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Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Prevalence of pressure injury on the medical wards of public general hospitals in Kuwait: a national cross-sectional study

Authors: Talal ALFadhalah, Marjan Lari, Gheed Al Salem, Shaimaa Ali, Hamad Al Kharji, Hossam Elamir

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Pressure injury is a severe problem that can significantly impact a patient’s health, quality of life, and healthcare expenses. The prevalence of pressure injuries is a widely used clinical indicator of patient safety and quality of care. This study aims to address the research gap that exists on this topic in Kuwait by investigating the prevalence of pressure injuries and preventive measures on the medical wards of the country’s public general hospitals.

Methods

A cross-sectional research design was adopted to measure the point prevalence of pressure injuries on 54 medical wards in the public general hospitals. Data, including variables pertaining to hospitals, patients, pressure injuries and preventive practices, were collected using an online form. The data were processed and analysed using Microsoft Excel and SPSS 23 (α level = 0.05). Analysis provided an overview of patient, pressure injury characteristics and preventive measures, and the relationships between the patient and pressure injury characteristics and the prevalence of pressure injuries. A model for predicting the determinants of pressure injury prevalence was constructed from a linear regression analysis.

Results

The mean national prevalence of pressure injury was 17.6% (95% CI: 11.3–23.8). Purely community-acquired pressure injuries represent the majority of pressure injuries nationally (58.1%). Regarding preventive measures, “pressure injury assessment on admission” has been provided to 65.5% of patients. Correlation analysis revealed that the only statistically significant correlation with the prevalence of hospital-acquired pressure injury was “pressure injury assessment on admission”, which was strongly negative (ρ = −0.857). Therefore, this was the only variable included in the regression analysis as a predictor of pressure injury prevalence (Beta = 0.839). The results showed many statistically significant differences between hospitals with respect to the variables studied.

