Lemetti Terhi, Heikkilä Anniina, Heikkilä Asta, Junttila Kristiina, Kaunonen Marja, Kortteisto Tiina, Nurmeksela Anu, Salmela Susanne, Tanttu Pia-Maria, Tervo-Heikkinen Tarja
Inflammation Center, Helsinki University Hospital and University of Helsinki, Meilahdentie 2, FI-00029 Helsinki, Finland.
Group Administration (Nursing), Helsinki University Hospital and University of Helsinki, Tukholmankatu 8 A, FI-00029 Helsinki, Finland.
Int J Qual Health Care. 2025 Jul 4;37(3). doi: 10.1093/intqhc/mzaf055.
Collecting data of quality of care and using these data in research and in developing clinical practice has become more systematic worldwide. Globally, one of the goals is to advance benchmarking nursing-sensitive quality of care between healthcare organizations. Inpatient falls and hospital-acquired pressure ulcers are widely used as nursing-sensitive quality indicators in benchmarking, as they are related to additional healthcare costs and the decrease in patients' quality of life. The aim of this study was to explore the prevalence of inpatient falls and hospital-acquired pressure ulcers among adult patients in Finnish acute and psychiatric care based on national nursing-sensitive benchmarking data.
The retrospective observational registry study was conducted in Finnish adult inpatient units in acute and psychiatric care between 2021 and 2022. The benchmarking data of inpatient falls covered 10 hospitals and hospital-acquired pressure ulcer data covered 11 hospitals. Frequencies and percentages were used to describe the results.
The data of inpatient falls covered a total of 2 518 152 patient days (per month min 70 581; max 122 628) and the data included 4526 falls. Of them, the number of falls with an injury was 1866 (41%), totalling 0.74 falls with an injury per 1000 patient days. In the hospital-acquired pressure ulcer data, there were 48 155 patients. Of them, 88% (n = 42 402) had their skin condition visually assessed from head-to-toe. A total of 3214 (7.6%) patients had pressure ulcers, of which 1917 (4.5%) were hospital-acquired pressure ulcers. The prevalence of hospital-acquired pressure ulcers in Stages 2-4 was 1.4% (n = 579). The highest inpatient fall rate was in psychogeriatric units, whereas the highest hospital-acquired pressure ulcer rate was in intensive care units.
The low prevalence rates of inpatient falls and hospital-acquired pressure ulcers indicate that the quality of nursing care in Finland is on a good level when compared to international research findings. However, there is still room for improvement, especially in units with a high number of adverse events. Results provide information about nursing care quality to further develop clinical practice. The experiences and principles obtained in benchmarking nursing quality can be utilized in creating an official national quality register for nursing-sensitive quality indicators.
在全球范围内，收集护理质量数据并将这些数据用于研究和临床实践发展已变得更加系统化。在全球范围内，目标之一是推进医疗保健机构之间护理敏感型护理质量的基准化。住院患者跌倒和医院获得性压疮在基准化中被广泛用作护理敏感型质量指标，因为它们与额外的医疗保健成本以及患者生活质量下降有关。本研究的目的是根据国家护理敏感型基准数据，探讨芬兰急性和精神科护理中成年患者的住院患者跌倒和医院获得性压疮的患病率。
2021年至2022年期间，在芬兰急性和精神科护理的成年住院病房进行了回顾性观察登记研究。住院患者跌倒的基准数据涵盖10家医院，医院获得性压疮数据涵盖11家医院。使用频率和百分比来描述结果。
住院患者跌倒数据总共涵盖2518152个患者日（每月最少70581个；最多122628个），数据包括4526次跌倒。其中，有损伤的跌倒次数为1866次（41%），每1000个患者日中有0.74次有损伤的跌倒。在医院获得性压疮数据中，有48155名患者。其中，88%（n = 42402）的患者从头到脚进行了皮肤状况的目视评估。共有3214名（7.6%）患者患有压疮，其中1917名（4.5%）为医院获得性压疮。2 - 4期医院获得性压疮的患病率为1.4%（n = 579）。住院患者跌倒率最高的是老年精神科病房，而医院获得性压疮率最高的是重症监护病房。
住院患者跌倒和医院获得性压疮的低患病率表明，与国际研究结果相比，芬兰的护理质量处于良好水平。然而，仍有改进空间，尤其是在不良事件数量较多的病房。研究结果为进一步发展临床实践提供了有关护理质量的信息。在护理质量基准化中获得的经验和原则可用于创建一个官方的国家护理敏感型质量指标质量登记册。
