Prevalencia de lesiones por presión y otras lesiones cutáneas relacionadas con la dependencia en población adulta en hospitales españolesresultados del 5º Estudio Nacional de 2017

  1. Pedro L. Pancorbo-Hidalgo 1
  2. Francisco P. García-Fernández 1
  3. Cristina Pérez-López 1
  4. J. Javier Soldevilla Agreda 2
  1. 1 Universidad de Jaén
    info

    Universidad de Jaén

    Jaén, España

    ROR https://ror.org/0122p5f64

  2. 2 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

Journal:
Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

ISSN: 1134-928X

Year of publication: 2019

Volume: 30

Issue: 2

Pages: 76-86

Type: Article

More publications in: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

Abstract

ABSTRACT Aims: To obtain updated epidemiological indicators for pressure injuries (PI) and other dependence-related skin lesions (DRSL) at adult hospitalization units of Spanish hospitals, both global and adjusted. To analyse both the demographic and clinical characteristics of people with DRSL and the characteristics of the lesions. Methods: Observational, cross-sectional study, as an epidemiological survey (5th National Prevalence Study), focused to all the hospitals in Spain. Data were collected by an on-line secure form. Variables: characteristics of the hospitals and the units, number of patients admitted, number of patients with each type of DRSL, lesions classification, size and time. The crude prevalence was calculated, both overall and adjusted by hospitals and units. Results: In this study have participated 554 units from 70 Spanish hospitals. Overall, the prevalence for DRSL of any kind, was 8,7%. By type of lesion, the prevalence was: pressure injuries (PI), 7,0%; moisture associated lesions, 1,4%; friction, 0,9%; combined lesions, 1,5%; and skin tears, 0,9%. For PI, the units with highest prevalence were: palliative care (16,7%), intensive care (14,9%) and post-surgery and reanimation units (14,0%). Most of the lesions were nosocomial (e.g. 72,2% of the PI), that is, produced at hospitals or nursing homes. This study has shown a high variability in the figures of prevalence of DRSL and PI, both at hospitals and units levels. Conclusions: The prevalence of PI is similar to that of previous studies at Spanish hospitals. This is the first time that the prevalence of other types of DRSL has been calculated. Since most of the dependence-related skin lesions were produced inside the hospitals and other facilities, such nursing homes, there is a need to improve the prevention of these lesions in these settings.

