Pediatric Pressure Ulcer Prevalence: A Multicenter, Cross-Sectional, Point Prevalence Study in Switzerland

Pressure ulcers (PUs) are a common concern for hospitalized children and adults, but knowledge about PU risk factors, prevalence, and incidence rates among children remains limited. To assess the prevalence of and risk factors for PUs in pediatric care settings, a 1-day cross-sectional study was conducted among all hospitalized children ages 0 to 18 years in all 14 pediatric hospitals in the German-speaking part of Switzerland. Data collection involved a direct systematic inspection and assessment of the skin. A standardized data collection instrument was used, and each patient was assessed by a previously instructed rater pair. The total number of participating children was 412 (75% of all hospitalized children). An overall PU prevalence of 35% (including European Pressure Ulcer Advisory Panel category 1 ulcers) was observed. Most patients with PUs (80%) had category 1 ulcers. The prevalence rate was highest among patients in the pediatric intensive care unit (PICU) (16/36, 44%), followed by the department of neonatology (47/109, 43%). The presence of a PU was significantly higher among patients with a medical device, who were young (<1 year old), had a longer length of stay, and low Braden scale score (P <0.05). Rates also varied by institution (P <0.05). Department, patient age, Braden scale score, and institution explained 25% of the variance in PU prevalence. The prevalence of PUs in pediatric patients is higher than expected, and the rate of category 1 PUs suggests that interventions to prevent PUs are needed, especially in the high-risk patients identified. Future studies are needed to further assess these risk factors, especially for patients in PICUs.