Bir Eğitim Hastanesinde Bası Yarası Prevalansı ve Bası Yarası Gelişiminde Etkili Risk Faktörleri
2 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
3 İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul
Pressure Ulcer Prevalance in a Teaching Hospital and Risk Factors Associated With Pressure Ulcer Development Pressure ulcers constitute a significant health problem by interfering with morbidity and mortality and prolonge the hospitalization period in many disease states. The present descriptive cross-sectional study was conducted to determine the prevalance of pressure ulcers among patients hospitalized in a Teaching Hospital and further to investigate the role of possible risk factors on pressure ulcer development. A total of 922 (483 male - 52,4% and 439 female - 47,6%) hospitalized patients in the Hospital of Cerrahpasa Medical Faculty, Istanbul University were included. Sociodemographic features of all the patients, pressure ulcer associated risk factors, the characteristics of present and previous pressure ulcers were evaluated. The prevalance of pressure ulcers was found as 7,2% in our hospital. This rate increased to 9,1% if ophtalmology, psychiatry, gynecology and obstetrics and pediatry wards were excluded. Grade I pressure ulcer was the most common (69%) followed by grade II (16%), grade III (10%) and grade IV (4,5%) ulcers. Sacrum (53,4%), heels (14,8%), trochanters (12,5%) and ischium (8%) were the most common sites of pressure ulcers. According to the results of the present study, older age (p<0,001), lower educational status (p<0,001), immobility (p<0,001), fractures (p<0,001), fecal (p<0,001) and urinary incontinence (p<0,001), diarrhea (p<0,05), urinary tract infection (p<0,01), urinary catheterization (p<0,001), hypoalbuminemia (p<0,001), sepsis (p<0,05), weight loss (p<0,001), malnutrition (p<0,001), presence of pressure ulcer history (p<0,001), concomittant disease (p<0,001), disorders of consciousness and cognition (p<0,001) and hospitalization in intensive care units (p<0,001) were significantly related to pressure ulcer development. However, after logistic regression analysis, only older age, fractures, fecal incontinence, disorders of consciousness and cognition, weight loss, presence of previous pressure ulcer history, immobility, hypoalbuminemia and intensive care history remained as independent risk factors for pressure ulcer development. The reason for the high rates of pressure sores in patients using air-bed, and electrical bedstead (p<0,001) was considered to be due to more common use of these types of beds for patients that already had developed pressure ulcers. No significant correlation was demonstrated between sociodemographical characteristics of care givers and the presence of pressure ulcers. This might be the result of a very few number of trained medicals and paramedicals on pressure ulcer prevention and treatment. It was concluded that intensive educational programmes should be carried out for nurses and the medical staff in order to decrease the prevalance of pressure ulcers in this hospital. We are planning to repeat this cross-sectional study after a comprehensive pressure ulcer management educational program including all the nurses in the hospital.
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