Hastanede Yatan Yaşlı Hastalarda Basınç Yaralanması Risk Faktörleri ve Prevalansı

Yıl 2023, Cilt: 26 Sayı: 3, 212 - 218, 11.09.2023

Neslihan Kartal , Yazile Sayın

https://doi.org/10.5152/JANHS.2023.23315

Öz

Amaç: Bu çalışmada hastanede yatan yaşlı hastalarda basınç yaralanması (BY) risk faktörleri ve prevalansının belirlenmesi amaçlandı.
Yöntemler: Bu çalışma, tanımlayıcı, prospektif kesitsel bir tasarımdır. Örneklem büyüklüğü 382 idi, veriler tanıtıcı bilgi formu ve sağlık tanılama formu, cilt değerlendirme kartı, Braden skalası ve Ulusal Basınç Yaralanması Danışma Paneli’nin BY evreleme sınıflandırması kullanılarak toplandı.
Bulgular: Hastaların yaş ortalaması 76,20 ± 8,36 idi. Bu çalışmada hastaların %55,2’si kadındı. Araştırma hastanesinde yatan hastaların %14,6’sında ve başka hastaneden sevk ile gelen hastaların %16,0’ında BY vardı. Hastaların BY evreleri I %6,8, II %31,6 ve III 17,9 idi. Evrelendirilemeyen ve şüpheli derin doku yaralanmaları vakaların %36.7’sini oluşturuyordu. BY çoğunlukla (%37,6) sakrum ve koksiks çevresindeydi. 75 yaş ve üstü grupta 65-74 yaş grubuna göre BY 2,5 kat daha yüksekti (P = ,001). BY yatakta pozisyon değiştiremeyen hastalarda 15,8 kat, çok sayıda invaziv işlem geçirenlerde 10,6 kat, idrar kaçırma varlığında 8,8 kat daha yüksekti.
Sonuç: Hastanede yatan yaşlı hastalarda BY prevalansı yüksekti. Hemşirelerin yaşlı hastaların risk faktörlerini belirlemesi önemlidir. BY sıklığı ve evreleri, yaşlı ve hareketsiz hastaların hemşirelerin dikkat etmesi gereken risk faktörlerine sahip olduğunu göstermektedir.

Anahtar Kelimeler

Yaşlı hasta, hastanede yatan hasta, basınç yaralanması, prevelans, risk faktörü

Risk Factors and Prevalence of Pressure Injury in Elderly Hospitalized Patients

Öz

Objective: This study aimed to determine the risk factors and prevalence of pressure injury (PI) in elderly hospitalized patients.
Methods: This study has a descriptive, prospective, cross-sectional design. The sample size was 382, and data were collected using an introductory information form, the Braden Scale, a health diagnosis form, a skin assessment chart, and the pressure injury staging classification of the National Pressure Injury Advisory Panel.
Results: The mean age of the patients was 76.20 ± 8.36 years. In this study, 55.2% of the patients were female. PI was present in 14.6% of patients hospitalized in the research hospital and 16.0% of patients referred from another hospital. About 6.8%, 31.6%, and 17.9% of the patients were in PI stages I, II, and III. Unstageable and suspected deep tissue injuries comprised of 36.7% of cases. PI was mostly (37.6%) around the sacrum and coccyx. PI was 2.5 times higher (P = .001) in the 75 years and older age group than in those aged between 65-74 years. PI was 15.8 times higher in patients who could not change the bed position, 10.6 times higher in those with many invasive procedures, and 8.8 times higher in the presence of urinary incontinence.
Conclusion: The prevalence of PI in hospitalized elderly patients is high. It is important for nurses to determine the risk factors for elderly patients. PI frequency and stages indicate the risk factors ofelderly and inmobile patients to which nurses should pay attention.

