• Deborah Bly, Marilyn Schallom, Carrie Sona, and Dean Klinkenberg.
• Deborah Bly is a staff nurse in the medical intensive care unit, Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research for Patient Care Services, Carrie Sona is a clinical nurse specialist in the surgical intensive care unit, and Dean Klinkenberg is lead statistical analyst in the Department of Research for Patient Care Services, Barnes-Jewish Hospital at Washington University, St Louis, Missouri. dcb9106@bjc.org.
• Am. J. Crit. Care. 2016 Mar 1; 25 (2): 156-64.

BackgroundAlthough most intensive care patients are at risk for pressure ulcers, not all experience such ulcers.ObjectiveTo examine a model of variables related to extrinsic and intrinsic pressure on skin and underlying tissues, oxygenation, perfusion, and baseline comorbid conditions to identify risk factors associated with pressure ulcers in critically ill adults.MethodA retrospective chart review was conducted on patients identified by weekly rounds from January 2010 through October 2010 to determine the prevalence of pressure ulcers. Variables were analyzed via bivariate analysis and logistic regression for unit-acquired pressure ulcers.ResultsData on 345 patients with 436 intensive care admissions were reviewed. Variables were significant in each model category at P < .05. In the regression analysis of first admission only (n = 306), the model was significant (P < .001) and yielded correct classification of 86.3% of patients. For all intensive care admissions (n = 391), the model was significant (P < .001) and yielded correct classification of 83.9% of patients. In both models, 4 of the same variables were significant: any transport off the unit, number of days to bed change, systolic blood pressure less than 90 mm Hg, and use of more than 1 vasopressor. History of pulmonary disease and presence of a feeding tube were also significant in regression analyses.ConclusionsSeveral variables within the model of pressure, oxygenation, and perfusion were significantly associated with development of pressure ulcers.©2016 American Association of Critical-Care Nurses.

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