Application of a pressure area risk calculator in an intensive care unit.

This study describes the use of a pressure area risk calculator designed specifically for intensive care (ICU) patients; the calculator used was that developed by Cubbin & Jackson (1991) (Table 1). This scale is a modified Norton scale with lower scores indicative of increased risk of pressure sore formation. The unit on which this study was undertaken is a six-bedded general adult ICU. A highly significant difference in lowest recorded scores was found between the group of patients who developed pressure sores compared with the group that did not (Mann-Whitney test, p < 0.01). The differences in scores between the two groups suggest that the calculator was measuring something useful, but it should be stressed that 40% (n = 100) of patients had scores below the threshold value and did not develop scores. Risk calculations were decisive in increasing the profile of pressure area care within the ICU and for this reason alone their use can be justified. There was a pressure sore incidence of 13% with 7% of patients having sores prior to admission to the ICU. Of the sores that were noted the commonest sites to be affected within intensive care were heels. The sacrum was the commonest site for sores that had occurred prior to admission. Pressure sore incidence can prove a useful audit tool in the management of pressure area care in intensive care, but variations in incidence over time must be examined with caution.