Methods: A prevalence study was conducted over a 12-hour period in a 274-bed Children’s Hospital in the southwest.  The Braden Q Scale for Predicting Pressure Ulcer Risk is a sensitive scale for predicting children at risk for pressure ulcer development (Curley, Quigley & Lin, 2003), and was used to evaluate risk among hospitalized neonatal and pediatric patients.  Demographic and clinical information was collected and physical assessments were conducted to determine the presence of pressure ulcers and alterations in skin integrity.  The National Pressure Ulcer Advisory Panel staging system (2003) was used to stage areas of skin alteration.  Bed surface and documented skin care practices were also collected.

Results: Of 222 children evaluated (99% of those hospitalized), two Stage I pressure ulcers were found. No ulcers more severe than a Stage I were noted. The Braden Q scores, skin assessment, clinical documentation and skin care practices were compared across groups.  Differences noted and skin integrity alterations will be presented.  An algorithm for guiding skin care practices was developed.  Conclusions:  Skin care practices and the use of a risk assessment scale can be used to guide the development of an algorithm to prevent pressure ulcer formation. Use of an evidence-based algorithm to guide nursing practice will reduce practice variation and decrease the risk of compromise to skin integrity.  

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