Preventing infections to improve wound care outcomes: an epidemiological approach

Measuring and tracking wound complications and associated risk factors are powerful tools in managing wound outcomes. The authors review fundamental epidemiological approaches to clinical investigation, beginning with some basic study designs, and their relative strengths and weaknesses, with respect to the usefulness of the findings. Examples of methods to calculate rates and proportions and ways to measure significant change over time are presented. A conceptual model that is universally used by infection prevention professionals in the development and implementation of prevention strategies is also described. Risk stratification systems that have been derived through the analysis of thousands of patients are presented. These systems help predict those patients who are at risk for developing adverse outcomes (eg, infections or pressure ulcers), and therefore, should help caregivers address those risks by applying scientifically derived prevention strategies. Finally, various prevention strategies and how they relate to the conceptual model of infection prevention are discussed.