الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Disruption of skin integrity, commonly called skin breakdown, is a
constant peril for the hospitalized or bedridden critically ill children.
Breakdown occurs when the skin is torn by friction or when continuous
pressure against the skin causes local tissue ischemia. Ischemic tissue
. deteriorates causing skin opening. Thus, constant safeguards are
necessary to prevent skin breakdown.
Critically ill children are more vulnerable for pressure sore
development due to several factors namely; altered nutrition, impaired
circulation, elevated body temperature, anemia, mental deterioration,
physical dependence, immobility, incontinence, surgery and medications.
Furthermore, neurological disorders that affect sensation also result in
greater risk of ulcer formation. In addition to children’s weight and age.
Prevention. Of pressure sores should be a -priority m caring, for
critically ill children and should not be limited to critically ill children
with restricted mobility. A key approach to prevent pressure sores lies in
the prediction of their occurrence in high risk critically ill children
admitted to the ICV. This approach implies that identification of critically
ill children at risk would lead to initiation of preventive strategies and
demands that systemic risk assessment procedures should be established
within hospitals. Moreover, critical care nurses should ensure that
meticulous pressure sores prevention measures are incorporated in the
•..
plan of care’ The aim of this study was to determine the effect of pressure-
relieving interventions on the occurrence of pressure sores among
critically ill children.
The sample of this study consisted of 2 groups: group I consisted
• 30 critically ill children admitted to the emergency recovery room and
- the intensive care units and meeting the following criteria: up to 16 years
old, bed ridden and free from bed sores on admission and receiving the
routine nursing care (control group). group II consisted of 30 critically
ill children meeting the same criteria as group I (studied group).
Two tools were used in this study:
Tool I consisted of a structured observation sheet used to assess critically
ill children’s conditions comprising 3 parts: Part 1 consists of critically ill
children’s characteristics. Part 2 comprises the Modified Braden Q
pressure ulcer risk assessment scale used to assess pressure sore risk in
children. Part 3 entails the pressure sore status tool used to assess
children’s skin condition for site, size and severity of any skin breakdown.
Tool 11 includes the developed nursing interventions pressure-relieving
measures for the prevention of pressure sore among critically ill children.
Findings of the present study revealed that 80% of the control group
were boys and 20% girls, compared to 66.66% and 33.33% of the studied
group. All the children had head trauma. As regards critically ill children’s
age, 56.67% were between 11 and 16 years and 43.33% were less than 11
years for the control group, compared to 800/0 and 200/0 for the studied
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group. Regarding their level of consciousness, it was noted that 66.67% of
the children were unconscious, 30% were semi-conscious and only 3.33%
were conscious for the control group compared to 36.67% and 63.33% for
the studied group while none of the children were conscious.
In relation to the hospital length of stay, it can be observed that,
43.33% of the children stayed in the hospital for more than 8 weeks, and
oly 10% for less than 8 weeks for the control group, compared to
36.67% respectively who stayed for more than 8 weeks and 100/0 for less
than 8 weeks for the studied group.
It was noted that the highest risk factors for pressure sore
formation was immobility, since all the children in the sample were
immobile, followed by the decrease in the level of consciousness which
were noticed by almost all the sample 96.66% and 100% respectively for
the control and studied groups. Moreover, sensory loss was observed by
90% of the control group and 93.33% of the studied group. However,
none of the children were incontinent.
It was observed that, the mean Braden Q Pressure Sore Risk
Assessment scale was 13.4±1.28 on admission, and increased to
16.3±2.37 respectively in the first and third week for the control group.
Moreover, the Braden scale increased significantly in the studied group,
as it was 13.57±2.3 on admission, and increased to 18.5±0.62 in the first
and third week.
It was noticed that the elbows were the highest pressure sore site
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for the control group as it was present in all critically ill children,
followed by the ears, the heel, the sacrum and the scapula, while the
lowest pressure sore sites were the trochanter and the medial knee. On the
other hand, the sacrum was the highest pressure sore site for the studied group followed by the ischium , the trochanter and the ears. While the lowest pressure sore sites were the sole and the lateral edge of the foot 3.34% respectively.