Hospitalized Pediatric Patients: Risk Factors Related to the Development of Immobility-Related and Medical Device-Related Pressure Injuries

GENERAL PURPOSE To review risk factors for the development of medical device-related and immobility-related pressure injuries in hospitalized pediatric patients. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will be better able to: 1. Describe trends in pressure injuries (PIs) for hospitalized pediatric patients as summarized in current literature. 2. Identify risk factors predictive of medical device-related and immobility-related PIs in hospitalized pediatric patients. 3. Summarize the methodology used to understand risk factors for developing PIs in the hospitalized pediatric patient population. ABSTRACT OBJECTIVE To determine the pressure injury (PI) risk factors associated with medical devices and immobility in varied ages of the pediatric population and determine if there is an association between medical devices, immobility, and PI development. METHODS A retrospective study was performed on an established PI database with medical records reviewed for accuracy. The sample consisted of 799 children who developed a PI at a pediatric hospital in the upper Midwestern US. Multivariate logistic analyses were conducted to determine PI risk factors associated with medical devices and immobility in the pediatric population by age. RESULTS Five risk factors were predicative of a medical device-related PI for the entire sample; additional risk factors were specific to individual ages. Conversely, only one risk factor was statistically significant for predicting immobility-related PI in the total sample: decreased sensory perception (P = .035). Immobility was not associated with the development of medical device-related PIs. CONCLUSIONS Medical devices and immobility remain a major concern in relation to their propensity to cause PIs in hospitalized pediatric patients. Although this vulnerable population is beginning to garner more attention in the literature, the standard is to use adult PI risk factors for the pediatric population. Adult risk factors do not always equally translate to the hospitalized pediatric patient; however, clinicians use this “measuring stick” because research extricating the differences between these populations is limited. Understanding the unique PI risk factors in the pediatric population is key to preventing PIs among these patients.