Risk Factors Related to the Development of Pediatric Pressure Injuries

Pressure injury (PI) development in hospital children poses a national concern. However, current PI prevention measures are based on risk factors for PI development in adults. (NPIAP, EPUAP, PPPIA, 2019). Children offer a unique concern for PI development as their bodies are in the process of developing and their skin responds differently to external pressure. Currently, only two published studies have assessed risk factors for PI development in children (Fuji et al., 2010; Schindler et al, 2011). This research explored risk factors for the development of full-thickness PIs and MDRPIs and for PI development over body locations in children aged 9́Þ28 weeks gestation - 21 years. The sample consisted of 799 children that developed a PI at an upper Midwest pediatric hospital. The results indicated differences in risk factors related to age, etiology, skin damage from pressure and body location. Multivariate analyses findings revealed that the risk factors for predicting a full-thickness PI included: 1) tissue perfusion and oxygenation: generalized edema and being in the OR (38 weeks gestation to 12 months), 2) malnutrition (38-week gestation - 12 months and total sample), 3) skin status: fragile (1 - 7 years), and 4) tissue perfusion and oxygenation: decreased oxygenation and ECMO (8 - 21 years old and total sample). Risk factors for a MDRPI included: 1) being in the OR (38-weeks to 12 months, ages 1 - 7 years and total sample), 2) decreased sensory perception (1 - 7 years old, total sample), 3) moisture (8 - 21 years, total sample) and 4) low hemoglobin, malnutrition, and skin dryness (total sample). Risk factors for a PI over the head and neck area included: 1) fragile skin (9́Þ28-week gestation, total sample), 2) immobility (38-weeks - 12 months), 3) medical devices and critical illness (8 - 21 years), and 4) decreased sensory perception (8 - 21 years, total sample). Risk factors for a PI in the pelvic region include: 1) full-thickness PI (38-week - 12 months, 2) critical illness (1 - 7 years), 3) immobility-related PI (1 - 7 years, 8 - 21 years, total sample). The results will assist in developing PI prevention measures for the pediatric population.