Kirkland-Khyn Holly, Teleten Oleg, Joseph Reena, Maguina Pirko
UC Davis Medical Center, Sacramento, CA.
Wound Manag Prev. 2019 Feb;65(2):14-19.
Hospital-acquired pressure ulcers/injuries (HAPU/I) have been a major focus of research, but information about community-acquired pressure ulcer/injuries (CAPU/I) is limited.
The aim of this study was to compare HAPU/I and CAPU/I in a 620-bed academic medical center in the western United States.
This descriptive study involved prospective/retrospective data collected from the National Data for Nursing Quality Indicators, including pressure ulcer stage (January 1, 2015, through December 31, 2017); the hospital's incident reporting system (January 1, 2017, through December 31, 2017); electronic medical records (EMR) as needed for verification; and the hospital's pressure ulcer registry (January 1, 2012, through December 31, 2017), developed by both EMR and manual extraction. Data regarding point prevalence, length of stay (LOS), source of admission, ulcer stage, and frequency of hospital encounters from patients at least 18 years of age with a pressure ulcer/injury documented in their records were abstracted. Data from pregnant or incarcerated persons and persons with missing or incomplete information on staging or origin of admission were excluded. Variables were analyzed using descriptive statistics.
The number of patients with data reviewed for point prevalence was 1787 for 2015, 1989 for 2016, and 1917 for 2017. For 2015, the average CAPU/I and HAPU/I point prevalence was 6.6% and 0.8%, respectively; for 2016, 6.0% and 1.5%, respectively; and for 2017, 6.9% and 0.9%, respectively. The average LOS for patients analyzed for 2017 admitted with a CAPU/I or HAPU/I was 10.5 days and 38.9 days, respectively. Hospital encounters were more frequent in the CAPU/I than in the HAPU/I group, with 821 CAPU/encounters compared to 45 HAPU/I encounters. The majority of patients with a HAPU/I (80%) or CAPU/I (65.4%) were admitted from home.
In this study, CAPU/I were more prevalent than HAPU/I and most patient encounters originated from home. More descriptive research that includes staging and source of admission is needed to document the rate of CAPU/I and characteristics of HAPU/I compared to CAPU/I in order to optimize pressure ulcer/injury practices across the continuum of care.
医院获得性压疮/损伤（HAPU/I）一直是研究的主要焦点，但关于社区获得性压疮/损伤（CAPU/I）的信息有限。
本研究的目的是在美国西部一家拥有620张床位的学术医疗中心比较HAPU/I和CAPU/I。
这项描述性研究涉及从国家护理质量指标数据中收集的前瞻性/回顾性数据，包括压疮分期（2015年1月1日至2017年12月31日）；医院的事件报告系统（2017年1月1日至2017年12月31日）；必要时用于核实的电子病历（EMR）；以及由EMR和人工提取共同建立的医院压疮登记册（2012年1月1日至2017年12月31日）。提取了至少18岁且记录中有压疮/损伤的患者的点患病率、住院时间（LOS）、入院来源、溃疡分期和医院就诊频率等数据。排除孕妇、被监禁者以及分期或入院来源信息缺失或不完整的人员的数据。使用描述性统计分析变量。
2015年接受点患病率数据审查的患者人数为1787人，2016年为1989人，2017年为1917人。2015年，CAPU/I和HAPU/I的平均点患病率分别为6.6%和0.8%；2016年分别为6.0%和1.5%；2017年分别为6.9%和0.9%。2017年因CAPU/I或HAPU/I入院的患者的平均住院时间分别为10.5天和38.9天。CAPU/I组的医院就诊次数比HAPU/I组更频繁，CAPU/I有821次就诊，而HAPU/I有45次就诊。大多数HAPU/I患者（80%）或CAPU/I患者（65.4%）是从家中入院的。
在本研究中，CAPU/I比HAPU/I更普遍，且大多数患者就诊源于家中。需要更多包括分期和入院来源的描述性研究，以记录CAPU/I的发生率以及与CAPU/I相比HAPU/I的特征，从而优化整个护理连续过程中的压疮/损伤处理措施。
