. 2021. doi:10.17049/ataunihem.902979
CR  - Sibbald RG, Ayello EA. Results of the 2022 wound survey on skin failure/end-of-life terminology and pressure injuries. Adv Skin Wound Care. 2023;36(3):151–157. doi:10.1097/01.asw.0000919400.33004.17
CR  - Yusharyahya SN, Legiawati L, Astriningrum R, Jonlean R, Andhira V. Characteristics of pressure injuries among geriatric patients at an Indonesian tertiary hospital: A cross-sectional study. Med J Indones. 2023;32(3):183–189. doi:10.13181/mji.oa.237092
CR  - Lim SY, Jeong YM, Jeong SY. Characteristics and risk factors for pressure ulcers in severe trauma patients admitted to the trauma intensive care unit. J Acute Care Surg. 2023;13(2):47–57.
CR  - VanGilder C, Cox J, Edsberg LE, Koloms K. Pressure injury prevalence in acute care hospitals with unit-specific analysis. J Wound Ostomy Continence Nurs. 2021;48(6):492–503. doi:10.1097/WON.0000000000000817
CR  - Bustamante YIV, Martinez OFA. Honduran nursing care to pressure injuries in patients with invasive mechanical ventilation: A qualitative study. Belitung Nurs J. 2025;11(1):25.
CR  - Gönderen K, Gönderen A, Simavlıoğlu G, İdil D. Yoğun bakım ünitesine yatış anında basınç ülseri olan ve yatışı sırasında basınç ülseri gelişen hastaların karşılaştırılması. Ankara Eğit Araştırma Hastanesi Tıp Derg. 2024;56(3):178–181. doi:10.20492/aeahtd.738260
CR  - Alkhatieb MT, Abdulwassi HK, Fallatah AM, Alghamdi KM, Al-Abbadi W, Altaifi R. Knowledge of diabetic foot among nurses at a tertiary hospital in Saudi Arabia. Med Arch. 2022;76(3):190. doi:10.5455/medarh.2022.76.190-197
CR  - Yılmazer T, Tüzer H, Tarla A. Basınç yarasının önlenmesinde hemşirelerin bilgi düzeylerinin incelenmesi. Sağlık Akademisi Kastamonu. 2019;4(3):211–22
CR  - Mostafa OE, Zakari N, Salem MR. Evaluation of nurses’ attitudes, behaviors, and barriers toward pressure ulcer prevention in neonatal and pediatric intensive care units. Front Pediatr. 2024;12. doi:10.3389/fped.2024.1455950
CR  - Isfahani P, Alirezaei S, Samani S, Bolagh F, Heydari A, Sarani M, et al. Prevalence of hospital-acquired pressure injuries in intensive care units of the eastern Mediterranean region: a systematic review and meta-analysis. Patient Saf Surg. 2024;18(1). doi:10.1186/s13037-023-00383-8
CR  - Karahan E, Çelik S, Uçar Ö. Incidence of pressure ulcers in the patients on mechanical ventilation: A prospective study. J Contemp Med. 2020;10(1):62–69. doi:10.16899/jcm.628095
CR  - Alshahrani B, Middleton R, Rolls K, Sim J. Critical care nurses’ knowledge and attitudes toward pressure injury prevention: A pre and post intervention study. Intensive Crit Care Nurs. 2023. doi:10.1002/nop2.2110
CR  - Lin F, Wu Z, Song B, Coyer F, Chaboyer W. The effectiveness of multicomponent pressure injury prevention programs in adult intensive care patients: A systematic review. Int J Nurs Stud. 2020; 102:103483.
CR  - Uçar Ö, İlçe A. Palyatif hemşirelerin basınç yarası önleme bilgi düzeyleri ile tutumları arasındaki ilişki. Bingöl Univ Sağlık Derg. 2023;4(2):213–223.
CR  - Beeckman D, Serraes B, Anrys C, et al. A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents. Int J Nurs Stud. 2019; 97:105–113.
CR  - Amini M, Mansouri F, Vafaee K, Janbakhsh A, Mahdavikian S, Moradi Y, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID‐19 patients admitted with a Braden scale below 14 in the intensive care unit: Retrospective cohort study. Int Wound J. 2022;19(8):2039–2054. Doi:10.1111/iwj.13804
CR  - Chaboyer W, Latimer S, Priyadarshani U, Harbeck E, Patton D, Sim J, et al. The effect of pressure injury prevention care bundles on pressure injuries in hospital patients: A complex intervention systematic review and meta-analysis. Int J Nurs Stud. 2024; 155:104768. doi:10.1016/j.ijnurstu.2024.104768
CR  - Alves J, Azevedo R, Marques A, Encarnação R, Alves P. Pressure injury prediction in intensive care units using artificial intelligence: A scoping review. Nurs Rep. 2025;15(4):126. doi:10.3390/nursrep15040126
CR  - Shi C, Dumville JC, Cullum N. Evaluating the development and validation of empirically-derived prognostic models for pressure ulcer risk assessment: A systematic review. Int J Nurs Stud. 2019; 89:88–103.