Conclusions

The national pressure injury prevalence is high compared to the global rate. The higher percentage of purely community-acquired pressure injuries requires particular attention. Many risk factors for the development of pressure injuries are public health concerns, and effective mitigating strategies are needed. Further research is required to assess the knowledge, attitude, and behaviour of nurses with respect to pressure injuries, and to evaluate preventive and management practices.
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Literature
1.
go back to reference Furtado KAX, Infante P, Sobral A, Gaspar P, Eliseu G, Lopes M. Prevalence of acute and chronic wounds– with emphasis on pressure ulcers– in integrated continuing care units in Alentejo, Portugal. Int Wound J. 2020;17:1002–10.PubMedPubMedCentralCrossRef Furtado KAX, Infante P, Sobral A, Gaspar P, Eliseu G, Lopes M. Prevalence of acute and chronic wounds– with emphasis on pressure ulcers– in integrated continuing care units in Alentejo, Portugal. Int Wound J. 2020;17:1002–10.PubMedPubMedCentralCrossRef
2.
go back to reference Davey CM. Pressure injuries. Wound Manag Prev. 2022;68:14–21. Davey CM. Pressure injuries. Wound Manag Prev. 2022;68:14–21.
3.
go back to reference Mondragon N, Zito PM. Pressure Injury. StatPearls. Treasure Island. FL, USA: StatPearls Publishing; 2023. Mondragon N, Zito PM. Pressure Injury. StatPearls. Treasure Island. FL, USA: StatPearls Publishing; 2023.
4.
go back to reference National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel., Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. 2nd edition. Osborne Park, Australia: Cambridge Media; 2014. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel., Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. 2nd edition. Osborne Park, Australia: Cambridge Media; 2014.
5.
go back to reference QAD. Incident Reporting Guidelines. 2nd edition. Kuwait city, Kuwait: Quality and Accreditation Directorate, Ministry of Health; 2015. QAD. Incident Reporting Guidelines. 2nd edition. Kuwait city, Kuwait: Quality and Accreditation Directorate, Ministry of Health; 2015.
6.
go back to reference Weller CD, Gershenzon ER, Evans SM, Team V, McNeil JJ. Pressure injury identification, measurement, coding, and reporting: key challenges and opportunities. Int Wound J. 2018;15:417–23.PubMedCrossRef Weller CD, Gershenzon ER, Evans SM, Team V, McNeil JJ. Pressure injury identification, measurement, coding, and reporting: key challenges and opportunities. Int Wound J. 2018;15:417–23.PubMedCrossRef
7.
go back to reference Lee T-T, Lin K-C, Mills ME, Kuo Y-H. Factors related to the Prevention and Management of pressure ulcers. CIN Comput Inform Nurs. 2012;30:489–95.PubMedCrossRef Lee T-T, Lin K-C, Mills ME, Kuo Y-H. Factors related to the Prevention and Management of pressure ulcers. CIN Comput Inform Nurs. 2012;30:489–95.PubMedCrossRef
8.
go back to reference Jiang L, Li L, Lommel L. Nurses’ knowledge, attitudes, and behaviours related to pressure injury prevention: a large-scale cross-sectional survey in mainland China. J Clin Nurs. 2020;29:3311–24.PubMedCrossRef Jiang L, Li L, Lommel L. Nurses’ knowledge, attitudes, and behaviours related to pressure injury prevention: a large-scale cross-sectional survey in mainland China. J Clin Nurs. 2020;29:3311–24.PubMedCrossRef
9.
go back to reference Padula WV, Pronovost PJ. Addressing the multisectoral impact of pressure injuries in the USA, UK and abroad. BMJ Qual Saf. 2018;27:171–3.PubMedCrossRef Padula WV, Pronovost PJ. Addressing the multisectoral impact of pressure injuries in the USA, UK and abroad. BMJ Qual Saf. 2018;27:171–3.PubMedCrossRef
10.
go back to reference Al Mutairi KB, Hendrie D. Global incidence and prevalence of pressure injuries in public hospitals: a systematic review. Wound Med. 2018;22:23–31.CrossRef Al Mutairi KB, Hendrie D. Global incidence and prevalence of pressure injuries in public hospitals: a systematic review. Wound Med. 2018;22:23–31.CrossRef
11.
go back to reference Gefen A. How much time does it take to get a pressure ulcer? Integrated evidence from human, animal, and in vitro studies. Ostomy Wound Manage. 2008;54:26–8.PubMed Gefen A. How much time does it take to get a pressure ulcer? Integrated evidence from human, animal, and in vitro studies. Ostomy Wound Manage. 2008;54:26–8.PubMed
12.
go back to reference Aghazadeh A, Lotfi M, Asgarpour H, Khajehgoodari M, Nobakht A. Frequency and risk factors of pressure injuries in clinical settings of affiliated to Tabriz University of Medical Sciences. Nurs Open. 2021;8:808–14.PubMedCrossRef Aghazadeh A, Lotfi M, Asgarpour H, Khajehgoodari M, Nobakht A. Frequency and risk factors of pressure injuries in clinical settings of affiliated to Tabriz University of Medical Sciences. Nurs Open. 2021;8:808–14.PubMedCrossRef
