A Cross-Sectional Study to Find Out the Incidence and Associated Risk Factors of Pressure Injury Acquired in the ICU Unit at Pt. B.D. PGIMS, Rohtak

Year : 2025 | Volume : 03 | Issue : 02 | Page : 7 41
    By

    Kavita Choudhary,

  • Pawan Kumar Singh,

  • Kunal,

  1. Lecturer (Jr.), Department of Nursing, College of Nursing, Pt. B.D. Sharma University of Health Sciences, Haryana, India
  2. Associate Professor, Department of Nursing, College of Nursing, Pt. B.D. Sharma University of Health Sciences, Haryana, India
  3. Student, Department of Nursing, College of Nursing, Pt. B.D. Sharma University of Health Sciences, Haryana, India

Abstract

Pressure injuries, also known as pressure ulcers or bedsores, remain a major concern in intensive care units (ICUs) due to their adverse impact on patient outcomes and healthcare quality. This study aimed to assess the incidence and associated risk factors of pressure injuries among patients admitted to the ICU at Pt. B.D. Sharma Post Graduate Institute of Medical Sciences (PGIMS), Rohtak. A descriptive cross-sectional design was adopted, and data were collected from 100 ICU patients using a structured clinical assessment tool and the Braden risk assessment scale. Demographic and clinical variables such as age, gender, duration of ICU stay, mobility, nutritional status, moisture exposure, comorbidities, and Braden scores were analyzed. The findings revealed that 27% of patients developed pressure injuries during their ICU stay. A statistically significant association was observed between pressure injury occurrence and factors such as low Braden score (≤16), immobility, and moisture exposure (p<0.05). Although variables like nutritional status and comorbidities did not show significant associations, they remain clinically relevant for overall patient management. The study highlights the importance of early identification of at-risk patients and implementation of targeted nursing interventions, including regular repositioning, effective moisture management, nutritional optimization, and use of pressure-relieving devices. These results underscore the need for structured prevention protocols and ongoing staff education to reduce the incidence of pressure injuries in critical care settings and improve patient outcomes.

Keywords: Pressure injuries, Braden Scale, intensive care unit, risk factors, nursing interventions

[This article belongs to International Journal of Emergency and Trauma Nursing and Practices ]

How to cite this article:
Kavita Choudhary, Pawan Kumar Singh, Kunal. A Cross-Sectional Study to Find Out the Incidence and Associated Risk Factors of Pressure Injury Acquired in the ICU Unit at Pt. B.D. PGIMS, Rohtak. International Journal of Emergency and Trauma Nursing and Practices. 2025; 03(02):7-41.
How to cite this URL:
Kavita Choudhary, Pawan Kumar Singh, Kunal. A Cross-Sectional Study to Find Out the Incidence and Associated Risk Factors of Pressure Injury Acquired in the ICU Unit at Pt. B.D. PGIMS, Rohtak. International Journal of Emergency and Trauma Nursing and Practices. 2025; 03(02):7-41. Available from: https://journals.stmjournals.com/ijetnp/article=2025/view=235386