Bibliographic References

  • Soldevilla Agreda, JJ,Torra i Bou, JE. (1999). Epidemiología de las úlceras por presión en España. Estudio piloto en la Comunidad Autónoma de la Rioja. Gerokomos. 10. 75-87
  • Torra i Bou, JE,Rueda López, J,Soldevilla Agreda, JJ,Martínez Cuervo, F,Verdú Soriano, J. (2003). Primer Estudio Nacional de Prevalencia de Úlceras por Presión en España. Epidemiología y variables definitorias de las lesiones y los pacientes. Gerokomos. 14. 37-47
  • Pancorbo Hidalgo, PL,García Fernández, FP,Torra Bou, JE,Verdú Soriano, J,Soldevilla Ágreda, J. (2014). Epidemiología de las úlceras por presión en España en 2013: 4º Estudio Nacional de Prevalencia. Gerokomos. 25. 162
  • Soldevilla Agreda, J,Torra i Bou, J,Verdú Soriano, J,Martínez Cuervo, F,López Casanova, P,Rueda López, J. (2006). Segundo estudio nacional de prevalencia de úlceras por presión en España, 2005. Epidemiología y variables definitorias de las lesiones y pacientes. Gerokomos. 17. 154
  • Soldevilla Agreda, JJ,Torra i Bou, JE,Verdú Soriano, J,López Casanova, P. (2011). Tercer Estudio Nacional de Prevalencia de Úlceras por Presión en España, 2009. Epidemiología y variables definitorias de las lesiones y pacientes. Gerokomos. 22. 77-90
  • García Fernández, FP,Soldevilla Agreda, JJ,Pancorbo Hidalgo, PL,Verdú Soriano, J,López Casanova, P,Rodríguez Palma, M. (2014). Clasificación-categorización de las lesiones relacionadas con la dependencia. Serie Documentos Técnicos GNEAUPP nº II. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • García-Fernández, FP,Soldevilla Agreda, JJ,Verdú, J,Pancorbo-Hidalgo, PL. (2014). A New Theoretical Model for the Development of Pressure Ulcers and Other Dependence-Related Lesions. J Nurs Scholarship. 46. 28-38
  • García-Fernández, FP,Soldevilla Agreda, JJ,Pancorbo-Hidalgo, PL,Verdú-Soriano, J,López Casanova, P,Rodríguez-Palma, M. (2016). Classification of dependence-related skin lesions: a new proposal. J Wound Care. 25. 26-32
  • National Pressure Ulcer Advisory Panel. NPUAP announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury.
  • Delmore, B,Ayello, EA,Smart, H,Tariq, G,Sibbald, G. (2019). Survey results from the Gulf Region: NPUAP changes in pressure injury terminology and definitions. Adv Skin Wound Care. 32. 131
  • Borsting, TE,Tvedt, CR,Skogestad, IJ,Granheim, TI,Gay, CL,Lerdal, A. (2018). Prevalence of pressure ulcer and associated risk factors in middleand older-aged medical inpatients in Norway. J Clin Nurs. 27. 535
  • Skogestad, IJ,Martinsen, L,Borsting, TE,Granheim, TI,Ludvigsen, ES,Gay, CL. (2017). Supplementing the Braden scale for pressure ulcer risk among medical inpatients: the contribution of self-reported symptoms and standard laboratory tests. J Clin Nurs. 26. 202
  • Bredesen, IM,Bjoro, K,Gunningberg, L,Hofoss, D. (2015). Patient and organisational variables associated with pressure ulcer prevalence in hospital settings: a multilevel analysis. BMJ Open. 5. 007584
  • Gunningberg, L,Sedin, IM,Andersson, S,Pingel, R. (2017). Pressure mapping to prevent pressure ulcers in a hospital setting: A pragmatic randomised controlled trial. Int J Nurs Stud. 72. 53
  • Chiari, P,Forni, C,Guberti, M,Gazineo, D,Ronzoni, S,D’Alessandro, F. (2017). Predictive Factors for Pressure Ulcers in an Older Adult Population Hospitalized for Hip Fractures: A Prognostic Cohort Study. PloS one. 12. 0169909
  • Rasero, L,Simonetti, M,Falciani, F,Fabbri, C,Collini, F,Molin, A dal. (2015). Pressure Ulcers in Older Adults: A Prevalence Study. Adv Skin Wound Care. 28. 461
  • Clark, M,Semple, MJ,Ivins, N,Mahoney, K,Harding, K. (2017). National audit of pressure ulcers and incontinence-associated dermatitis in hospitals across Wales: a cross-sectional study. BMJ Open. 7. 015616
  • Bernardes, R,Caliri, M. (2016). Pressure ulcer prevalence in emergency hospitals: a cross-sectional study. Online Braz J Nurs. 15. 236
