Pressure injury identification, measurement, coding, and reporting: Key challenges and opportunities

Area of Science:

• Healthcare Quality Measurement
• Patient Safety
• Epidemiology

Background:

• Pressure injury (PI) rates are key performance indicators in acute and subacute care settings.
• Accurate and reproducible measurement of PI rates is essential to avoid misidentification of healthcare quality.
• Inconsistent identification, coding, and risk adjustment complicate PI rate assessment.

Purpose of the Study:

• To identify and describe the primary challenges in the identification, coding, and reporting of pressure injuries.
• To discuss potential strategies for improving data collection and benchmarking of PI prevalence.

Main Methods:

• Analysis of current practices in PI identification, including admission assessment and detection intensity.
• Review of coding variations and risk adjustment methodologies for diverse patient populations.
• Examination of epidemiological approaches (cross-sectional vs. discharge surveys) and potential financial influences on reporting.

Main Results:

• Key challenges include inconsistent PI identification at admission and varying detection intensity.
• Differing coding practices and risk adjustment strategies significantly impact reported PI rates.
• Epidemiological survey methods (cross-sectional vs. discharge) and financial incentives can influence PI reporting accuracy.

Conclusions:

• Addressing inconsistencies in PI identification, coding, and risk adjustment is vital for reliable healthcare performance measurement.
• Implementing improved data collection and benchmarking strategies can aid in reducing overall PI prevalence.
• Standardized approaches are needed to ensure accurate and reproducible reporting of pressure injuries.