Bowel incontinence and other clinical factors predict the development of pressure ulcers
Research Activities, August 2012, No. 384
The elderly are vulnerable to pressure ulcers, particularly when they have limited mobility and cannot ambulate. Once they develop, such ulcers need care and treatment to prevent systemic infections and hospitalization. Identifying which patients are most at risk for pressure ulcers is an important part of prevention. In this study, researchers were able to determine a set of factors that raise the risk of developing pressure ulcers in older home care patients. Information was obtained on 5,395 patients 60 years of age and older who were cared for by 5 home health care agencies. The researchers used data from the Outcome and Assessment Information Set (OASIS), which must be collected in order to receive reimbursement from Medicare and Medicaid. Various details on clinical, functional, and mental health status were extracted that represented potential predictors of pressure ulcer development. Patients were followed until they developed an ulcer or were discharged from home health care.
The cumulative incidence of new pressure ulcers was 1.3 percent. Among the 71 patients who developed an ulcer, there was a higher prevalence of a cancer diagnosis, diabetes, and longer time in home health care. The two top predictors of developing a new ulcer were bowel incontinence and patient inability to transfer self. Other factors included needing assistance with grooming and dressing, dependence in toileting, being bedfast or chairfast, and already having a pressure ulcer at the start of home health care. The usefulness of OASIS data to identify patients most at risk for pressure ulcers can assist agencies to develop prevention protocols and improve quality of care. The study was supported in part by the Agency for Healthcare Research and Quality (HS17353).
See "Outcome and assessment information set data that predict pressure ulcer development in older adult home health patients," by Sandra Bergquist-Beringer, Ph.D., R.N., C.W.C.N. and Byron J. Gajewski, Ph.D., in Advances in Skin & Wound Care 24(9), pp. 404-414, 2011.