Pressure injury prevention measures in pediatric wards: nursing professionals' actions




Patient Safety; Quality of Health Care; Pressure Ulcer; Pediatrics; Nursing.


Objective: to classify the quality of nursing care and analyze the association between professionals' characteristics and the implementation of preventive measures for pressure injuries in hospitalized children. Methods: this observational, cross-sectional study involved 235 nursing professionals. The Pressure Injury Prevention instrument comprised three domains with a total of 23 items: Preventive measures and early detection of pressure injuries (9 items), Pressure relief measures (8 items), and Assessment and reporting (6 items), analyzed using the Positivity Index for Quality of Care. Results: Most participants were females (98.7%), with a mean age of 38.83 ± 9.94 years, nursing technicians (57.4%), and had more than five years of experience (77.1%). Nursing care was predominantly inadequate across all three domains, with 82.6% of actions rated as poor. Significant associations were found between "participation in training courses" and "work-related exhaustion". There was a trend towards increased compliance with measurements among professionals aged 31-40. Conclusion: nursing care was predominantly poor and participation in training courses and the presence of exhaustion were associated with better adherence to preventive measures. Contributions to practice: the study highlights the pressing need for investments in professional training and the provision of necessary resources to support high-quality and safe nursing care.


Gupta P, Shiju S, Chacko G, Thomas M, Abas A, Savarimuthu I, et al. A quality improvement programme to reduce hospital-acquired pressure injuries. BMJ Open Qual. 2020;9(3):e000905. doi:

European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide [Internet]. 2019 [cited Jan 5, 2023]. Available from:

Tschannen D, Anderson C. The pressure injury predictive model: a framework for hospital‐acquired pressure injuries. J Clin Nurs. 2020;29(7-8):1398-421. doi:

Kriesberg CP, Little JM, Mohr L, Kato K. Reducing pressure injuries in a pediatric cardiac care unit: a quality improvement project. J Wound Ostomy Continence Nurs. 2018;45(6):497-502. doi:

Neta APR, Cavalcante TB, Lima ABS, Maciel SM, Miranda SM, Sousa ARA. Epidemiological and clinical characterization of children with pressure injuries. Rev Enferm Atual In Derme. 2018;86(24):1-9. doi:

Bargos-Munarriz M, Bermúdez-Pérez M, Martínez-Alonso AM, García-Molin P, Orts-Cortés MI. Prevention of pressure injuries in critically ill children: a preliminary evaluation. J Tissue Viability. 2020;29(4):310-8. doi:

Rodrigues CBO, Prado TN, Nascimento LCN, Laignier MR, Primo CC, Bringuente MEO. Management tools in nursing care for children with pressure injury. Rev Bras Enferm. 2020;73(Supl 4):e20180999. doi:

Rebouças RO, Belchior AB, Marques ADB, Figueiredo SV, Carvalho REFL, Oliveira SKP. Quality of care in an intensive care unit for the prevention of pressure injuries. Estima. 2020;18:e3420. doi:

Ferreira MKM. Construção e validação do instrumento prevenção de lesão por pressão na pediatria [Internet]. 2018 [cited Jan 5, 2023]. Available from:

Haddad MCL, Évora YDM. Qualidade da assistência de enfermagem: a opinião do paciente internado em hospital universitário público. Ciênc Cuid Saúde. 2008;7(Supl 1):45-52. doi:

Sandoval LJS, Lima FET, Barbosa LP, Pascoal LM, Almeida PC, Moran YL. Professional performance in the administration of medicines in pediatrics: a study cross-sectional observational. Rev Bras Enferm. 2022;75(3):e20200299. doi:

Lotfi M, Zamanzadeh V, Valizadeh L, Khajehgoodari M. Assessment of nurse–patient communication and patient satisfaction from nursing care. Nurs Open. 2019;6(3):1189-96. doi:

Williams LJ, Waller K,Chenoweth RP, Ersig AL. Stakeholder perspectives: communication, care coordination and transitions in care for children with medical complexity. J Spec Pediatr Nurs. 2021;26(1):e12314. doi:

