Implementation of Pressure Injury Prevention Strategies in Acute Care: Results From the 2018-2019 International Pressure Injury Prevalence Survey.
Laura E Edsberg, Jill Cox, Kimberly Koloms and 1 others
PMID 35523235WHAT IT FOUND
Prevention strategies were reported more often in acute care patients with hospital-acquired pressure injuries than in those without, but repositioning, heel elevation, moisture management and nutrition support still had gaps.
Key findings
01The survey included 296,014 hospitalized patients, with pressure injury prevalence 8.97% and hospital-acquired pressure injury prevalence 2.58%.
02For at-risk patients, routine repositioning was reported for 67.9% of those without hospital-acquired pressure injuries, 79.5% of those with Stage 1 or 2 injuries, and 84.8% of those with severe pressure injuries; pressure redistribution surfaces were reported for 74.6%, 82.8% and 91.9% in the same groups.
03Heel elevation was reported for 62.1% of patients with severe hospital-acquired pressure injuries, and the largest head-of-bed group was 30 to 35 degrees, with greater than 35 degrees the second largest group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Facilities self-reported patient data, so recording errors and response bias could affect the reported prevention practices. The survey captured practices only during a 24-hour period, so it cannot show whether prevention was consistent before or after the assessment. The study compared groups at one time point, so higher reported use in patients with pressure injuries does not mean those strategies caused or failed to prevent the injuries. Patients on support surfaces used by fewer than 100 survey patients were excluded, removing 4105 patients from that part of the analysis. The paper did not test a pressure injury prevention bundle, so it cannot tell clinicians whether adding or changing one strategy will reduce hospital-acquired pressure injuries.
Declared interests
The International Pressure Ulcer Prevalence database has been facilitated by HillRom, Inc. since 1989. The authors reported no conflicts of interest.
The easy way to misread this
Do not read higher reported use of prevention strategies in patients with hospital-acquired pressure injuries as proof that those strategies caused or failed to prevent the injuries. The study observed practices at one 24-hour assessment and did not test any intervention.