Are pressure ulcers preventable? A survey of experts

Abstract

Objective: There is considerable debate regarding whether pressure ulcers can truly be prevented in nursing homes. New pressure ulcers are often taken as a sign of negligence that can lead to a lawsuit. This study sought to determine expert opinion regarding the preventability of pressure ulcers, the resources available to nursing homes for prevention, and the role of negligence lawsuits in pressure ulcer care.

Design: Survey mailed to a convenience sample of 98 experts in the field of pressure ulcer care. The survey contained 36 questions, most based on a 5-point Likert scale from "strongly agree"to"strongly disagree." Several questions asked respondents to rank items.

Results: Sixty-five of 92 surveys were completed (6 were returned but not completed) for a response rate of 71%. Sixty-two percent of respondents disagreed with the statement that all pressure ulcers are preventable. Only 5% said that nursing homes have adequate resources to prevent all pressure ulcers. Although most respondents disagreed that pressure ulcers are necessarily a sign of neglect and that nursing homes should be sued when a resident develops a pressure ulcer, 38% agreed with the concept that lawsuits are an appropriate way to stimulate improvement in nursing home care.

Conclusion: The results of this survey demonstrated divergent expert opinion on whether pressure ulcers are preventable. The role of regulations and litigation in pressure ulcer prevention needs to be further defined.