Li Z, Marshall AP, Lin F, Ding Y, Chaboyer W. Pressure injury prevention practices among medical surgical nurses in a tertiary hospital: an observational and chart audit study. Int Wound J. 2022;19(5):1165-79. doi:

Curley MAQ, Hasbani NR, Quigley SM, Stellar JJ, Pasek TA, Shelley SS, et al. Predicting pressure injury risk in pediatric patients: the Braden QD Scale. J Pediatr. 2018;192:189-95.e2. doi:

Stellar JJ, Hasbani NR, Kulik LA, Shelley SS, Quigley S, Wypij D, et al. Medical device–related pressure injuries in infants and children. J Wound Ostomy Continence Nurs. 2020;47(5):459-69. doi:

Cummins KA, Watters R, Leming-Lee T. Reducing pressure injuries in the Pediatric Intensive Care Unit. Nurs Clin North Am. 2019;54(1):127-40. doi:

Gonçalves KMM, Costa MTTCA, Silva DCB, Baggio ME, Corrêa AR, Manzo BF. Ludic strategy for promoting engagement of parents and caregivers in the safety of pediatric patients. Rev Gaúcha Enferm. 2020;41:e20190473. doi:

Gaita MC, Fontana RT. Perceptions and knowledges about pediatric patient safety. Esc Anna Nery. 2018;22(4):e20170223. doi:

Biasibetti C, Hoffmann LM, Rodrigues FA, Wegner W, Rocha PK. Communication for patient safety in pediatric hospitalizations. Rev Gaúcha Enferm. 2019;40(esp):e20180337. doi:

Ferreira MKM, Gurgel SS, Lima FET, Cardoso MVLML, Silva VM. Instruments for the care of pressure injury in pediatrics and hebiatrics: an integrative review of the literature. Rev Latino-Am Enfermagem. 2018;26:e3034. doi:

Luo WJ, Zhou XZ, Lei JY, Xu Y, Huang RH. Predictive risk scales for development of pressure ulcers in pediatric patients admitted to general ward and intensive care unit. World J Clin Cases. 2021;9(35):10956-68. doi:

Pimenta CJL, Vicente MC, Ferreira GRS, Frazão MCLO, Costa TF, Costa KNFM. Health conditions and Nurses’ work characteristics at a university hospital. Rev Rene. 2020;21:e43108. doi:

Mondini CCSD, Cunha ICKO, Trettene AS, Fontes CMB, Bachega MI, Cintra FMR. Authentic leadership among nursing professionals: knowledge and profile. Rev Bras Enferm. 2020;73(4):e20180888. doi:

Zhang YB, He L, Gou L, Pei JH, Nan RL, Chen HX, et al. Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device–related pressure injury: a cross‐sectional study in western China. Int Wound J. 2021;18(6):777-86. doi:

Sari SP, Everink IHJ, Amir Y, Lohrmann C, Halfens JGR, Moore Z, Beeckman D. Knowledge and attitude of community nurses on pressure injury prevention: a cross‐sectional study in an Indonesian city. Int Wound J. 2021;18(4):422-31. doi:

Souza ACB, Vieira SAM, Cavalcante PP. Patient safety and medication errors: a literature review. Sci Elec Arch. 2018;11(3):128-35. doi:

Moreira AS, Lucca SR. Psychosocial factors and Burnout Syndrome among mental health professionals. Rev Latino-Am Enfermagem. 2020;28:e3336. doi:

Ramírez-Elvira S, Romero-Béjar JL, Suleiman-Martos N, Gómez-Urquiza JL, Monsalve-Reyes C, Cañadas-De la Fuente GA, et al. Prevalence, risk factors and burnout levels in intensive care unit nurses: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(21):11432. doi:



How to Cite

Ferreira, M. K. M., Lima, F. E. T., Diógenes, M. da S., Florencio, S. de S. G., Araújo, P. R., Almeida, P. C. de, & Costa, C. O. da. (2023). Pressure injury prevention measures in pediatric wards: nursing professionals’ actions. Rev Rene, 24, e83237.



Research Article

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 > >>