Yarkıner Zalihe, Bahar Arzu, Sönmez Münevver, Kapan Emine, Şahin Simge, Köstekçi Ezgi, Erdeve Ömer
Cyprus International University Department of Basic Sciences and Humanities, Faculty of Arts and Sciences, Northern Cyprus Via Mersin, Turkey.
Yuksek Ihtisas University, Faculty of Health Sciences, Fundamentals of Nursing, Ankara, Turkey.
J Tissue Viability. 2024 Nov;33(4):916-922. doi: 10.1016/j.jtv.2024.09.005. Epub 2024 Sep 17.
This study was conducted to investigate the incidence of medical device-related pressure injuries (MDRPIs) and the risk factors influencing their occurrence in the neonatal intensive care unit (NICU).
This study is a prospective, descriptive study. The research was conducted with 116 newborns between June 1, 2022, and June 1, 2023. Newborns who stayed in the neonatal intensive care unit for at least 24 h were observed daily for medical device-related pressure injuries under and around each medical device throughout their stay in the intensive care unit. The "Case Report Form," "MDRPIs Monitoring Form," "Braden Q scale for children," National Pressure Injury Advisory Panel (NPIAP) Pressure Grading, and Glasgow Coma Scale were used in the research.
The incidence of medical device-related pressure injuries is 35.3 % (41/116). It was found that 38.1 % (16/42) of medical device-related pressure injuries developed due to Near-Infrared Spectroscopy (NIRS) probes, and 33.5 % (14/42) developed due to medical devices related to the respiratory system. In terms of anatomical location, 38.1 % occurred on the forehead, and 23.8 % on the arm/leg. The difference between birth weight, gestational age, development of MDRPIs in newborns receiving sedation and inotropes was found to be statistically significant. Regression analysis identified gestational age (p = 0.040, OR = 0.795, 95%CI = [0.632-1.000]) as an independent risk factor for the occurrence of medical device-related pressure injuries.
The incidence of medical device-related pressure injuries in newborns was relatively high in this study, with gestational age being the most significant risk factor for MDRPIs formation. It is crucial for neonatal intensive care nurses to consider associated risk factors while providing newborn care and implement appropriate preventive measures to reduce the incidence of MDRPIs.
本研究旨在调查新生儿重症监护病房（NICU）中与医疗器械相关的压力性损伤（MDRPIs）的发生率及其发生的危险因素。
本研究是一项前瞻性描述性研究。研究对象为2022年6月1日至2023年6月1日期间的116名新生儿。对在新生儿重症监护病房至少停留24小时的新生儿，在其入住重症监护病房期间，每天观察每个医疗器械下方及周围是否发生与医疗器械相关的压力性损伤。研究中使用了“病例报告表”“MDRPIs监测表”“儿童Braden Q量表”、国家压力性损伤咨询小组（NPIAP）压力分级以及格拉斯哥昏迷量表。
与医疗器械相关的压力性损伤发生率为35.3%（41/116）。发现38.1%（16/42）的与医疗器械相关的压力性损伤是由近红外光谱（NIRS）探头引起的，33.5%（14/42）是由呼吸系统相关医疗器械引起的。在解剖位置方面，38.1%发生在前额，23.8%发生在手臂/腿部。发现出生体重、胎龄、接受镇静和使用血管活性药物的新生儿中MDRPIs的发生情况存在统计学差异。回归分析确定胎龄（p = 0.040，OR = 0.795，95%CI = [0.632 - 1.000]）是发生与医疗器械相关的压力性损伤的独立危险因素。
本研究中新生儿与医疗器械相关的压力性损伤发生率相对较高，胎龄是MDRPIs形成的最显著危险因素。对于新生儿重症监护护士来说，在提供新生儿护理时考虑相关危险因素并采取适当的预防措施以降低MDRPIs的发生率至关重要。