References

  1. Kyari F, Gudlavalleti MV, Sivsubramaniam S, Gilbert CE, Abdull MM, Entekume G, Foster A; Nigeria National Blindness and Visual Impairment Study Group. Prevalence of blindness and visual impairment in Nigeria: the National Blindness and Visual Impairment Study. Invest Ophthalmol Vis Sci. 2009 May;50(5):2033-9. doi: 10.1167/iovs.08-3133. Epub 2008 Dec 30. PMID: 19117917.
  2. Coyer F, Tayyib N. Risk factors for pressure injury development in critically ill patients in the Intensive Care Unit: a systematic review protocol. Syst Rev. 2017;6:58. doi: 10.1186/s13643-017-0451-5. PMID: 28320459; PMCID: PMC5359849.
  3. Flaxman SR, Bourne RRA, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV, Das A, Jonas JB, Keeffe J, Kempen JH, Leasher J, Limburg H, Naidoo K, Pesudovs K, Silvester A, Stevens GA, Tahhan N, Wong TY, Taylor HR; Vision Loss Expert Group of the Global Burden of Disease Study. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. Lancet Glob Health. 2017 Dec;5(12):e1221-e1234. doi: 10.1016/S2214-109X(17)30393-5. Epub 2017 Oct 11. PMID: 29032195.
  4. Dulal S, Sapkota YD. Prevalence of blindness and visual impairment and its causes among people aged 50 years and above in Karnali Zone, Nepal. Nepal J Ophthalmol. 2012;4:282-7. doi: 10.3126/nepjoph.v4i2.6545. PMID: 22864035.
  5. Resnikoff S, Pascolini D, Etya’ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004;82:844-51. PMID: 15640920; PMCID: PMC2623053.
  6. Murthy GVS, Vashist P, John N, Pokharel G, Ellwein LB. Prevalence and causes of visual impairment and blindness in older adults in an area of India with a high cataract surgical rate. Ophthalmic Epidemiol. 2010;17:185-95. doi: 10.3109/09286586.2010.483751. PMID: 20642340; PMCID: PMC6031136.
  7. Bourne RRA, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, Jonas JB, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor HR; Vision Loss Expert Group. Causes of vision loss worldwide, 1990–2010: a systematic analysis. Lancet Glob Health. 2013;1:e339-e349. doi: 10.1016/S2214-109X(13)70113-X. Epub. PMID: 25104599.
  8. Wen L, Wang Y, Lin Z, Wang FH, Li D, Feng K, Liang YB, Zhang DX, Dou Y, Zhai G. The prevalence and causes of visual impairment in type 2 diabetes mellitus in Northeast China. J Ophthalmol. 2020 Nov 29;2020:5969816. doi: 10.1155/2020/5969816. PMID: 33312726; PMCID: PMC7719542.
  9. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96:614-8. doi: 10.1136/bjophthalmol-2011-300539. Epub. PMID: 22133988.
  10. Chan VF, Singer S, Naidoo KS. Disability-related distress in primary school learners with vision impairment due to uncorrected refractive error in KwaZulu-Natal Province, South Africa: a qualitative study. PLoS One. 2020;15:e0229108. doi: 10.1371/journal.pone.0229108. PMID: 32126114; PMCID: PMC7053722.
  11. Muhit M, Wadud Z, Islam J, Khair Z, Shamanna BR, Jung J, Khandaker G. Generating evidence for program planning: rapid assessment of avoidable blindness in Bangladesh. Ophthalmic Epidemiol. 2016;23:176-84. doi: 10.3109/09286586.2016.1155716. Epub. PMID: 27142593.
  12. Gou L, Zhang Z, A Y. Risk factors for medical device-related pressure injury in ICU patients: a systematic review and meta-analysis. PLoS One. 2023;18:e0287326. doi: 10.1371/journal.pone.0287326. PMID: 37352180; PMCID: PMC10289390.
  13. Fleurence RL. Cost-effectiveness of pressure-relieving devices for the prevention and treatment of pressure ulcers. Int J Technol Assess Health Care. 2005;21:334-41. doi: 10.1017/S0266462305050440. PMID: 16110713.
  14. Engkasan JP. How effective is alternating pressure (active) air surfaces for preventing pressure ulcers? A Cochrane review summary with commentary. NeuroRehabilitation. 2023;52:149-51. doi: 10.3233/NRE-228028. PMID: 36617764.
