Image: Research shows pressure injury prevention practices have significantly reduced their incidence (Photo courtesy of Stryker).
A 50% reduction in pressure injury prevalence in U.S. hospitals – and other acute care settings over the past decade – is ascribed to improved preventive practices, according to a new study.
Researchers at Hill-Rom (Batesville, IN, USA) conducted an International Pressure Ulcer Prevalence (IPUP) survey, using a population sample composed of 918,621 patients in the United States, with data spanning the years 2006 to 2015 collected from over 1,000 volunteer facilities. In each facility, internal clinical teams collected information during a predetermined 24-hour period, which included pressure injury prevalence, demographics, and other pertinent clinical information. Aggregate data was the analyzed.
The results revealed that the prevalence of pressure injuries decreased from 13.5% in 2006 to 9.3% in 2015 across all care settings, a relative reduction of 31%. Significant reductions were evident in facility-acquired prevalence (FAP), which measures new pressure injuries developing after the patient was admitted to hospital; FAP decreased from 6.2%in 2006 to a range of 3.1-3.4% in 2013-2015, a 50% relative reduction. More than 90% of patients were reported from acute care settings, such as academic medical centers and community hospitals; in these settings, the FAP declined from 6.4% in 2006 to 2.9% in 2015.
Prevalence of pressure injuries varied in other settings, such as long-term acute care and rehabilitation centers, showed no clear-cut directional trends. For example, while body weight increased in most care settings, patient age decreased. But based on the Braden score, a standard prediction scale, there was no significant change in the patients' risk of pressure injury. According to the researchers, this indicates that the declines in prevalence most likely resulted from improved pressure injury prevention practices, rather than any change in patient risk factors. The study was published on December 13, 2016, in the Journal of Wound, Ostomy and Continence Nursing.
“Several national initiatives aimed at reducing pressure injuries have been introduced in recent years. The IPUP Survey is an important tool for hospitals and other facilities to measure and benchmark their pressure injury prevalence rates,” concluded lead author Catherine VanGilder, MBA, BSc, MT, CCRA, and colleagues. “As Braden score has remained constant and facility-acquired prevalence has gone down, this means that your pressure ulcer prevention programs are working. Keep up the good work!”
According to the survey, the greatest reductions in prevalence occurred between 2008 and 2009, most likely reflecting the change in payment policy by the U.S. Centers for Medicare and Medicaid Services (CMS, Baltimore, MD, USA), which discontinued acute care payments for ancillary care of hospital-acquired pressure injuries in 2008.
U.S. Centers for Medicare and Medicaid Services