Anahtar Kelimeler

Elderly patient, hospitalized patient, pressure injury, prevalence, risk factor

Kaynakça

• 1. Kaşıkçı M, Aksoy M, Ay E. Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: a cross-sectional study. J Tissue Viability. 2018;27(3):135-140. [CrossRef]
• 2. Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised national pressure ulcer advisory panel pressure injury staging system: revised pressure injury staging system. J Wound Ostomy Continence Nurs. 2016;43(6):585-597. [CrossRef]
• 3. Kayser SA, VanGilder CA, Lachenbruch C. Predictors of superficial and severe hospital-acquired pressure injuries: a cross-sectional study using the international pressure ulcer prevalence survey. Int J Nurs Stud. 2019;89:46-52. [CrossRef]
• 4. Theisen S, Drabik A, Stock S. Pressure ulcers in older hospitalised patients and its impact on length of stay: a retrospective observational study. J Clin Nurs. 2012;21(3-4):380-387. [CrossRef]
• 5. Vangilder CA, Cox J, Edsberg LE, Koloms K. Pressure injury prevalence in acute care hospitals with unit-specific analysis: results from the International Pressure Ulcer Prevalence (IPUP) Survey database. J Wound Ostomy Continence Nurs. 2021;48(6):492-503. [CrossRef]
• 6. Chung ML, Widdel M, Kirchhoff J, et al. Risk factors for pressure injuries in adult patients: a narrative synthesis. Int J Environ Res Public Health. 2022;19(2):761. [CrossRef]
• 7. Koloms K, Cox J, VanGilder CA, Edsberg LE. Incontinence management and pressure injury rates in US acute care hospitals: analysis of data from the 2018-2019 international pressure injury prevalence™ (IPUP) survey. J Wound Ostomy Continence Nurs. 2022;49(5):405-415. [CrossRef]
• 8. Coleman S, Gorecki C, Nelson EA, et al. Patient risk factors for pressure ulcer development: systematic review. Int J Nurs Stud. 2013; 50(7):974-1003. [CrossRef]
• 9. Zhou Q, Yu T, Liu Y, et al. The prevalence and specific characteristics of hospitalised pressure ulcer patients: a multicentre cross-sectional study. J Clin Nurs. 2018;27(3-4):694-704. [CrossRef]
• 10. Bergstrom N, Braden BJ, Laguzza A, Holman V. The Braden scale for predicting pressure sore risk. Nurs Res. 1987;36(4):205-210. [CrossRef]
• 11. Pınar R, oğuz S. Testing the Reliability and Validity of the Norton and Braden Pressure Assessment Scales in Live Bedridden Patients [in Turkish]. VI. National Nursing Congress. Ankara, Turkey: Damla Typography; 1998:173.
• 12. George D, Mallery P. IBM SPSS Statistics 25 Step by Step: A Simple Guide and Reference. 15th ed. New York: Routledge; 2019:114.
• 13. Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546. [CrossRef]
• 14. Mervis JS, Phillips TJ. Pressure ulcers: pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019;81(4): 881-890. [CrossRef]
• 15. Roth GA, Abate D, Abate KH. Global, regional, and national age-sex specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736-1788. [CrossRef]
• 16. Baumgarten M, Margolis DJ, Localio AR, et al. Pressure ulcers among elderly patients early in the hospital stay. J Gerontol A Biol Sci MedSci. 2006;61(7):749-754. [CrossRef]
• 17. Bereded DT, Salih MH, Abebe AE. Prevalence and risk factors of pressure ulcer in hospitalized adult patients; a single center study from Ethiopia. BMC Res Notes. 2018;11(1):847. [CrossRef]
• 18. Uzun Ö, Kaya U. Determination of pressure sore risk factors in inpatients: a university hospital study. Med J West Black Sea. 2020; 4(3):158-166. [CrossRef]
• 19. Graves N, Birrell F, Whitby M. Effect of pressure ulcers on length of hospital stay. Infect Control Hosp Epidemiol. 2005;26(3):293-297. [CrossRef]
• 20. Takahashi PY, Chandra A, Cha SS. Risk factors for pressure ulceration in an older community-dwelling population. Adv Skin Wound Care. 2011;24(2):72-77. [CrossRef]
• 21. Reed RL, Hepburn K, Adelson R, Center B, McKnight P. Low serum albumin levels, confusion, and fecal incontinence: are these risk factors for pressure ulcers in mobility-impaired hospitalized adults? Gerontology. 2003;49(4):255-259. [CrossRef]
• 22. Tsaras K, Chatzi M, Kleisiaris CF, Fradelos EC, Kourkouta L, Papathanasiou IV. Pressure ulcers: developing clinical indicators in evidence based practice. A prospective study. Med Arch. 2016;70(5):379-383. [CrossRef]
• 23. Nonnemacher M, Stausberg J, Bartoszek G, Lottko B, Neuhaeuser M,Maier I. Predicting pressure ulcer risk: a multifactorial approach toassess risk factors in a large university hospital population. J Clin Nurs. 2009;18(1):99-107. [CrossRef]
• 24. Rasero L, Simonetti M, Falciani F, Fabbri C, Collini F, Dal Molin A. Pressure ulcers in older adults: a prevalence study. Adv Skin Wound Care.2015;28(10):461-464. [CrossRef]
• 25. Tescher AN, Branda ME, Byrne TJo, Naessens JM. All at-risk patients are not created equal: analysis of Braden pressure ulcer risk scores to identify specific risks. J Wound Ostomy Continence Nurs. Nur Soc. 2012;39(3):282-291. [CrossRef]
• 26. Rigazzi J, Fähndrich C, osinga R, et al. osteomyelitis and antibiotic treatment in patients with grade IV pressure injury and spinal cord lesion—a retrospective cohort study. Spinal Cord. 2022;60(6):540-547. [CrossRef]
• 27. Ek AC, Unosson M, Larsson J, Von Schenck H, Bjurulf P. The development and healing of pressure sores related to the nutritional state. Clin Nutr. 1991;10(5):245-250. [CrossRef]
• 28. Miller MW, Emeny RT, Snide JA, Freed GL. Patient-specific factors associated with pressure injuries revealed by electronic health record analyses. Health Inform J. 2020;26(1):474-485. [CrossRef]
• 29. Manzano F, Colmenero M, Pérez-Pérez AM, et al. Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses. Intensive Care Med. 2014;40(11):1679-1687. [CrossRef]
• 30. Sternal D, Wilczyński K, Szewieczek J. Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk. Clin Interv Aging. 2017;12:37-44. [CrossRef]
• 31. Cox J, Schallom M, Jung C. Identifying risk factors for pressure injury in adult critical care patients. Am J Crit Care. 2020;29(3):204-213.[CrossRef]
• 32. osis SL, Diccini S. Incidence and risk factors associated with pressure injury in patients with traumatic brain injury. Int J Nurs Pract. 2020;26(3):e12821. [CrossRef]
• 33. Reddy M, Gill SS, Kalkar SR, Wu W, Anderson PJ, Rochon PA. Treatment of pressure ulcers: a systematic review. JAMA. 2008;300(22):2647-2662. [CrossRef]
• 34. Keast DH, Fraser C. Treatment of chronic skin ulcers in individuals with anemia of chronic disease using recombinant humanerythropoietin (EPo): a review of four cases. Ostomy Wound Manage. 2004;50(10):64-70.