13.
go back to reference Braden B, Bergstrom N. A conceptual Schema for the study of the etiology of pressure sores. Rehabil Nurs J. 1987;12:8.CrossRef Braden B, Bergstrom N. A conceptual Schema for the study of the etiology of pressure sores. Rehabil Nurs J. 1987;12:8.CrossRef
14.
go back to reference Mervis JS, Phillips TJ. Pressure ulcers: pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019;81:881–90.PubMedCrossRef Mervis JS, Phillips TJ. Pressure ulcers: pathophysiology, epidemiology, risk factors, and presentation. J Am Acad Dermatol. 2019;81:881–90.PubMedCrossRef
16.
go back to reference Oner B, Zengul FD, Oner N, Ivankova NV, Karadag A, Patrician PA. Nursing-sensitive indicators for nursing care: a systematic review (1997–2017). Nurs Open. 2021;8:1005–22.PubMedCrossRef Oner B, Zengul FD, Oner N, Ivankova NV, Karadag A, Patrician PA. Nursing-sensitive indicators for nursing care: a systematic review (1997–2017). Nurs Open. 2021;8:1005–22.PubMedCrossRef
17.
go back to reference Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546.PubMedCrossRef Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: a systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546.PubMedCrossRef
18.
go back to reference Grešš Halász B, Bérešová A, Tkáčová Ľ, Magurová D, Lizáková Ľ. Nurses’ knowledge and attitudes towards Prevention of pressure ulcers. Int J Environ Res Public Health. 2021;18:1705.PubMedPubMedCentralCrossRef Grešš Halász B, Bérešová A, Tkáčová Ľ, Magurová D, Lizáková Ľ. Nurses’ knowledge and attitudes towards Prevention of pressure ulcers. Int J Environ Res Public Health. 2021;18:1705.PubMedPubMedCentralCrossRef
19.
go back to reference Ebi WE, Hirko GF, Mijena DA. Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design. BMC Nurs. 2019;18:20.PubMedPubMedCentralCrossRef Ebi WE, Hirko GF, Mijena DA. Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design. BMC Nurs. 2019;18:20.PubMedPubMedCentralCrossRef
20.
go back to reference Tervo-Heikkinen T, Heikkilä A, Koivunen M, Kortteisto T, Peltokoski J, Salmela S, et al. Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study. BMC Nurs. 2023;22:198.PubMedPubMedCentralCrossRef Tervo-Heikkinen T, Heikkilä A, Koivunen M, Kortteisto T, Peltokoski J, Salmela S, et al. Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study. BMC Nurs. 2023;22:198.PubMedPubMedCentralCrossRef
21.
go back to reference Jackson D, Hutchinson M, Barnason S, Li W, Mannix J, Neville S, et al. Towards international consensus on patient harm: perspectives on pressure injury policy. J Nurs Manag. 2016;24:902–14.PubMedCrossRef Jackson D, Hutchinson M, Barnason S, Li W, Mannix J, Neville S, et al. Towards international consensus on patient harm: perspectives on pressure injury policy. J Nurs Manag. 2016;24:902–14.PubMedCrossRef
22.
go back to reference Corbett LQ, Funk M, Fortunato G, O’Sullivan DM. Pressure Injury in a Community Population: a descriptive study. J Wound Ostomy Continence Nurs. 2017;44:221.PubMedCrossRef Corbett LQ, Funk M, Fortunato G, O’Sullivan DM. Pressure Injury in a Community Population: a descriptive study. J Wound Ostomy Continence Nurs. 2017;44:221.PubMedCrossRef
23.
go back to reference Kuwait Direct Investment Promotion Authority. 3- Key Sectors for opportunities. Investing in Kuwait: a guide for Investment opportunities in Kuwait. Kuwait city. Kuwait: KDIPA; 2021. p. 83. Kuwait Direct Investment Promotion Authority. 3- Key Sectors for opportunities. Investing in Kuwait: a guide for Investment opportunities in Kuwait. Kuwait city. Kuwait: KDIPA; 2021. p. 83.
24.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of Observational studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573–7.CrossRef von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of Observational studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573–7.CrossRef
25.
go back to reference Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018;18:305.PubMedPubMedCentralCrossRef Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018;18:305.PubMedPubMedCentralCrossRef
26.
go back to reference Chaudhary AK, Israel GD. The Savvy Survey #8: Pilot Testing and Pretesting Questionnaires. 2021. Chaudhary AK, Israel GD. The Savvy Survey #8: Pilot Testing and Pretesting Questionnaires. 2021.
27.
go back to reference Centers for Disease Control and Prevention. Checklist to Evaluate the Quality of Questions. 2018. Centers for Disease Control and Prevention. Checklist to Evaluate the Quality of Questions. 2018.
