Computer identification of patients at risk for skin breakdown

Decreasing the incidence of pressure ulcers in acute care settings is a major healthcare challenge. Compared with other wounds, pressure ulcers are slow healing, are difficult to manage, increase healthcare costs, and lengthen hospitalization. Guidelines for pressure ulcer prediction and prevention from the U.S. Department of Health and Human Services state that most pressure ulcers are preventable when risk is identified and preventive measures individualized. Use of pressure ulcer risk assessment tools and laboratory tests for screening of nutritional status is advocated. Overseeing a pressure ulcer prevention program by traditional methods is difficult because patient acuity status changes daily and lengths of stay are shortened. In this article, a systematic way to identify highest risk patients using the hospital computer is described. When used creatively, the computer can provide a list of high-risk patients using factors that are entered daily in the patient classification system and the laboratory package.