Efectiveness of Additional Measures for the Prevention of Pressure Injuries in an Intensive Care Unit: A Retrospective Cohort Study

Background/Objectives: Pressure injuries (PI), an indisputable indicator of the quality of care, have a higher incidence in Intensive Care Units (ICU). Our objective was to determine whether the "unprotected" patient, after applying additional protective measures, developed PI. Method: Historical cohort study in an adult ICU. Of the 811 patients admitted in 2022, 400 were selected. All of them were subjected to the ICU PI Prevention Protocol, and additionally, those with a moving average of the COMHON Index ≥11were given two extra measures: multilayer dressing on the sacrum and anti-equinus and heel pressure-relieving boots. Results: 36 patients presented with PI (cumulative incidence of 9%). Significant differences were observed in the mean length of stay and in the disease severity score (APACHE-II). Most of the pressure ulcers were located on the sacrum, followed by the heel. Prior to the appearance of the PI, the sacral dressing was applied 100%, and the anti-equinus and heel pressure-relieving boots were only applied 58.3%. Of the 36 patients with PI, 52.8% had PI on the sacrum and 22.2% on the heel. Conclusions: focusing only on those who presented with PI, we observed that these measures were not effective in all patients to prevent PI. We should analyze the individual characteristics of these patients and verify if the Prevention Protocol was followed to determine how they could have been prevented or if they are the so-called unavoidable PI.