Natural History of Pressure Injury Among Ethnically/Racially Diverse Nursing Home Residents: The Pressure Ulcer Detection Study.
Barbara M Bates-Jensen, Kailey Anber, Maximus M Chen and 12 others
PMID 33626163WHAT IT FOUND
In nursing homes, pressure injuries varied by race/ethnicity.
Asian residents developed more injuries, Black residents had more severe heel injuries, and use of heel boots was low. Assess beyond visual color and increase simple prevention.
Key findings
01Asian participants developed significantly more pressure injuries than other groups.
02Black participants' heel pressure injuries were more severe than other race/ethnicity groups on the wound assessment tool.
03Documented specific pressure reduction device use ranged from 39% to 51%, and heel boot use was low for all groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All nursing homes were urban Los Angeles and 18 of 19 were for-profit, so results may not apply to rural or nonprofit homes. Prevention data were mostly from medical record documentation, which may overestimate what staff actually did. The 16-week study could not determine healing time for all pressure injuries. Only the first observed pressure injury at each trunk or heel location was analyzed, and 36 subsequent injuries were excluded. Race/ethnicity categories were limited to those available in the MDS, and underrepresented groups were not included. Observational design cannot show that prevention interventions caused better or worse outcomes.
The easy way to misread this
Do not conclude that race/ethnicity caused pressure injury differences or that low heel boot use caused more severe injuries. This observational study reported associations and documented care, and medical record data may not reflect actual practice.