PREVENTING PRESSURE ULCERS IN NEONATAL AND PEDIATRIC INTENSIVE CARE UNIT

Sri Hendrawati

Abstract


Critically ill neonates and pediatrics are at risk for developing pressure ulcers and associated with pain, infection risk, and prolonged hospitalization. The reported incidence of pressure ulcers in critically ill neonates and pediatrics is 18% to 27%. Anatomic, physiologic, and developmental factors place critically ill neonates and pediatrics at risk for pressure ulcers. Peventing pressure ulcers is critical to optimizing outcomes in hospitalized patients. Nursing interventions to prevent the development of the pressure ulcers have not been established. This literature review aims to identify the prevention of pressure ulcers in neonatal and pediatric intensive care unit. Articles were collected through Medline, CINAHL from EBSCOhost, Google Scholar, PubMed, and Proquest electronic database using the keywords prevention, pressure ulcer, skin injury, skin care, neonatal, pediatric, and intensive care unit using qualitative and quantitative studies. The reviewed articles were only articles with full text, written in English, and published during period 2006 to 2017. The following were excluded: unpublished studies (grey literature) and studies involving patients with pressure ulcers upon admission. The methodological quality of this literature review was assessed according to the guidelines of the Critical Appraisal Skills Programme. A total of 491 articles were found and only nine articles which met the criteria. There are six essential elements of pediatric pressure ulcer prevention: conduct a pressure ulcer admission assessment using neonatal skin risk assessment scale (NSRAS) for neonatal and braden Q scale for pediatric; reassessment of risk factors; inspect skin daily; manage moisture with keep the patient dry and improve moisturize skin management; optimize nutrition and hydration; and minimize pressure with repositioning and pressure-relieving surfaces or support surface. The development of pressure ulcers is still an important clinical problem in critically ill neonates and pediatrics. Nursing interventions play an important role in the prevention of pressure ulcers.

 


Keywords


Intensive care unit, neonatal, pediatric, pressure ulcer, prevention, skin care, skin injury

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References


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