Research progress on medical device-related pressure injury in neonatal intensive care unit_West China Medical Journal

Authors：

LI Siqing ¹ ,  HU Ailing ²

1. School of Nursing, Sun Yet-sen University, Guangzhou, Guangdong 510080, P. R. China;
2. Nursing Department, Lingnan Branch of the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510070, P. R. China;

Corresponding author：

HU Ailing, Email: h-ailing@163.com

Keywords：

Neonatal intensive care unit; Medical device; Pressure injury; Nursing

DOI：

10.7507/1002-0179.201901093

Video：

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Medical device-related pressure injury (MDRPI) is a kind of pressure injury that occurs in the course of diagnosis and treatment, and its appearance is similar to that of medical device. Neonatal intensive care unit (NICU) infants are more likely to develop MDRPI than children and adults because of the physiological characteristics of skin and the influence of disease. At present, the occurrence of MDRPI in NICU infants is attracting worldwide attention. Its treatment and nursing consume a large amount of medical resources, which not only affect the outcome of the disease, but also increase the economic burden of the family and society. This article summarizes the MDRPI from three aspects: summary, influencing factors, and evaluation tools. It is expected that NICU nurses will carry out large sample clinical investigation of MDRPI in the future, so as to provide a reference for risk prediction model and risk assessment tools to identify high-risk infants and take effective measures in advance to reduce the incidence of MDRPI.

Citation： LI Siqing, HU Ailing. Research progress on medical device-related pressure injury in neonatal intensive care unit. West China Medical Journal, 2019, 34(2): 218-222. doi: 10.7507/1002-0179.201901093 Copy

