Search

Introduction. The incidence of a pressure ulcer in intensive care units (ICU) is significantly higher than in noncritical care settings. The patients in the ICU are the most vulnerable group to disruption of the skin’s integrity. Prior studies in Ethiopia failed to evaluate pressure ulcers in intensive care units and were limited to general wards. The purpose of this study was to identify the incidence and predictors of pressure ulcers in adult patients admitted to intensive care units in Southern Ethiopia. Methods. A single-arm prospective open cohort of 216 patients was used to determine the presence of a pressure ulcer in the intensive care units from June 2021 to April 2022. A consecutive sampling was used until the sample size was reached. The data were collected using a structured questionnaire and analyzed using Stata 14. A cumulative incidence of a pressure ulcer was computed. The life table was used to estimate the cumulative survival. A multivariable Cox proportional hazard regression was used to identify independent predictors of a pressure ulcer. An adjusted hazard ratio with a 95% CI was used to measure the degree of association; a P value ≤ 0.05 was considered significant. Results. Twenty-five patients developed a pressure ulcer (PU), making a cumulative incidence of 11.57%. Out of 25 incident cases of pressure ulcers, four-fifths (80%) of the study patients developed PU within 6 days of their admission to the ICUs. The incidence rate was 32.98 PU per 1000 person-days of ICU stay. Pressure ulcers were most commonly found on the sacrum, followed by the shoulder. Among the incident cases, 52% were stage 2 ulcers. The presence of friction or shearing forces, as well as being 40 years of age or older, was independently associated with pressure ulcers. Conclusion. The overall cumulative incidence of the pressure ulcer was lower than that in other studies but occurred at a faster rate. Age (40 years of age or older) and the presence of friction or shearing forces were the main predictors of pressure ulcers in the intensive care units. Therefore, nurses working in ICUs should continually anticipate the risk of a pressure ulcer. Moreover, special attention should be given to patients of advanced ages. Furthermore, monitoring the installation of a mattress, keeping bed linens unwrinkled, and keeping patients in a proper position on a bed to prevent or reduce friction or shearing forces are very crucial in the prevention of pressure ulcers.

Background. Pediatric surgical situations are often disregarded around the world, particularly in developing countries. The number of children hospitalized for surgical reasons has climbed dramatically. There is extensive research on the management outcome of pediatric surgical admissions in industrialized countries, but developing countries have paid little attention to it. Furthermore, to the best of the authors’ knowledge, there has been no research in the study area on the management outcome of pediatric surgical patient admission. Objective. To assess management outcome and factors associated with pediatric surgical patients admitted to Arbaminch General Hospital, Southern Ethiopia, 2021. Method. An institution-based retrospective cross-sectional study design was employed among 265 children with surgical problems. Data were collected from patients’ medical records using pretested data collection checklist. Epi Data 4.2 was used to enter data, and data were exported to SPSS version 25 for analysis. Those variables with P -value ≤0.25 in bivariable analysis were entered into multivariable logistic regression analysis, and statistical significance was declared at P < 0.05 . Result. A total of 265 surgically admitted children were included in this study. About 26% of study subjects were discharged with unfavorable management outcome. Children admitted due to trauma cause (AOR: 5.753, 95% CI: 2.366–13.987), children with a preexisting medical condition (AOR: 3.240, 95% CI: 1.436–7.310), children with an early complication (AOR: 2.515, 95% CI: 1.130–5.599), presenting to hospital ≥24 hr after the onset (AOR:8.351, 95% CI: 2.089–33.381), hospital stay >7 days (AOR: 10.671, 95% CI: 1.363–83.546), and children treated with surgery (AOR: 2.742, 95% CI: 1.137–6.611) were associated with unfavorable management outcome. Conclusion and recommendations: Twenty-six percent of patients were discharged with unfavorable outcome. Reasons for admission, preexisting medical condition, early complications, duration of hospital presentation, length of hospitalization, and type of management were all linked to the outcome of pediatric surgical admission. To have a good outcome, early identification and treatment of the cause are required, as well as well-equipped surgical care centers.