A pre-post study evaluating the effectiveness of a new initiative, the “PRESSURE Bundle,” Compared with standard care in reducing the incidence and prevalence of sacral pressure ulcers in Critically Ill Patients in an intensive care unit in Riyadh, Saudi Arabia

Abstract

Objective: Pressure ulcers present a major health challenge worldwide, and critically ill patients are considered to be at the greatest risk for pressure ulcer development. A study was undertaken to evaluate the effectiveness of pressure ulcer prevention measures (“PRESSURE bundle”) compared with standard care in reducing the incidence and prevalence of sacral pressure ulcers in critically ill patients in an Intensive Care Unit (ICU) in Riyadh, Saudi Arabia. Methods: Patients were assigned to the standard care group (n = 330) or the “PRESSURE bundle” group (n = 360). The follow-up period for both treatment groups was 2 months. A pre-post study design was used where data were collected in two samples. Patients were aged 16 years or over and included all new patients admitted to the ICU who did not have but were considered at risk of developing, sacral pressure ulcers (Braden scale score <18). Results: In the PRESSURE care bundle group, there was a significant reduction (P < 0.001) in the incidence of newly developed sacral pressure ulcers in the 2 months treatment period (n = 1, 0.3%) compared with the standard care group (n = 16, 4.6%). There was also a significant reduction (P < 0.001) in the prevalence of sacral pressure ulcers in the PRESSURE care bundle group (4.75%) compared with the standard care group (22.7%) when prevalence figures were compared at the end of the treatment periods. Conclusion: The application of a group of pressure ulcer prevention measures (“PRESSURE bundle”) coincided with a reduction in incidence and prevalence of sacral pressure ulcers in critically ill patients who are at risk for developing pressure ulcers.