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Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation
Nicole Keong1, David Ricketts, Nuki Alakeson
1Department of Orthopaedic Surgery, Princess Royal Hospital, Haywards Heath, West Sussex, UK.
Objective:
To assess the reliability of reporting protocols regarding pressure sores.
Methods:
Retrospective data were collected regarding pressure sore rates following total hip arthroplasty operations carried out during 2001 at two orthopaedic units in an NHS hospital (Princess Royal Hospital) and in a local private hospital.
Results:
Preliminary results presented in audit and interim reports indicated an alarmingly high pressure sore rate across the two sites (17/172 [9.9%] NHS, 23/71 [32.4%] private hospital). On analysis, the data collection system was revealed to be flawed. Grade 1 areas (erythema with no ulceration) were included, leading to a dramatic discrepancy between reported and confirmed pressure sores. Re-analysis showed the confirmed pressure sore rates to be much lower (2.3% NHS, 1.0% private hospital).
Conclusions:
This audit suggests that both poor data collection and education lead to inaccurate audit. This may lead to subsequent inappropriate management and inappropriate NHS star ratings.
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