Auditoria do cuidado para prevenção da lesão por pressão em pessoas com mobilidade prejudicada

Abstract

Introduction: Pressure injury (PI) is a bodily damage that occurs in the skin or adjacent tissues, primarily affecting individuals with impaired mobility. It commonly develops in areas with bony prominences or underneath medical devices. Prevention of pressure injuries is a crucial activity and is defined as the sixth international patient safety goal. Despite its importance, a lack of essential care is often observed in clinical practice, characterized by care omissions. In this perspective, nursing care audit is a potential activity to contribute to the improvement of preventive care for pressure injuries. Objective: To estimate the rate of care omissions for pressure injury prevention in patients admitted to Intensive Care Units (ICUs) within a hospital complex located in the state of Minas Gerais, Brazil. Method: This is an observational, crosssectional, descriptive, and documentary study conducted in four ICUs of a public hospital complex that is 100% funded by the Unified Health System (SUS) and administered by a parastate organization in Minas Gerais. The study was carried out from June 2022 to April 2023, and data were collected by extracting information from the audit records of the specialized wound prevention and treatment service of the hospital complex. Results: A total of 215 patients participated in this study, with the majority being male (61.9%). The risk of developing pressure injuries was stratified using the Braden Scale in the audit. Regarding nursing care for pressure injury prevention, it was found that the majority of patients received preventive care. However, actions such as proper skin hygiene, appropriate use of adhesives, and adequate fixation of medical devices were the most commonly omitted care practices. The overall care omission rate was 25.6%, and the omission rate for the set of care measures aimed at complete package of preventive care in each patient was 70.6%. There were statistically significant associations between proper skin hygiene and adequate skin hydration (p=.021), use of specialized mattresses (p=.032), appropriate fixation of medical devices (p=.012), and skin inspection upon admission (p=.042).Conclusion: It was found that there are omissions in all preventive actions, with particular emphasis on skin hygiene, with a nursing care omission rate of 70.6% in one or more components of care when evaluating the application of the care package as a whole in each patient.