Benchmarking to the international pressure ulcer prevalence survey

Authors and team members from the naval medical center at portsmouth (NMCP), virginia, obtained data on the prevalence and incidence of pressure ulcers (PUs) in our agency and compared them to national benchmark data as a basis for improving our wound care protocols.

health care facilities throughout the nation volunteered to participate in the data collection process for a multiday PU prevalence survey performed in february 2009, including nmcp. Each facility collected prevalence data during a preselected 24-hour period out of the 72-hour time frame selected by the national study.

A standardized 1-page data collection form for each subject included demographic data, use of wound care protocols and pressure redistribution surfaces, PU stage and location, risk assessment using the braden scale for pressure sore risk, head-of-bed position, turning and repositioning, mobility, weight, incontinence, documentation of a PU within 24 hours of admission, device-related ulcers, and adequacy of documentation. Facility-specific data on a second form included braden scale score, bed type, use of pressure redistribution devices on the heels, hospital unit, turn schedule use, plastic brief use, presence of incontinence-associated dermatitis, and nursing documentation. Chart reviews were performed to determine hospital- versus non-hospital-acquired PU occurrence. Each PU was recorded separately and linked to its identifying stage.

The PU incidence of adults managed in acute care inpatient units at NMCP was 6.6% and the prevalence was 10%. The most common location of facility-acquired PUs was the heels (50%). In contrast, national benchmarking data found that the highest incidence of PUs occurred in the sacral region.

Benchmarking allows health care professionals to compare outcomes in their agencies to outcomes in comparable facilities. Identification of areas in which agency outcomes compare negatively to benchmark data should prompt implementation of quality improvement initiatives. National PU prevalence surveys provide a benchmark to evaluate an individual facility's care and treatment of patients at risk for pressure ulceration. The true benefit of participation in such surveys, however, is determined by local health care professionals' ability to use national data to improve clinical practice.