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. 2010 Oct;7(5):358-65.
doi: 10.1111/j.1742-481X.2010.00699.x.

Medical device related pressure ulcers in hospitalized patients

Joyce M Black  1 , Janet E Cuddigan, Maralyn A Walko, L Alan Didier, Maria J Lander, Maureen R Kelpe
Affiliations

Medical device related pressure ulcers in hospitalized patients

Joyce M Black et al. Int Wound J. 2010 Oct.

Abstract

Most pressure ulcers occur over bony prominences such as heels and the sacrum. However, the National Pressure Ulcer Advisory Panel recognises that pressure ulcers can also occur on any tissue under pressure and thereby can develop beneath medical devices. This article reports on results from a secondary analysis of existing data collected by The Nebraska Medical Center on pressure ulcer quality improvement initiatives and outcomes. The purpose of this study was to quantify the extent of the problem and identify risk factors for medical device related (MDR) pressure ulcer development in hospitalised patients. A subset of data collected during eight quarterly pressure ulcer incidence and prevalence studies (N = 2178) was created and analysed. The overall rate of hospital-acquired pressure ulcers was 5·4% (113 of 2079). The proportion of patients with hospital-acquired ulcers related to medical devices was 34·5% (39 of 113). Findings indicate that if a patient had a medical device, they were 2·4 times more likely to develop a pressure ulcer of any kind. Numerous risk factors for pressure ulcer development were identified; however, none differentiated between those with MDR and traditional pressure ulcers.

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Figures

Figure 1
Figure 1
Distribution of stages of medical device related pressure ulcers. The most common stages of medical device related pressure ulcers were stage I and II. Unstageable and deep tissue injury pressure ulcers were present.
Figure 2
Figure 2
Locations of hospital acquired pressure ulcers on patients in critical care. The most common location for a medical device related pressure ulcer was the ear. However, they occurred on many body areas.
Figure 3
Figure 3
Pressure ulcer on the lip from an endotracheal tube.
Figure 4
Figure 4
Pressure ulcer from wrist splint.
Figure 5
Figure 5
Pressure ulcer from arterial line tubing.
Figure 6
Figure 6
Occipital pressure ulcer from a cervical collar.
Figure 7
Figure 7
Deep tissue injury pressure ulcer on the heel. The patient was wearing antiembolism stockings.
Figure 8
Figure 8
Locations in the hospital where medical device related ulcers were found. Pressure ulcers from medical devices occurred in almost equal frequency in intensive care unit, step‐down and general medical surgical nursing units.
Figure 9
Figure 9
Continuous quality improvement efforts were associated with fewer medical device related hospital‐acquired pressure ulcers over time.
See this image and copyright information in PMC

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