Intrinsic and Extrinsic Risk Factors for Nosocomial Pressure Injury among Hospitalized Adults at a Tertiary Hospital in Western Kenya

Abstract

The high incidence and prevalence of nosocomial pressure injuries pose a threat to safe hospitalization and additional strain on the healthcare system. Analysis of pressure injury risk factors is necessary for efficient prevention and management as part of the program to ensure that no patient experiences any preventable harm while receiving care, as per the international patient safety goals. This study evaluated the intrinsic and extrinsic risk factors for pressure injury among cohorts of hospitalized adults using a prospective approach. The Braden Scale was used to assess the participants’ level of risk and classify low (score 15 to 23) and high (score 6 to 14) cohorts prior to follow-up. Binary regression analysis was used to establish an association between the risk factors and the development of stage 2 and above pressure injuries and the odds reported. The intrinsic factors—nutrition, sex, age, and primary diagnosis—influenced the occurrence of pressure injuries. Similarly, the extrinsic factors—sensory perception, moisture, mobility and activity, presence of a medical device, friction, and shear—showed an association with the development of pressure injuries. Poor nutrition, impaired mobility, and persistent moisture, however, were statistically the most significantly associated risk factors, at OR 18.20, CI 2.18–151.69, p =.01; OR 20.93, CI 1.13–387.92, p =.04; OR 16.11, CI 2.02–128.52, p =.01, respectively, confirming a significant association between intrinsic and extrinsic risk factors and the development of hospital-acquired pressure injury. These identified risk factors can be used to tailor intervention earlier on admission and avert these preventable injuries. Standardized, timely risk assessment and proactive addressing of the identified risk factor among hospitalized patients are therefore recommended.