International comparison of pressure ulcer measures in long-term care facilities: Assessing the methodological robustness of 4 approaches to point prevalence measurement.

This is not a patient study, so it does not show whether any intervention reduces pressure ulcers. It compares only selected existing survey systems, so findings may not apply to other measurement programs. Facility participation and sampling differ, including voluntary participation and incomplete random sampling, so national or facility comparisons may be biased. HALT and EIP were not designed primarily for pressure ulcer measurement, so their training and definitions may be less specific. Pressure ulcer category and deep tissue injury definitions are not handled consistently, which can change counts. Some recommended improvements, such as head-to-toe assessment and training, may be resource intensive.

Do not read differences in reported pressure ulcer prevalence between countries or facilities as differences in care quality. The systems use different skin assessment methods, definitions, and sampling, so the rates may not be comparable.