Quality and Outcomes Reports - Critical Care

Pressure Ulcers

Why we measure it - While any hospitalized child is at risk of getting a pressure ulcer (bed sore), children who are critically ill are at a higher risk. This is because of how sick the patients are and the kinds of treatments they need. By studying when and why these ulcers occur, we can reduce many of these risks. 

What this means - The two lines represent the two groups of pressure ulcers. The graphs shows the number of reported new pressure ulcers (Stage 1 through Stage 4 based on national guidelines, where Stage 4 is the most severe) for every 1,000 days in the Pediatric Intensive Care Unit.

About the data - Stage 1 or 2 pressure ulcers are more mild and are watched very carefully to prevent more serious injury. Stage 3 or 4 pressure ulcers are more serious skin injury. Unfortunately, there is no solid comparison group with which to compare our data. Prevention and early identification of potential pressure ulcers is an important part of providing quality care. It excludes patients who have pressure ulcers when they are admitted to the hospital. The increased rate of Stage 1 and 2 pressure ulcers shows we are catching them earlier and preventing the more severe Stage 3 and 4 ulcers. During this time period, we had no deep tissue injury.

Related dimensions of care:

What we're doing to provide the best care:

• Doctors and other staff at Children's Hospital of Wisconsin led a national effort with other hospitals to do a risk assessment and identify pressure ulcers as a high risk and preventable health care issue. This study identified the best treatments to reduce pressure ulcers. Using the results of this work, the team at Children's Hospital of Wisconsin developed an evidence-based pressure ulcer prevention bundle that significantly decreased pressure ulcers in the Pediatric Intensive Care Unit.
• The interdisciplinary pressure ulcer prevention team focuses on prevention, categorization and treatment in the PICU.

Patients and families:

• Be an advocate for your child. Participate in daily bedside clinical discussions. Provide any information about your child that may be helpful to staff.
• If you have a concern about your child's skin, please have your child's nurse contact a member of the pressure ulcer prevention team.

Referring physicians:

• Referring physicians can access our specialists for consultation or transport 24 hours a day. Call our physician referral line at (800) 266-0366.  
• Health care providers from outside of our southeastern Wisconsin service area are encouraged to use our web-based 
  e-Consult service. This service is available for non-urgent patient cases only and gives providers access to our specialists to review patient cases, obtain medical advice or second opinions, and receive care recommendations for rare symptoms and illnesses.
  e-Consult is not to be used by the general public, parents/guardians or families.
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If you have questions about this information, email us or call (414) 266-6556.