Factores asociados al desarrollo de lesiones en piel adquiridas durante hospitalización, en pacientes adultos que recibieron cuidado preventivo en piel
Thesis
Introduction: A significant problem for public health is the skin injuries related to health care, as they lead to severe problems that impact the quality of life of patients, family members, and caregivers; added to the critical economic and workload contribution for health teams and systems. These injuries are primarily preventable;however, despite the resources invested in the development of preventive measures, it is observed that the compliance usually changes, and sometimes the measures are not adequate, seeing that less than half of the patients at risk receive the suitable measures. Adequate prevention would improve the quality indicators of health institutions and the quality of life of patients, families, and caregivers. Objective: Determine the factors associated with the development of skin lesions acquired in hospitalization among patients participating in a preventive nursing care program between 2018 and 2020. Methodology: Analytical observational study of cases and controls, carried out in a fourth-level institution in Bogotá, including a period of 3 years, between 2018 and 2020. The medical records of patients over 18 years of age who were hospitalized in the institution and met the inclusion criteria were reviewed. Statistical analysis was performed using the SPSS tool. A univariate statistical analysis was performed using frequencies and proportions for categorical variables and median, maximum, and minimum for continuous variables (since they had a non-normal distribution). A comparison was made between the group of patients who developed a lesion (cases) and those who did not (controls) using Chi-square (X²) for categorical variables and the Mann-Whitney U test for continuous variables. A significant difference was declared for a value of p<0.05. The variables identified as potentially significant related to the incidence of skin lesions were evaluated using a logistic regression model. Results: The percent of skin lesions in the preventive program was 10.2%. The following variables were identified as risk factors: parenteral, enteral, and mixed nutrition, hospital stay (1.01 CI 95% 1.01 - 1.02), the use of dressing (6.43 CI 95% 2.86 – 14.46) and the use of hyperoxygenated fatty acids (2.92 CI 95% 1.24 – 6.85). As protective factor was identified the variable of mechanical ventilation (0.17 95% CI 0.04 - 0.74). Conclusions: This study showed a possible association between parenteral, enteral, and mixed nutrition, hospital stay, the use of dressings, and the use of hyperoxygenated fatty acids with the development of skin lesions. The protective factor of mechanical ventilation must be carefully analyzed.
