Pressure ulcers (PU) are painful, common, costly, often preventable, and potentially fatal. (1-4) Reducing the incidence of PUs has been an important part of quality improvement efforts in healthcare facilities for many years. These efforts increased in 2008 due to an announcement by the Centers for Medicare and Medicaid Services (CMS) regarding denying payments related to stage III and IV hospital-acquired PUs. (5)
Typically, PU rates in general hospital units are lower than those in intensive care units (ICU). A study of almost 26,000 patients found an overall PU prevalence rate of 3.6%. The rate in critical care units was 8.1% while that in general medical/surgical units was 2.6%. (6) Multiple studies demonstrate that the incidence of ICU-acquired PUs ranges from 10% to 56%. (7-10) This range may be explained by the varying populations cared for in these ICUs and different data collection methods. Rates of 5.2% to 13.7% were reported in general care ICUs (11-12) and incidences of 4.5% in nephrology patients and approximately 3% in surgical patients were also previously reported. (13-14)
ICU patients have risk factors that increase the potential of developing a PU. These factors include the type of devices/equipment and medications used, limitations in movement, and decreased nutritional state. In addition, there are important risk factors …show more content…
PREVALENCE: Many hospitals, including ours, collect surveillance PU data using the National Database of Nursing Quality Indicators (NDNQI) prevalence survey guide. (18) Prevalence is defined as the percentage of patients with PUs among all patients surveyed. In a prevalence survey, all patients on a unit on survey day who consent are evaluated for a PU through direct observation. Generally, data are collected on one day per month. A hospital- or unit- acquired PU prevalence rate can be calculated using these data. A recent NDNQI PU prevalence rate for critical care units from 1419 hospitals was 8.1%
Typically, PU rates in general hospital units are lower than those in intensive care units (ICU). A study of almost 26,000 patients found an overall PU prevalence rate of 3.6%. The rate in critical care units was 8.1% while that in general medical/surgical units was 2.6%. (6) Multiple studies demonstrate that the incidence of ICU-acquired PUs ranges from 10% to 56%. (7-10) This range may be explained by the varying populations cared for in these ICUs and different data collection methods. Rates of 5.2% to 13.7% were reported in general care ICUs (11-12) and incidences of 4.5% in nephrology patients and approximately 3% in surgical patients were also previously reported. (13-14)
ICU patients have risk factors that increase the potential of developing a PU. These factors include the type of devices/equipment and medications used, limitations in movement, and decreased nutritional state. In addition, there are important risk factors …show more content…
PREVALENCE: Many hospitals, including ours, collect surveillance PU data using the National Database of Nursing Quality Indicators (NDNQI) prevalence survey guide. (18) Prevalence is defined as the percentage of patients with PUs among all patients surveyed. In a prevalence survey, all patients on a unit on survey day who consent are evaluated for a PU through direct observation. Generally, data are collected on one day per month. A hospital- or unit- acquired PU prevalence rate can be calculated using these data. A recent NDNQI PU prevalence rate for critical care units from 1419 hospitals was 8.1%