  • Mehta, C,George, JV,Mehta, Y,Wangmo, N. (2015). Pressure ulcer and patient characteristics--A point prevalence study in a tertiary hospital of India based on the European Pressure Ulcer Advisory Panel minimum data set. J Tissue Viability. 24. 123
  • Aljezawi, M,Tubaishat, A. (2018). Pressure Injuries Among Hospitalized Patients With Cancer: Prevalence and Use of Preventive Interventions. J Wound Ostomy Continence Nurs. 45. 227
  • Zhou, Q,Yu, T,Liu, Y,Shi, R,Tian, S,Yang, C. (2018). The prevalence and specific characteristics of hospitalised pressure ulcer patients: A multicentre cross-sectional study. J Clin Nurs. 27. 694-704
  • Amir, Y,Lohrmann, C,Halfens, RJ,Schols, JM. (2017). Pressure ulcers in four Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics, prevention and treatment. Int Wound J. 14. 184
  • Kasikci, M,Aksoy, M,Ay, E. (2018). 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. 27. 135
  • Gardiner, JC,Reed, PL,Bonner, JD,Haggerty, DK,Hale, DG. (2016). Incidence of hospital-acquired pressure ulcers a population-based cohort study. Int Wound J. 13. 809
  • Coyer, F,Miles, S,Gosley, S,Fulbrook, P,Sketcher-Baker, K,Cook, JL. (2017). Pressure injury prevalence in intensive care versus non-intensive care patients: A state-wide comparison. Aust Crit Care. 30. 244
  • Moore, Z,Johansen, E,Etten, M,Strapp, H,Solbakken, T,Smith, BE. (2015). Pressure ulcer prevalence and prevention practices: a cross-sectional comparative survey in Norway and Ireland. J Wound Care. 24. 333
  • Tayyib, N,Coyer, F,Lewis, P. (2016). Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study. Int Wound J. 13. 912
  • He, M,Tang, A,Ge, X,Zheng, J. (2016). Pressure Ulcers in the Intensive Care Unit: An Analysis of Skin Barrier Risk Factors. Adv Skin Wound Care. 29. 493
  • Borghardt, AT,Prado, TN,Bicudo, SD,Castro, DS,Bringuente, ME. (2016). Pressure ulcers in critically ill patients: incidence and associated factors. Rev Bras Enferm. 69. 460
  • Becker, D,Tozo, TC,Batista, SS,Mattos, AL,Silva, MCB,Rigon, S. (2017). Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. Intensive Crit Care Nurs. 42. 55-61
  • Bezerra de Medeiros, L,Ribeiro da Silva, D,Faustino da Silva Guedes, C,Carvalho de Souza, T,Araújo Neta, B. (2017). Prevalence of pressure ulcers in intensive care units. J Nurs UFPE online. 11. 2697
  • Smith, I,Harrison, L,Letzkus, L,Quatrara, B. (2016). What Factors Are Associated With the Development of Pressure Ulcers in a Medical Intensive Care Unit?. Dimens Crit Care Nurs. 35. 37-41
  • Lachenbruch, C,Ribble, D,Emmons, K,VanGilder, C. (2016). Pressure Ulcer Risk in the Incontinent Patient: Analysis of Incontinence and Hospital-Acquired Pressure Ulcers From the International Pressure Ulcer Prevalence Survey. J Wound Ostomy Continence Nurs. 43. 235
  • Gray, M,Giuliano, KK. (2018). Incontinence-Associated Dermatitis, Characteristics and Relationship to Pressure Injury: A Multisite Epidemiologic Analysis. J Wound Ostomy Continence Nurs. 45. 63
  • Roca Biosca, A,García Fernández, FP,Chacón Garcés, S,Rubio Rico, L,Molina Fernández, M,Anguera Saperas, L. (2015). Identificación y clasificación de las lesiones relacionadas con la dependencia: de la teoría a la práctica clínica. Gerokomos. 26. 58-62
  • Real López, L,Diez Estébanez, M,Serrano Hernantes, M,Iglesia García, E de la,Blasco Romero, I,Capa Santamaría, S. Prevalencia de úlceras por presión y lesiones cutáneas asociadas a la humedad en el Hospital Universitario de Burgos. Gerokomos. 28. 103
  • Pancorbo Hidalgo, PL,Torra Bou, JE,García Fernández, FP,Soldevilla Ágreda, J. (2018). Prevalence of pressure injuries and other dependence-related skin lesions among paediatric patients in hospitals in Spain. EWMA Journal. 19. 29-37
  • Newcombe, RG. (1998). Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 17. 857