1.	The National Pressure Ulcer Advisory Panel. National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury. (2016-04-13)[2016-06-13]. http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/.
2.	Black JM, Cuddigan JE, Walko MA, et al. Medical device related pressure ulcers in hospitalized patients. Int Wound J, 2010, 7(5): 358-365.
3.	World Health Organization. Preterm birth, 2018. (2018-02-19)[2018-11-29]. http://www.who.int/news-room/fact-sheets/detail/preterm-birth.
4.	Fujii K, Sugama J, Okuwa M, et al. Incidence and risk factors of pressure ulcers in seven neonatal intensive care units in Japan: a multisite prospective cohort study. Int Wound J, 2010, 7(5): 323-328.
5.	Grosvenor J, Dowling M. Prevention of neonatal pressure injuries. J Neonatal Nurs, 2018, 24(3): 122-125.
6.	Amir Y, Lohrmann C, Halfens RJ, et al. Pressure ulcers in four Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics, prevention and treatment. Int Wound J, 2017, 14(1): 184-193.
7.	Peterson MJ, Gravenstein N, Schwab WK, et al. Patient repositioning and pressure ulcer risk--monitoring interface pressures of at-risk patients. J Rehabil Res Dev, 2013, 50(4): 477-488.
8.	靳辞辞, 王惠琴. 医疗器械相关性压疮的研究现状. 护理与康复, 2016, 15(10): 946-949.
9.	Willock J, Harris C, Harrison J, et al. Identifying the characteristics of children with pressure ulcers. Nurs Times, 2005, 101(11): 40-43.
10.	Visscher M, Taylor T. Pressure ulcers in the hospitalized neonate: rates and risk factors. Sci Rep, 2014, 4: 7429.
11.	Coyer FM, Stotts NA, Blackman VS. A prospective window into medical device-related pressure ulcers in intensive care. Int Wound J, 2014, 11(6): 656-664.
12.	Apold J, Rydrych D. Preventing device-related pressure ulcers: using data to guide statewide change. J Nurs Care Qual, 2012, 27(1): 28-34.
13.	刘亚红, 李婷, 付成成, 等. ICU 医疗器械相关性压疮的原因分析及对策. 中华现代护理杂志, 2014, 20(11): 1252-1254.
14.	胡军, 王秀锋, 李玉环, 等. 压疮分期与危险因素的研究及预防进展. 上海护理, 2011, 11(2): 69-72.
15.	Defloor T. The risk of pressure sores: a conceptual scheme. J Clin Nurs, 1999, 8(2): 206-216.
16.	徐玲. 住院患者压疮现患率的多中心联合横断面调查研究. 南京: 南京中医药大学, 2012.
17.	Fauroux B, Lavis JF, Nicot F, et al. Facial side effects during noninvasive positive pressure ventilation in children. Intens Care Med, 2005, 31(7): 965-969.
18.	García-Molina P, Balaguer-López E, García-Fernández FP, et al. Pressure ulcers’ incidence, preventive measures, and risk factors in neonatal intensive care and intermediate care units. Int Wound J, 2018, 15(4): 571-579.
19.	程莉萍, 董建英, 雷娜, 等. NICU 患儿压疮预防护理进展. 中华现代护理杂志, 2014, 20(20): 2590-2592.
20.	Newnam KM, McG rather JM, Estes T, et al. An integrative review of skin breakdown in the preterm infant associated with nasal continuous positive airway pressure. J Obstet Gynecol Neonatal Nurs, 2013, 42(5): 508-516.
21.	Visscher MO, White CC, Jones JM, et al. Face masks for noninvasive ventilation: fit, excess skin hydration, and pressure ulcers. Respir Care, 2015, 60(11): 1536-1547.
