Incidence of pressure ulcers in intensive care unit patients at risk according to the Waterlow scale and factors influencing the development of pressure ulcers
Article first published online: 11 DEC 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Journal of Clinical Nursing
Volume 18, Issue 5, pages 765–774, March 2009
How to Cite
Sayar, S., Turgut, S., Doğan, H., Ekici, A., Yurtsever, S., Demirkan, F., Doruk, N. and Taşdelen, B. (2009), Incidence of pressure ulcers in intensive care unit patients at risk according to the Waterlow scale and factors influencing the development of pressure ulcers. Journal of Clinical Nursing, 18: 765–774. doi: 10.1111/j.1365-2702.2008.02598.x
- Issue published online: 12 FEB 2009
- Article first published online: 11 DEC 2008
- Accepted for publication: 5 December 2007
- intensive care;
- pressure ulcer;
- risk assessment;
Aims. To determine incidence of pressure ulcers in patients at risk according to the Waterlow scale in intensive care units and to evaluate the effects of risk factors in critically ill patients.
Background. Pressure ulcers continue to be an important health problem that increases the risk of illness and death, extends patients’ length of hospital stay and increases healthcare expenses.
Design. The study was conducted as a descriptive and prospective study.
Method. The sample consisted of 140 patients. Data were collected using a data collection form, the skin assessment instrument and the Waterlow scale.
Results. The incidence of pressure ulcers in intensive care unit patients was found to be 14·3%. The majority of pressure ulcers (74%) were grade I. The mean length of time for pressure ulcer development was found to be 10·4 (SD 1·85) days. A statistically significant difference was found in the patients for pressure ulcer development according to their level of consciousness, activity, cooperation, length of stay, Waterlow scale score and C-reactive protein level. In the multiple stepwise logistic regression analysis, the most influential factors for pressure ulcer development were determined to be length of stay and activity level.
Conclusions. Extra care needs to be taken to prevent pressure ulcer development in intensive care unit patients who have an extended length of stay, are dependent for activities, have high Waterlow scores, are unconscious and are not cooperative.
Relevance to clinical practice. This study determined the incidence of and factors that can affect the development of pressure ulcers in intensive care unit patients who are in a high risk group for the development of pressure ulcers and presented the importance of having Turkish nurses implement interventions directed at these factors.