Pressure ulcer prediction in older adults receiving home health care: implications for use with the OASIS

Abstract

Objective: To determine whether admission data routinely collected on the Outcome and Assessment Information Set (OASIS) might be used to identify the older adult at risk for pressure ulcer development in home health care.

Design: Secondary analysis of data from a retrospective cohort study.

Setting and subjects: The sample included 1711 nonhospice patients 60 years or older and free of pressure ulcers who were admitted to the intermittent skilled nursing division of a large midwestern home health care agency between January 1995 and March 1996.

Main outcome measures: Data on potential risk factors were extracted from admission information. Those identical to items on the admission OASIS assessment were included in the study. Patient records were followed forward chronologically to either pressure ulcer development or absence.

Main results: Cox regression analysis showed that limitation in activity to bed, dependence in dressing, urinary incontinence, and needing assistance with transferring predicted Stage I pressure ulcer development (P </=.001). Bowel/bladder incontinence, oxygen use, a current fracture, and dependence in dressing predicted Stage II and greater pressure ulcer development (P </=.001). Predictors of Stage I plus Stage II and greater pressure ulcers included those predictors from each of the individual models, including limitation in activity to bed, dependence in dressing, a current fracture, oxygen use, needing assistance with transferring, and urinary incontinence (P </=.001).

Conclusion: These findings suggest that the admission OASIS assessment may provide a method for identifying elderly patients who are at risk for developing Stage I and Stage II pressure ulcers in home health care.