Prevalence and Risk Factors of hospital-acquired pressure ulcers in intensive care nursing staff
DOI:
https://doi.org/10.5281/zenodo.22814944Keywords:
pressure ulcer, intensive care unit, nurse staffing, prevalence, risk factorsAbstract
Background: Hospital-acquired pressure ulcers (HAPUs) remain one of the most common preventable adverse events in critical care, with reported intensive care unit (ICU) prevalence ranging widely across health systems and case-mix.
Objective: This review synthesizes the published evidence on the prevalence, anatomical distribution, and risk factors for HAPUs among adult ICU patients, with particular attention to nursing staffing levels, workload, and repositioning practice as modifiable determinants.
Methods: We synthesized point-prevalence surveys, prospective cohort studies, and nurse-staffing analyses addressing pressure ulcer occurrence, device-related skin injury, and nurse-to-patient ratios in adult intensive care settings.
Findings: ICU point-prevalence estimates for HAPU commonly fall between roughly 10% and 30% depending on setting and surveillance method, with the sacrum, heels, and device-contact sites accounting for the large majority of lesions; hemodynamic instability, vasopressor use, mechanical ventilation, and immobility are consistently identified independent risk factors, while lower nurse-to-patient ratios and higher workload scores correlate with reduced repositioning frequency and higher incidence.
Conclusions: HAPU risk in the ICU is best understood as the product of patient-level physiological vulnerability and unit-level nursing capacity; structured risk assessment, adequately staffed repositioning schedules, and pressure-redistributing support surfaces together form the core of an evidence-based prevention bundle, and sustained reductions depend on treating nursing workload as a modifiable structural risk factor rather than a background constraint.
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