  • Sistema de entrenamiento en la clasificación de las lesiones adquiridas relacionadas con la dependencia (SECLARED).
  • Chiquero Valenzuela, S,Rodríguez Palma, M,Pancorbo-Hidalgo, PL,Soldevilla-Agreda, JJ,García-Fernández, FP. (2019). Seclared, una nueva herramienta de aprendizaje virtual para mejorar las habilidades de identificación y clasificación de las lesiones relacionadas con la dependencia. Rev ROL Enfermería. 42. 45-50
  • Barrois, B,Colin, D,Allaert, FA. (2018). Prevalence, characteristics and risk factors of pressure ulcers in public and private hospitals care units and nursing homes in France. Hospital Practice. 46. 1
  • Artico, M,Dante, A,DÁngelo, D,Lamarca, L,Mastroianni, C,Petiti, T. (2017). Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: a retrospective chart review. Palliative Medicine. 32. 299-307
  • Castro Mendoza Queiroz, AC de,Correa de Faria Mota, DD,Bachion, MM,Mendes Ferreira, AC. (2014). Pressure ulcers in palliative home care patients: prevalence and characteristics. Rev Escola Enferm USP. 48. 264
  • (2016). Crossroads Hospice Foundation. Understanding wound care in the Hospice and palliative setting.
  • Vanderwee, K,Clark, M,Dealey, C,Gunninberg, L,Defloor, T. (2007). Pressure ulcer prevalence in Europe: a pilot study. J Eval Clin Pract. 13. 227
  • Gunningberg, L,Stotts, NA,Idvall, E. (2011). Hospital-acquired pressure ulcers in two Swedish County Councils: cross-sectional data as the foundation for future quality improvement. Int Wound J. 8. 465
  • Hurd, T,Posnett, J. (2009). Point prevalence of wounds in a sample of acute hospitals in Canada. Int J Wound. 6. 287
  • Kottner, J,Wilborn, D,Dassen, T,Lahmann, N. (2009). The trend of pressure ulcer prevalence rates in German hospitals: results of seven cross-sectional studies. J Tissue Viability. 18. 36-46
  • Valls-Matarin, J,Cotillo-Fuente, M del,Ribal-Prior, R,Pujol-Vila, M,Sandalinas-Mulero, I. (2017). Incidencia de lesiones cutáneas asociadas a la humedad en una unidad de cuidados intensivos. Enferm Intensiva. 28. 13-20
  • Werth, SL,Justice, R. (2019). Prevalence of Moisture-Associated Skin Damage in an acute care setting: outcomes from a quality improvement Project. J Wound Ostomy Continenece Nurs. 46. 51
  • Arnold-Long, M,Johnson, E. (2019). Epidemiology of Incontinence-Associated Dermatitis and Intertriginous Dermatitis (Intertrigo) in an acute care facility. J Wound Ostomy Continenece Nurs. 46.
  • Johansen, E,Bakken, LN,Duvaland, E,Faulstich, J,Moore, Z,Vestby, EM. (2018). Incontinence-Associated Dermatitis (IAD): Prevalence and associated factors in 4 hospitals in Southeast Norway. J Wound Ostomy Continenece Nurs. 45. 527
  • Carville, K,Lewin, G,Newall, N,Haslehurst, P,Michael, R,Santamaria, N. (2007). STAR: a consensus for skin tear classification. Primary Intention. 15. 18-28
  • Rumbo Prieto, JM,Palomar Llatas, F. (2015). Lesiones cutáneas laceradas (skin tears), ¿qué sabemos sobre ellas?. Enferm Dermatol. 9. 7-10
  • Payne, R,Martin, M. (1990). Skin tears: The epidemiology and management of skin tears in older adults. Ostomy Wound Management. 26. 26-37
  • White, M,Karam, S,Cowell, B. (1994). Skin tears in frail elders: a practical approach to prevention. Geriatric Nurs. 15. 95
  • Morey, P. Skin tears, prevalence and treatment. Joint Western Australia Wound Care Association and Infection Control Association Conference. Perth. 16 Sept 2003.
  • Edwards, H,Gaskill, D,Nash, R. (1998). Treating skin tears in nursing home residents: a pilot study comparing four types of dressings. Int J Nurs Prac. 4. 25-32
  • LeBlanc, K,Baranoski, S. (2011). Skin tears consensus panel members Skin tears: state of the science: consensus statements for the prevention, prediction, assessment and treatment of skin tears. Adv Skin W Sound Care. 24. 2-15