A three year multiphase pressure ulcer prevalence/incidence study in a regional referral hospital.

Pressure ulcers can have a devastating impact on health and care provision, ranging from patient discomfort and increased healthcare costs to a potential reflection on the quality of care. To evaluate the outcomes of prevention education and skin integrity interventions on the incidence of pressure ulcers, a multiphase project was initiated in an urban 154-bed regional referral community hospital in Ontario, Canada that provides care to an urban and rural population. The prevalence study included 84 adult subjects at baseline, 77 after one year (Phase 1), and 100 after 3 years (Phase 2). The Braden Scale for Predicting Pressure Sore Risk and a data collection form were used to record prevalence, incidence, stage and location of pressure ulcers, and related documented interventions. Incidence data were obtained from patient charts and defined as ulcers that developed over 24 hours following admission. Phase 1 interventions involved staff education and replacement of existing skin care products. Phase 2 interventions included adoption of pressure ulcer prevention protocols, advanced wound care products, improved support surface usage, modification of documentation methods, and staff education. Of the 84 patients assessed at baseline , 15 (17.9 %) developed 22 pressure ulcers compared to 4 of 77 (5.2%) during Phase 1 and 2 out of 100 (2.0%) during Phase 2. The difference between baseline and both subsequent time points was statistically significant (P greater than 0.05). These results suggest that education and the implementation of appropriate skin care products and procedures and pressure ulcer prevention protocols may reduce the incidence of hospital-acquired pressure ulcers.