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

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

Bortézomib (mode d'action et intérêt dans le traitement du myélome multiple)

LYON1-BU Santé (693882101) / SudocSudocFranceF

L'automatisation de la distribution globale des médicaments au sein d'une pharmacie à usage intérieur

Le circuit du médicament est une des composantes essentielles de la prise en charge d'un patient au sein d'un établissement de santé et il est possible, à l'heure actuelle, d'optimiser son fonctionnement grâce à l'automatisation, dans les Pharmacies à Usage Intérieur comme dans les unités de soins. Les Pharmaciens du Groupement Hospitalier Edouard Herriot ont choisi d'implanter un système automatisé pour optimiser l'activité de dispensation de médicaments, auparavant effectuée de manière manuelle par les opérateurs. Le but de ce travail est d'analyser les moyens actuels, ainsi que l'organisation à adopter en vue de l'installation de l'automate choisi. Dans un premier temps, nous examinerons l'environnement général actuel autour du circuit du médicament d'un point de vue réglementaire et organisationnel. Les différentes solutions techniques dont disposent les hôpitaux pour automatiser leur circuit du médicament seront aussi abordées. Nous étudierons dans la deuxième partie de ce travail la méthodologie à adopter lors de l'installation de l'automate. Nous présenterons donc successivement une analyse de faisabilité du projet, les démarches prospectives entreprises auprès des fournisseurs, les visites de PUI équipées, la rédaction d'un appel d'offres, et l'étude des réponses à celui-ci. Nous aborderons enfin la mise en place d'indicateurs dans le but d'évaluer dans un futur proche la valeur ajoutée. Cette étude n'est que purement prospective car elle est antérieure à l'implantation du système automatisé dans la PUI. Il sera par conséquent souhaitable de compléter celle-ci lorsque le système sera en place, afin de vérifier l'exactitude de l'étude de faisabilité, d'exécuter la qualification de l'équipement, et de collecter des données grâce aux indicateurs préétablis.LYON1-BU Santé (693882101) / SudocSudocFranceF

L'élaboration d'un guide pratique pour les médicaments à usage parentéral

LYON1-BU Santé (693882101) / SudocSudocFranceF

Pratique de l'aérosolthérapie par nébulisation dans un service de gériatrie à l'hôpital Edouard Herriot (Hospices civils de Lyon)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Identification, pondération et analyse des risques liés au processus de traitement par chimiothérapie anticancéreuse (étude pilote appliquée aux cancers digestifs)

LYON1-BU Santé (693882101) / SudocSudocFranceF

L'arrêt de commercialisation du Dextropropoxyphène (quelles alternatives dans la prise en charge de la douleur ?)

LYON1-BU Santé (693882101) / SudocSudocFranceF

La programmation du lien ville-hôpital dans les programmes d'éducation thérapeutique (positionnement des pharmaciens)

LYON1-BU Santé (693882101) / SudocSudocFranceF