29.
go back to reference Borojeny LA, Albatineh AN, Dehkordi AH, Gheshlagh RG. The incidence of pressure ulcers and its associations in different wards of the hospital: a systematic review and meta-analysis. Int J Prev Med. 2020;11:171. Borojeny LA, Albatineh AN, Dehkordi AH, Gheshlagh RG. The incidence of pressure ulcers and its associations in different wards of the hospital: a systematic review and meta-analysis. Int J Prev Med. 2020;11:171.
30.
go back to reference Rondinelli J, Zuniga S, Kipnis P, Kawar LN, Liu V, Escobar GJ. Hospital-Acquired pressure Injury: risk-adjusted comparisons in an Integrated Healthcare Delivery System. Nurs Res. 2018;67:16–25.PubMedPubMedCentralCrossRef Rondinelli J, Zuniga S, Kipnis P, Kawar LN, Liu V, Escobar GJ. Hospital-Acquired pressure Injury: risk-adjusted comparisons in an Integrated Healthcare Delivery System. Nurs Res. 2018;67:16–25.PubMedPubMedCentralCrossRef
31.
go back to reference Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Adv Wound Care. 2018;7:57–67.CrossRef Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Adv Wound Care. 2018;7:57–67.CrossRef
32.
go back to reference González-Méndez MI, Lima-Serrano M, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018;27:1028–37.PubMedCrossRef González-Méndez MI, Lima-Serrano M, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018;27:1028–37.PubMedCrossRef
33.
go back to reference Kaşıkçı M, Aksoy M, Ay E. Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: a cross-sectional study. J Tissue Viability. 2018;27:135–40.PubMedCrossRef Kaşıkçı M, Aksoy M, Ay E. Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: a cross-sectional study. J Tissue Viability. 2018;27:135–40.PubMedCrossRef
34.
go back to reference Edsberg LE, Langemo D, Baharestani MM, Posthauer ME, Goldberg M. Unavoidable pressure Injury: state of the Science and Consensus outcomes. J Wound Ostomy Continence Nurs. 2014;41:313.PubMedCrossRef Edsberg LE, Langemo D, Baharestani MM, Posthauer ME, Goldberg M. Unavoidable pressure Injury: state of the Science and Consensus outcomes. J Wound Ostomy Continence Nurs. 2014;41:313.PubMedCrossRef
35.
go back to reference Sardo PMG, Guedes JAD, Alvarelhão JJM, Machado PAP, Melo EMOP. Pressure ulcer incidence and Braden subscales: retrospective cohort analysis in general wards of a Portuguese hospital. J Tissue Viability. 2018;27:95–100.PubMedCrossRef Sardo PMG, Guedes JAD, Alvarelhão JJM, Machado PAP, Melo EMOP. Pressure ulcer incidence and Braden subscales: retrospective cohort analysis in general wards of a Portuguese hospital. J Tissue Viability. 2018;27:95–100.PubMedCrossRef
36.
go back to reference Kennepp L, Resolutions. It’s time to revamp your pressure injury prevention programs. Healthc Manage Forum. 2023;36:5–14. Kennepp L, Resolutions. It’s time to revamp your pressure injury prevention programs. Healthc Manage Forum. 2023;36:5–14.
37.
go back to reference Tervo-Heikkinen TA, Heikkilä A, Koivunen M, Kortteisto T-R, Peltokoski J, Salmela S, et al. Pressure injury prevalence and incidence in acute inpatient care and related risk factors: a cross-sectional national study. Int Wound J. 2022;19:919–31.PubMedCrossRef Tervo-Heikkinen TA, Heikkilä A, Koivunen M, Kortteisto T-R, Peltokoski J, Salmela S, et al. Pressure injury prevalence and incidence in acute inpatient care and related risk factors: a cross-sectional national study. Int Wound J. 2022;19:919–31.PubMedCrossRef
38.
go back to reference Oguoma VM, Coffee NT, Alsharrah S, Abu-Farha M, Al-Refaei FH, Al-Mulla F, et al. Prevalence of overweight and obesity, and associations with socio-demographic factors in Kuwait. BMC Public Health. 2021;21:667.PubMedPubMedCentralCrossRef Oguoma VM, Coffee NT, Alsharrah S, Abu-Farha M, Al-Refaei FH, Al-Mulla F, et al. Prevalence of overweight and obesity, and associations with socio-demographic factors in Kuwait. BMC Public Health. 2021;21:667.PubMedPubMedCentralCrossRef
39.
go back to reference Alkandari A, Alarouj M, Elkum N, Sharma P, Devarajan S, Abu-Farha M, et al. Adult Diabetes and Prediabetes Prevalence in Kuwait: data from the Cross-sectional Kuwait Diabetes Epidemiology Program. J Clin Med. 2020;9:3420.PubMedPubMedCentralCrossRef Alkandari A, Alarouj M, Elkum N, Sharma P, Devarajan S, Abu-Farha M, et al. Adult Diabetes and Prediabetes Prevalence in Kuwait: data from the Cross-sectional Kuwait Diabetes Epidemiology Program. J Clin Med. 2020;9:3420.PubMedPubMedCentralCrossRef
40.