  15. Karimian M, Khalighi E, Salimi E, Borji M, Tarjoman A, Mahmoudi Y. The effect of educational intervention on the knowledge and attitude of intensive care nurses in the prevention of pressure ulcers. Int J Risk Saf Med. 2020;31:89-95. doi: 10.3233/JRS-191038. PMID: 32039864.
  16. Guerrero JG, Mohammed H, Pingue-Raguini M, Cordero RP, Aljarrah I. A multicenter assessment of nurses’ knowledge regarding pressure ulcer prevention in intensive care units utilizing the PUKAT 2.0. SAGE Open Nurs. 2023;9:23779608231177790. doi: 10.1177/23779608231177790. PMID: 37273548; PMCID: PMC10233595.
  17. Coleman S, Gorecki C, Nelson EA, Closs SJ, Defloor T, Halfens R, Farrin A, Brown J, Schoonhoven L, Nixon J. Patient risk factors for pressure ulcer development: systematic review. Int J Nurs Stud. 2013;50:974-1003. doi: 10.1016/j.ijnurstu.2012.11.019. Epub. PMID: 23375662.
  18. Gefen A, Alves P, Ciprandi G, Coyer F, Milne CT, Ousey K, Ohura N, Waters N, Worsley P. Device-related pressure ulcers: secure prevention. J Wound Care. 2020;29(Sup2a):S1-S52. doi: 10.12968/jowc.2020.29.Sup2a.S1. PMID: 32067552.
  19. Keller BPJA, Wille J, van Ramshorst B, van der Werken C. Pressure ulcers in intensive care patients: a review of risks and prevention. Intensive Care Med. 2002;28:1379-88. doi: 10.1007/s00134-002-1487-z. Epub. PMID: 12373461.
  20. Sving E, Gunningberg L, Högman M, Mamhidir AG. Registered nurses’ attention to and perceptions of pressure ulcer prevention in hospital settings. J Clin Nurs. 2012;21:1293-303. doi: 10.1111/j.1365-2702.2011.04000.x. Epub. PMID: 22429848.
  21. Padula WV, Makic MBF, Wald HL, Campbell JD, Nair KV, Mishra MK, Valuck RJ. Hospital-acquired pressure ulcers at Academic Medical Centers in The United States, 2008–2012: Tracking changes since the CMS nonpayment policy. Jt Comm J Qual Patient Saf. 2015;41:257–263. doi:10.1016/S1553-7250(15)41035-9. PMID: 25990891.
  22. Chaboyer WP, Thalib L, Harbeck EL, Coyer FM, Blot S, Bull CF, Nogueira PC, Lin FF. 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. PMID: 30095501.
  23. 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. PMID: 30702158. PMCID: PMC6354222.
  24. Braden B, Bergstrom N. A conceptual schema for the study of the etiology of pressure sores. Rehabil Nurs. 1987;12:8–12. doi:10.1002/j.2048-7940.1987.tb00541.x. PMID: 3643620.
  25. Tannen A, Dassen T, Halfens R. Differences in prevalence of pressure ulcers between the Netherlands and Germany–Associations between risk, prevention and occurrence of pressure ulcers in hospitals and nursing homes. J Clin Nurs. 2008;17:1237–1244. doi:10.1111/j.1365-2702.2007.02225.x. PMID: 18416798.
  26. Cox J. Predictors of pressure ulcers in adult critical care patients. Am J Crit Care. 2011;20:364–375. doi:10.4037/ajcc2011934. PMID: 21885457.
  27. Kottner J, Balzer K. Do pressure ulcer risk assessment scales improve clinical practice? J Multidiscip Healthc. 2010;3:103–111. doi:10.2147/JMDH.S9286. PMID: 21197359. PMCID: PMC3004596.
  28. Chen HL, Shen WQ, Liu P. A meta-analysis to evaluate the predictive validity of the Braden Scale for pressure ulcer risk assessment in long-term care. Ostomy Wound Manage. 2016;62:20–28. PMID: 27668477.
  29. Demarré L, Vanderwee K, Defloor T, Verhaeghe S, Schoonhoven L, Beeckman D. Pressure ulcers: Knowledge and attitude of nurses and nursing assistants in Belgian nursing homes. J Clin Nurs. 2012;21:1425–1434. doi:10.1111/j.1365-2702.2011.03878.x. Epub 2011 Nov 1. PMID: 22039896.
  30. Waugh SM. Attitudes of nurses toward pressure ulcer prevention: A literature review. Medsurg Nurs. 2014;23:350–357. PMID: 26292449.
Regular Issue Subscription Original Research
Volume 03
Issue 02
Received 25/10/2025
Accepted 10/11/2025
Published 19/11/2025
Publication Time 25 Days
64

Login


My IP

PlumX Metrics