Risk, prevalence and prevention of pressure ulcers in three Swedish health-care settings

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Abstract
Objective: This cross-sectional survey set out to delineate risk, prevalence and prevention of pressure ulcers in a university hospital, a general hospital and a nursing home in Sweden. It also looked at the differences in risk factors and preventive strategies between patients with and without pressure ulcers. Method: The one-day survey followed the methodology developed by the European Pressure Ulcer Advisory Panel (EPUAP). It was conducted on Tuesday 5 February 2002. Each patient was visited by two registered nurses, their skin was inspected and any pressure ulcer classified according to the EPUAP grading system. A total of 695 patients were included: 612 from the university hospital, 38 from the general hospital and 45 from the nursing home. Results: The prevalence of pressure ulcers was 23.9% (university hospital), 13.2% (general hospital) and 20.0% (nursing home). Most (60–66%) of the pressure ulcers in the hospitals were assessed as grade 1. Only half of the patients at risk or with pressure ulcers were placed on a pressure-reducing mattress and a third of these patients had a plan for repositioning. Significant variables associated with pressure ulcers were old age, geriatric care, low Braden score and incontinence. Conclusion: Prevalence of pressure ulcers was higher than expected. Results relating to both prevalence of pressure ulcers (grade 1 excluded) and the preventive care given to patients at risk or with pressure ulcers accord with those of a larger Dutch study. Attention must focus on the appropriate risk-assessment skills, highlighting grade 1 as pressure damage, and the use of appropriate preventive strategies, based on the level of risk. Declaration of interest: None.