CR  - National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers: Clinical practice guideline. NPUAP/EPUAP/PPPIA; 2014. [Available from: https://www.npuap.org]
CR  - López M, Jiménez JM, Fernández M, Martín B, Cao MJ, Castro MJ. Relationship between pressure ulcer risk based on Norton Scale and on the “Eating/Drinking” need assessment. J Nurs Manag. 2019;27(1):117–124.
CR  - Serrano ML, Méndez MIG, Cebollero FMC, Rodríguez JSL. Risk factors for pressure ulcer development in intensive care units: A systematic review. Med Intensiv. 2017; 41:339–346. doi: 10.1016/j.medin.2016.09.003
CR  - Ladios-Martin M, Fernández-de-Maya J, Ballesta-López FJ, Belso-Garzas A, Mas-Asencio M, Cabañero-Martínez MJ. Predictive modeling of pressure injury risk in patients admitted to an intensive care unit. Am J Crit Care. 2020;29:e70–e80. doi:10.4037/ajcc2020237
CR  - Picoito R, Lapuente S, Ramos A, Rabiais I, Deodato S, Nunes E. Risk assessment instruments for pressure ulcer in adults in critical situation: A scoping review. Rev Lat Am Enferm. 2023;31: e3983. Doi:10.1590/1518-8345.6659.3983
CR  - Wei M, Wu L, Chen Y, Fu Q, Chen W, Yang D. Predictive validity of the Braden Scale for pressure ulcer risk in critical care: A meta-analysis. Nurs Crit Care. 2020; 25:165–170. doi:10.1111/nicc.12500
CR  - Vocci MC, Lopes Saranholi T, Amante Miot H, Fernandes Abbade LP. Intensive care pressure injuries: A cohort study using the CALCULATE and Braden Scales. Adv Skin Wound Care. 2022; 35:1–8. doi: 10.1097/01.ASW.0000815488.17717.68
CR  - Moore ZE, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019;(1):CD006471. doi: 10.1002/14651858.CD006471.pub4
CR  - Adıbelli Z, Korkmaz M. Effects of repositioning intervals on pressure sore development in critically ill patients: A systematic review. J Nurs Res. 2018;26(3):253–261. doi:10.1097/jnr.0000000000000258
CR  - Nisa MU, Rafiq N, Ali A, Rizwan Z, Ilyas F, Fatima N. Evaluation of knowledge among nurses about pressure ulcer in a tertiary care hospital, Lahore. J Health Rehabil Res. 2024;4(2):543–547.
CR  - Wahyuni S, Sahar J, Rustina Y. A systematic review of pressure ulcer prevention. Fundam Manag Nurs J. 2023;6(1):e41956. Doi:10.20473/fmnj. v6i1.41956
CR  - Peng G, Wang L, Tian S, Fan Y. Modular pressure redistribution cushion with proprioceptive soft–rigid hybrid actuator. Adv Intell Syst. 2024;6(1):2300422.
CR  - Teleten O, Polyak TS, Espinoza J, Li AI, Rodgers AJ, Kirkland-Kyhn H. Measuring pressure redistribution properties of 4 hospital bed surfaces: A quality improvement project. Wound Manag Prev. 2022;68(6):18–26.
CR  - Neupane G, Sah C. Knowledge regarding preventive measures of pressure ulcer among nurses. J Chitwan Med Coll. 2020;10(2):40–45. doi:10.54530/jcmc.119
CR  - Anita F, Chayati N, Wantonoro W. Pressure-relieving devices to prevent pressure injury in bedridden patients: A literature review. Bali Med J. 2021;10(3):1357–1363. Doi:10.15562/bmj. v10i3.3037
CR  - Galetto SGS, Nascimento ERP, Hermida PMV, Malfussi LBH. Medical device-related pressure injuries: an integrative literature review. Rev Bras Enferm. 2019;72(2):505–512. doi:10.1590/0034-7167-2018-0530
CR  - Ni TF, Wang J, Chen C, Shih DF, Wang J. Can a prolonged healing pressure injury be benefited by using an AI mattress? A case study. BMC Geriatr. 2024;24(1). Doi:10.1186/s12877-024-04900-x
CR  - Martel T, Orgill DP. Medical device–related pressure injuries during the COVID-19 pandemic. J Wound Ostomy Continence Nurs. 2020;47(5):430–434. doi:10.1097/WON.0000000000000689
CR  - Erbay Dallı Ö, Kelebek Girgin N. Medical Device-Related Pressure Injury Care and Prevention Training Program (DevICeU): Effects on intensive care nurses' knowledge, prevention performance and point prevalence. Intensive Crit Care Nurs. 2024; 82:103622. Doi: 10.1016/j.iccn.2024.103622
UR  - https://doi.org/10.58605/bingolsaglik.1694661
L1  - https://dergipark.org.tr/tr/download/article-file/4848872
ER  -