Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

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Enriched Timoshenko beam finite element for modeling bending and shear failure of reinforced concrete frames

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Tobacco prevention interventions - developing life skills through playful activities among children and preteens: A systematic review

International audienceIn children and adolescents, risky behaviours such as tobacco use may be addressed by developing life skills. In the field of tobacco prevention, the deployment of playful activities for the development of life skills has received little attention. This review describes the methods and results of tobacco prevention interventions using playful activities to develop life skills in children and preteens. A literature search was conducted in the PubMed, Web of Science and PsycInfo databases. Articles were included in the review based on the following five criteria: (1) the article totally or partially concerns a study of a tobacco prevention intervention; (2) the subjects were children and preteens aged between 6 and 12 years (with an average age within this age range or with an interval including all or part of this age range), from a general or specific population; (3) the intervention was a life skills development action or program; (4) playful activities were employed; (5) design, implementation, evaluation methods and/or results are available in the article. A total of 11 studies, composed of 9 interventions, were included in this systematic review. Most were carried out in school settings (n = 8/11) and involved teachers (n = 7/11). Web-based interventions (video games, mobile health games/websites and e-learning programs) were the playful activities most often used (n = 4/11). The majority of the interventions aimed to develop social skills such as the ability to resist pressure (n = 9/11). In this review, there were only four randomized controlled trial (n = 4/11). The evaluation was immediately after the RCTs. Among the measured outcome variables, knowledge (n = 8/11), attitudes (n = 5/11), intentions (n = 5/11), self-efficacy (n = 4/11) and skills (n = 3/11) were the most assessed. Only two of the studies reviewed here conducted a process evaluation (n = 2/11). This systematic review provides guidance for future youth smoking prevention interventions. Among these, a process evaluation is strongly suggested, as well as the use of appropriate variables and validated scales to assess the effectiveness of prevention programs. In addition, participatory research must allow for the design of adapted and relevant interventions, but also for the proper development of intervention research methodologies in health promotion