go back to reference Alibrahim A, AlAjeel A. Noncommunicable diseases and Hospital utilization in Kuwait: A Generalizable Approach using the World Health Survey. Med Princ Pract. 2022;31:445–53.PubMedPubMedCentralCrossRef Alibrahim A, AlAjeel A. Noncommunicable diseases and Hospital utilization in Kuwait: A Generalizable Approach using the World Health Survey. Med Princ Pract. 2022;31:445–53.PubMedPubMedCentralCrossRef
41.
go back to reference Kreedi F, Brown M, Marsh L. The experience of the transition from a student nurse to a registered nurse of Kuwaiti newly graduated registered nurses: a qualitative study. Healthcare. 2022;10:1856.PubMedPubMedCentralCrossRef Kreedi F, Brown M, Marsh L. The experience of the transition from a student nurse to a registered nurse of Kuwaiti newly graduated registered nurses: a qualitative study. Healthcare. 2022;10:1856.PubMedPubMedCentralCrossRef
42.
go back to reference Zhang Y-B, He L, Gou L, Pei J-H, Nan R-L, Chen H-X, 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;18:777–86.PubMedPubMedCentralCrossRef Zhang Y-B, He L, Gou L, Pei J-H, Nan R-L, Chen H-X, 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;18:777–86.PubMedPubMedCentralCrossRef
43.
go back to reference Latimer S, Chaboyer W, Gillespie B. Pressure injury prevention strategies in acute medical inpatients: an observational study. Contemp Nurse. 2016;52:326–40.PubMedCrossRef Latimer S, Chaboyer W, Gillespie B. Pressure injury prevention strategies in acute medical inpatients: an observational study. Contemp Nurse. 2016;52:326–40.PubMedCrossRef
44.
go back to reference Moore ZE, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019;2019:41. Moore ZE, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019;2019:41.
45.
go back to reference Lima-Serrano M, González-Méndez MI, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Med Intensiva Engl Ed. 2018;42:82–91.PubMedCrossRef Lima-Serrano M, González-Méndez MI, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. Med Intensiva Engl Ed. 2018;42:82–91.PubMedCrossRef
46.
go back to reference Mordiffi SZ, Kent B, Phillips NM, Choon Huat GK. Assessing pressure injury risk using a single mobility scale in hospitalised patients: a comparative study using case-control design. J Res Nurs. 2018;23:387–403.PubMedPubMedCentralCrossRef Mordiffi SZ, Kent B, Phillips NM, Choon Huat GK. Assessing pressure injury risk using a single mobility scale in hospitalised patients: a comparative study using case-control design. J Res Nurs. 2018;23:387–403.PubMedPubMedCentralCrossRef
47.
go back to reference Moore ZE, Webster J. Dressings and topical agents for preventing pressure ulcers. Cochrane Database Syst Rev. 2018;:88. Moore ZE, Webster J. Dressings and topical agents for preventing pressure ulcers. Cochrane Database Syst Rev. 2018;:88.
48.
go back to reference Chaboyer W, Bucknall T, Gillespie B, Thalib L, McInnes E, Considine J, et al. Adherence to evidence-based pressure injury prevention guidelines in routine clinical practice: a longitudinal study. Int Wound J. 2017;14:1290–8.PubMedPubMedCentralCrossRef Chaboyer W, Bucknall T, Gillespie B, Thalib L, McInnes E, Considine J, et al. Adherence to evidence-based pressure injury prevention guidelines in routine clinical practice: a longitudinal study. Int Wound J. 2017;14:1290–8.PubMedPubMedCentralCrossRef
49.
go back to reference Nursing Administartion Directorate. Nurse staffing ratios. 2013. Nursing Administartion Directorate. Nurse staffing ratios. 2013.
50.
go back to reference Johnson LL. Chapter 17 - design of Observational studies. In: Gallin JI, Ognibene FP, Johnson LL, editors. Principles and practice of Clinical Research. Boston, MA, USA: Academic Press; 2018. pp. 231–48.CrossRef Johnson LL. Chapter 17 - design of Observational studies. In: Gallin JI, Ognibene FP, Johnson LL, editors. Principles and practice of Clinical Research. Boston, MA, USA: Academic Press; 2018. pp. 231–48.CrossRef
51.
go back to reference Scheld K, Zittermann A, Heer M, Herzog B, Mika C, Drummer C, et al. Nitrogen Metabolism and Bone metabolism markers in healthy adults during 16 weeks of Bed Rest. Clin Chem. 2001;47:1688–95.PubMedCrossRef Scheld K, Zittermann A, Heer M, Herzog B, Mika C, Drummer C, et al. Nitrogen Metabolism and Bone metabolism markers in healthy adults during 16 weeks of Bed Rest. Clin Chem. 2001;47:1688–95.PubMedCrossRef
Metadata
Title
Prevalence of pressure injury on the medical wards of public general hospitals in Kuwait: a national cross-sectional study
Authors
Talal ALFadhalah
Marjan Lari
Gheed Al Salem
Shaimaa Ali
Hamad Al Kharji
Hossam Elamir
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10615-x

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