Outcome and assessment information set data that predict pressure ulcer development in older adult home health patients

Abstract

Objectives: To identify risk factors for pressure ulcer (PrU) development in older adult home health patients from admission Outcome and Assessment Information Set (OASIS) data.

Design: Retrospective cohort study.

Setting: A convenience sample of 5 home healthcare agencies from across the United States.

Participants: The cohort sample included 5395 nonhospice patients 60 years or older who were admitted for intermittent skilled home healthcare between September 30, 2007, and January 30, 2009.

Main measures: OASIS data on age, sex, race/ethnicity, diagnoses, caregiving, mental health status, clinical status, and functional status relevant to PrU risk were extracted from the electronic medical record of eligible patients in participating agencies. Patient OASIS data were followed forward chronologically from admission to new PrU development or discharge.

Main results: The 3323 females (61.6%) and 2072 males (38.4%) ranged from age 60 to 103 years (mean, 78.2 [SD, 8.6] years). The cumulative incidence of PrUs was 1.3% (n = 71 patients). Multiple logistic regression analyses revealed that bowel incontinence, needing assistance with grooming, dependence in ability to dress the upper body, dependence in ability to dress the lower body, dependence in toileting, inability to transfer, being chairfast or bedfast, and the presence of a PrU on admission were positively associated with new PrU development. Among patients who were PrU-free on admission, bowel incontinence and inability to transfer best predicted PrU development.

Conclusion: Results suggest that OASIS data can be used to identify patients who are at risk for PrUs with potential for use nationwide.