Pressure ulcers: the Minimum Data Set and the Resident Assessment Protocol

Abstract

As Americans age and live longer with chronic disabilities, more elderly citizens will reside in nursing homes. The nationally mandated Minimum Data Set (MDS) and Resident Assessment Protocol (RAP) were designed to help plan for the care of the frail elderly residing in nursing homes. One of the areas specifically targeted was pressure ulcers. This study was designed to describe the prevalence, incidence, and current management practices relating to pressure ulcers in nursing homes based on MDS data. In addition, a cross-sectional investigation was performed to examine the MDS items found in the pressure ulcer RAP. The MDS data for 2,011 nursing home residents, aged 60 or older, who lived in 270 facilities from 10 states were evaluated. The results found a prevalence of 11.2% for Stage II-IV lesions and a 6-month incidence of 6.2%. Logistic regression analysis determined that dependence in transfer or mobility, being bedfast, having diabetes mellitus, and having had a pressure ulcer in the past were significantly associated with a Stage II-IV pressure ulcer. The MDS and its associated RAP for pressure ulcers provide the data to begin devising a care plan for patients with pressure ulcers.