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Tracking quality over time: what do pressure ulcer data show?

Lena Gunningberg1, Nancy A Stotts

  • 1Nursing Research and Development, Surgery Division, Uppsala University Hospital, Uppsala, Sweden. lena.gunningberg@akademiska.se

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|April 9, 2008
PubMed
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Pressure ulcer prevalence remained stable despite a quality improvement program. Early skin assessment and prevention are crucial for older, at-risk patients to reduce hospital-acquired pressure ulcers.

Area of Science:

  • Healthcare quality improvement
  • Patient safety
  • Wound care research

Background:

  • Pressure ulcers are a significant concern in healthcare settings, impacting patient outcomes and quality of care.
  • Effective prevention strategies are essential to reduce the incidence of hospital-acquired pressure ulcers.

Purpose of the Study:

  • To compare pressure ulcer prevalence and prevention methods before and after a quality improvement program.
  • To identify patient characteristics associated with pressure ulcer development.
  • To analyze the implementation and effectiveness of pressure ulcer prevention strategies.

Main Methods:

  • A descriptive comparative study utilizing two cross-sectional surveys (2002, 2006) at a Swedish university hospital.
  • Retrospective audit of electronic health records and administrative data for patients with pressure ulcers.

Related Experiment Videos

  • Data collected on pressure ulcer prevalence and prevention interventions (e.g., pressure-reducing mattresses, repositioning, cushions).

    • Main Results:

    • Overall pressure ulcer prevalence showed minimal change between 2002 (23.9%) and 2006 (22.9%).
    • Excluding non-blanchable erythema, prevalence increased from 8.0% to 12.0%.
    • Use of pressure-reducing mattresses increased, while planned repositioning decreased; older, at-risk, incontinent patients with longer stays developed ulcers.

    Conclusions:

    • A comprehensive quality improvement program did not significantly decrease pressure ulcer prevalence.
    • Targeted prevention efforts are needed for older patients, especially upon acute admission.
    • Early skin and risk assessment, alongside consistent prevention, are vital from hospital admission.