22.	何利, 安如俊, 龙燕琼, 等. 新生儿液体渗漏后预防皮肤损害的临床观察. 实用预防医学, 2006, 13(5): 1321.
23.	Irving V. Caring for and protecting the skin of preterm neonates. J Wound Care, 2001, 10: 253-256.
24.	金平, 赵红玲, 王珊丹. 新生儿压疮风险量表的编制和信效度分析. 中国实用护理杂志, 2016, 32(9): 682-684.
25.	余卓文, 顾莺. 危重患儿发生压疮的危险因素及评估进展. 护理研究, 2011, 25(2): 101-103.
26.	王娟, 张岚. 医疗设备相关压疮的发生原因及预防研究进展. 护理学杂志, 2015, 30(7): 100-102.
27.	Schindler CA, Mikhailov TA, Kuhn EM, et al. Protecting fragile skin: nursing interventions to decrease development of pressure ulcers in pediatric intensive care. Am J Crit Care, 2011, 20(1): 26-34.
28.	Murray JS, Noonan C, Quigley S, et al. Medical device-related hospital-acquired pressure ulcers in children: an integrative review. J Pediatr Nurs, 2013, 28(6): 585-595.
29.	彭均, 王颖. 压疮危险因素及护理干预的研究进展. 解放军护理杂志, 2010, 27(7A): 987-989.
30.	Razmus I, Lewis L, Wilson D. Pressure ulcer development in infants: state of the science. J Healthc Qual, 2008, 30(5): 36-42.
31.	Kottner J, Wilborn D, Dassen T. Frequency of pressure ulcers in the paediatric population: a literature review and new empirical data. Int J Nurs Stud, 2010, 47(10): 1330-1340.
32.	杨晓玲, 江湖, 蒲亨萍. 儿童医疗器械相关性压疮的护理研究进展. 上海护理, 2017, 17(4): 78-81.
33.	王皓月, 李红艳, 赵艳芳, 陈晓玉, 等. NICU 发生医疗设备相关压疮的原因及预防进展. 当代护士 (下旬刊), 2016(10): 19-22.
34.	Makic MB. Medical device-related pressure ulcers and intensive care patients. J Perianesth Nurs, 2015, 30(4): 336-337.
35.	张颖, 孙一丹. 医疗器械相关性压疮的预防及护理现状. 天津护理, 2018, 26(1): 117-119.
36.	张翠凤, 李娅, 朱跟娣. " 鸟巢”式护理在早产儿临床中的应用. 国际护理学志, 2011, 30(11): 1663-1664.
37.	Quigley S, Curley M. Skin integrity in the pediatric population; preventing and managing pressure ulcers. J Soc Pediatr Nurs, 1996, 1(1): 7-18.
38.	Curley MAQ, Quigley SM, Lin M. Pressure ulcers in pediatric intensive care: incidence and associated factors. Pediatr Crit Care Med, 2003, 4(3): 284-290.
39.	Curley MAQ, Hasbani NR, Quigley SM, et al. Predicting pressure injury risk in pediatric patients: the Braden QD Scale. J Pediatr, 2018, 192: 189-195.
40.	陆晔峰, 楼建华, 陆秀文. 2 种压疮评估量表在患儿中的应用研究. 中国实用护理杂志, 2010, 26(11): 41-43.
41.	Noonan C, Quigley S, Curley MA. Using the Braden Q Scale to predict pressure ulcer risk in pediatric patients. J Pediatr Nurs, 2010, 26(6): 566-575.
42.	Gray M. Which pressure ulcer risk scales are valid and reliable in a pediatric population?. J Wound Ostomy Continence Nurs, 2004, 31(4): 157-160.
43.	韩雪馨, 许红梅, 于秀荣, 等. 儿童压疮风险评估工具临床应用的研究进展. 中国实用护理杂志, 2015, 31(33): 2572-2574.
44.	Resar R, Pronovost P, Haraden C, et al. Using a bundle approach to improve ventilator care processes and reduce ventilator associated pneumonia. J Qual Patient Saf, 2005, 31(5): 243-248.
45.	汪丽平, 鲁琦, 张海玲. 新生儿皮肤风险评估护理记录单在预防 NICU 危重患儿压疮中的应用. 国际护理学杂志, 2014, 33(11): 3152-3153.
46.	黄艳, 王小红, 王媛. 压疮风险因素评估量表在儿科中的应用进展. 齐鲁护理杂志, 2011, 17(17): 46-47.
47.	罗婵, 梁绮镰, 温宋佳, 等. 新生儿压疮风险评估量表的临床应用. 全科护理, 2018, 16(17): 2067-2070.
48.	冯新荣, 薛虹, 白亚莎. 新生儿压疮风险评估量表的设计与应用效果. 天津护理, 2015, 23(5): 423-424.

