Lyder CH, Preston J, Grady JN, Scinto J, Allman R, Bergstrom N, Rodeheaver G, et al.
Archives of internal medicine. Date of publication 2001 Jun 25;volume 161(12):1549-54.
1. Arch Intern Med. 2001 Jun 25;161(12):1549-54.
Quality of care for hospitalized medicare patients at risk for pressure ulcers.
Lyder CH(1), Preston J, Grady JN, Scinto J, Allman R, Bergstrom N, Rodeheaver G.
Author information:
(1)Yale University School of Nursing, 100 Church St S, PO Box 9740, New Haven, CT
06536, USA. Courtney.Lyder@Yale.edu
Comment in
Arch Intern Med. 2002 Jan 14;162(1):100.
BACKGROUND: No state peer review organization has attempted to identify processes
of care related to pressure ulcer prediction and prevention in US hospitals.
OBJECTIVE: To profile and evaluate the processes of care for Medicare patients
hospitalized at risk for pressure ulcer development by means of the Medicare
Quality Indicator System pressure ulcer prediction and prevention module.
METHODS: A multicenter retrospective cohort study with medical record abstraction
was used to obtain a total of 2425 patients aged 65 years and older discharged
from acute care hospitals after treatment for pneumonia, cerebrovascular disease,
or congestive heart failure. Six processes of care for prevention of pressure
ulcers were evaluated: use of daily skin assessment; use of a pressure-reducing
device; documentation of being at risk; repositioning for a minimum of 2 hours;
nutritional consultation initiated for patients with nutritional risk factors;
and staging of pressure ulcer. The associations between processes of care and
incidence of pressure ulcer were determined with Kaplan-Meier survival analyses.
RESULTS: National estimates of compliance with process of care were as follows:
use of daily skin assessment, 94%; use of pressure-reducing device, 7.5%;
documentation of being at risk, 22.6%; repositioning for a minimum of 2 hours,
66.2%; nutritional consultation, 34.3%; stage 1 pressure ulcer staged, 20.2%; and
stage 2 or greater ulcer staged, 30.9%.
CONCLUSION: These results suggest that US hospitals and physicians have numerous
opportunities to improve care related to pressure ulcer prediction and
prevention.
DOI: 10.1001/archinte.161.12.1549
PMID: 11427104 [Indexed for MEDLINE]
