Pressure ulcer prevalence and incidence in acute care

Abstract

Objective: The objectives of the study were to identify the incidence and prevalence of pressure ulcers (PrUs) in acute-care patients, including the major contributing factors, and to modify existing policy and practices to align with the Institute for Healthcare Improvement recommendations for PrU prevention.

Design: In a cross-sectional, descriptive study, PrU prevalence was measured at quarterly intervals on predetermined days in 2009 using a standard data collection form. Incidence was measured 4 days later according to the facility's average length of stay. Patient demographics included age, sex, primary diagnoses, and contributing factors toward PrU development.

Patients: The study comprised adult medical, surgical, and intensive care patients in a northern California hospital.

Results: PrU prevalence ranged from 12% to 19.7%; incidence ranged from 0% to 5.4%. The most common PrU sites were heel (26%), coccyx (20%), and ear (19%). The major contributing factors were Braden score of less than 18 (84%), serum albumin level of less than 3 (74%), fecal and/or urine incontinence (73%), fragile skin (67%), and bed bound (63%).

Conclusion: This study supports the importance of collecting PrU prevalence and incidence data as an effective measure of nursing care and patient outcomes and to identify facility trends.