1. The National Pressure Ulcer Advisory Panel. National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury. (2016-04-13)[2016-06-13]. http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/.
2. Black JM, Cuddigan JE, Walko MA, et al. Medical device related pressure ulcers in hospitalized patients. Int Wound J, 2010, 7(5): 358-365.
3. World Health Organization. Preterm birth, 2018. (2018-02-19)[2018-11-29]. http://www.who.int/news-room/fact-sheets/detail/preterm-birth.
4. Fujii K, Sugama J, Okuwa M, et al. Incidence and risk factors of pressure ulcers in seven neonatal intensive care units in Japan: a multisite prospective cohort study. Int Wound J, 2010, 7(5): 323-328.
5. Grosvenor J, Dowling M. Prevention of neonatal pressure injuries. J Neonatal Nurs, 2018, 24(3): 122-125.
6. Amir Y, Lohrmann C, Halfens RJ, et al. Pressure ulcers in four Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics, prevention and treatment. Int Wound J, 2017, 14(1): 184-193.
7. Peterson MJ, Gravenstein N, Schwab WK, et al. Patient repositioning and pressure ulcer risk--monitoring interface pressures of at-risk patients. J Rehabil Res Dev, 2013, 50(4): 477-488.
8. 靳辞辞, 王惠琴. 医疗器械相关性压疮的研究现状. 护理与康复, 2016, 15(10): 946-949.
9. Willock J, Harris C, Harrison J, et al. Identifying the characteristics of children with pressure ulcers. Nurs Times, 2005, 101(11): 40-43.
10. Visscher M, Taylor T. Pressure ulcers in the hospitalized neonate: rates and risk factors. Sci Rep, 2014, 4: 7429.
11. Coyer FM, Stotts NA, Blackman VS. A prospective window into medical device-related pressure ulcers in intensive care. Int Wound J, 2014, 11(6): 656-664.
12. Apold J, Rydrych D. Preventing device-related pressure ulcers: using data to guide statewide change. J Nurs Care Qual, 2012, 27(1): 28-34.
13. 刘亚红, 李婷, 付成成, 等. ICU 医疗器械相关性压疮的原因分析及对策. 中华现代护理杂志, 2014, 20(11): 1252-1254.
14. 胡军, 王秀锋, 李玉环, 等. 压疮分期与危险因素的研究及预防进展. 上海护理, 2011, 11(2): 69-72.
15. Defloor T. The risk of pressure sores: a conceptual scheme. J Clin Nurs, 1999, 8(2): 206-216.
16. 徐玲. 住院患者压疮现患率的多中心联合横断面调查研究. 南京: 南京中医药大学, 2012.
17. Fauroux B, Lavis JF, Nicot F, et al. Facial side effects during noninvasive positive pressure ventilation in children. Intens Care Med, 2005, 31(7): 965-969.
18. García-Molina P, Balaguer-López E, García-Fernández FP, et al. Pressure ulcers’ incidence, preventive measures, and risk factors in neonatal intensive care and intermediate care units. Int Wound J, 2018, 15(4): 571-579.
19. 程莉萍, 董建英, 雷娜, 等. NICU 患儿压疮预防护理进展. 中华现代护理杂志, 2014, 20(20): 2590-2592.
20. Newnam KM, McG rather JM, Estes T, et al. An integrative review of skin breakdown in the preterm infant associated with nasal continuous positive airway pressure. J Obstet Gynecol Neonatal Nurs, 2013, 42(5): 508-516.
21. Visscher MO, White CC, Jones JM, et al. Face masks for noninvasive ventilation: fit, excess skin hydration, and pressure ulcers. Respir Care, 2015, 60(11): 1536-1547.
22. 何利, 安如俊, 龙燕琼, 等. 新生儿液体渗漏后预防皮肤损害的临床观察. 实用预防医学, 2006, 13(5): 1321.
23. Irving V. Caring for and protecting the skin of preterm neonates. J Wound Care, 2001, 10: 253-256.
24. 金平, 赵红玲, 王珊丹. 新生儿压疮风险量表的编制和信效度分析. 中国实用护理杂志, 2016, 32(9): 682-684.
25. 余卓文, 顾莺. 危重患儿发生压疮的危险因素及评估进展. 护理研究, 2011, 25(2): 101-103.
26. 王娟, 张岚. 医疗设备相关压疮的发生原因及预防研究进展. 护理学杂志, 2015, 30(7): 100-102.
27. Schindler CA, Mikhailov TA, Kuhn EM, et al. Protecting fragile skin: nursing interventions to decrease development of pressure ulcers in pediatric intensive care. Am J Crit Care, 2011, 20(1): 26-34.
28. Murray JS, Noonan C, Quigley S, et al. Medical device-related hospital-acquired pressure ulcers in children: an integrative review. J Pediatr Nurs, 2013, 28(6): 585-595.
29. 彭均, 王颖. 压疮危险因素及护理干预的研究进展. 解放军护理杂志, 2010, 27(7A): 987-989.
30. Razmus I, Lewis L, Wilson D. Pressure ulcer development in infants: state of the science. J Healthc Qual, 2008, 30(5): 36-42.
31. Kottner J, Wilborn D, Dassen T. Frequency of pressure ulcers in the paediatric population: a literature review and new empirical data. Int J Nurs Stud, 2010, 47(10): 1330-1340.
32. 杨晓玲, 江湖, 蒲亨萍. 儿童医疗器械相关性压疮的护理研究进展. 上海护理, 2017, 17(4): 78-81.
33. 王皓月, 李红艳, 赵艳芳, 陈晓玉, 等. NICU 发生医疗设备相关压疮的原因及预防进展. 当代护士 (下旬刊), 2016(10): 19-22.
34. Makic MB. Medical device-related pressure ulcers and intensive care patients. J Perianesth Nurs, 2015, 30(4): 336-337.
35. 张颖, 孙一丹. 医疗器械相关性压疮的预防及护理现状. 天津护理, 2018, 26(1): 117-119.
36. 张翠凤, 李娅, 朱跟娣. " 鸟巢”式护理在早产儿临床中的应用. 国际护理学志, 2011, 30(11): 1663-1664.
37. Quigley S, Curley M. Skin integrity in the pediatric population; preventing and managing pressure ulcers. J Soc Pediatr Nurs, 1996, 1(1): 7-18.
38. Curley MAQ, Quigley SM, Lin M. Pressure ulcers in pediatric intensive care: incidence and associated factors. Pediatr Crit Care Med, 2003, 4(3): 284-290.
39. Curley MAQ, Hasbani NR, Quigley SM, et al. Predicting pressure injury risk in pediatric patients: the Braden QD Scale. J Pediatr, 2018, 192: 189-195.
40. 陆晔峰, 楼建华, 陆秀文. 2 种压疮评估量表在患儿中的应用研究. 中国实用护理杂志, 2010, 26(11): 41-43.
41. Noonan C, Quigley S, Curley MA. Using the Braden Q Scale to predict pressure ulcer risk in pediatric patients. J Pediatr Nurs, 2010, 26(6): 566-575.
42. Gray M. Which pressure ulcer risk scales are valid and reliable in a pediatric population?. J Wound Ostomy Continence Nurs, 2004, 31(4): 157-160.
43. 韩雪馨, 许红梅, 于秀荣, 等. 儿童压疮风险评估工具临床应用的研究进展. 中国实用护理杂志, 2015, 31(33): 2572-2574.
44. Resar R, Pronovost P, Haraden C, et al. Using a bundle approach to improve ventilator care processes and reduce ventilator associated pneumonia. J Qual Patient Saf, 2005, 31(5): 243-248.
45. 汪丽平, 鲁琦, 张海玲. 新生儿皮肤风险评估护理记录单在预防 NICU 危重患儿压疮中的应用. 国际护理学杂志, 2014, 33(11): 3152-3153.
46. 黄艳, 王小红, 王媛. 压疮风险因素评估量表在儿科中的应用进展. 齐鲁护理杂志, 2011, 17(17): 46-47.
47. 罗婵, 梁绮镰, 温宋佳, 等. 新生儿压疮风险评估量表的临床应用. 全科护理, 2018, 16(17): 2067-2070.
48. 冯新荣, 薛虹, 白亚莎. 新生儿压疮风险评估量表的设计与应用效果. 天津护理, 2015, 23(5): 423-424.

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