Pressure Injury Prevalence and the Rate of Hospital-Acquired Pressure Injury Among Pediatric Patients in Acute Care

J Wound Ostomy Continence Nurs. Mar/Apr 2017;44(2):110-117. doi: 10.1097/WON.0000000000000306.


Purpose: The purpose of this study was to describe the prevalence and rate of hospital-acquired pressure injuries (HAPIs) in pediatric patients.

Design: Descriptive, secondary analysis of 2012 data on pressure injuries among pediatric patients from the National Database for Nursing Quality Indicators (NDNQI).

Subjects and setting: The sample included 39,984 patients 1 day to 18 years old from 678 pediatric acute care units (general pediatrics, pediatric critical care, neonatal intensive care, pediatric step-down, and pediatric rehabilitation units) in 271 US hospitals that submitted pressure injury data to the NDNQI for at least 3 quarters during 2012.

Results: The pressure injury prevalence was 1.4% and the prevalence of HAPI was 1.1%. The rate of HAPI among males was 1.06%, and the rate among females was 1.14%. HAPI rates were highest among children ages 9 to 18 years (1.6%) and 5 to 8 years (1.4%) and lowest among patients 1 to 30 days of age (0.72%). By unit type, HAPIs were highest among patients in pediatric critical care units (3.7%) and pediatric rehabilitation units (4.6%) and lowest in general pediatrics units (0.57%). Most of the HAPIs were Stage 1 and Stage 2 (65.6%); 14.3% were deep tissue pressure injuries and 10.1% were unstageable pressure injuries.

Conclusion: Acutely ill children develop pressure injuries, including HAPI. Study findings provide data on HAPI from a large sample of hospitalized children and by pediatric unit type for comparison purposes.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Iatrogenic Disease*
  • Infant
  • Infant, Newborn
  • Inpatients / statistics & numerical data
  • Intensive Care Units, Neonatal / organization & administration
  • Intensive Care Units, Pediatric / organization & administration
  • Male
  • Pediatrics / standards
  • Pediatrics / statistics & numerical data
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / nursing
  • Prevalence*
  • Quality Indicators, Health Care / statistics & numerical data
  • Treatment Outcome
  • United States / epidemiology