Hospital-Acquired Pressure Ulcers

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Abstract
PRESSURE ULCERS are an uncomfortable, painful, and costly complication of bed rest.1-4 As most pressure ulcers can be prevented through identification of patients at risk and application of appropriate preventive measures,5,6 their frequency is a potentially useful indicator of quality of care for inpatient facilities. In contrast to nursing homes,7-9 general hospitals rarely include pressure ulcer incidence among these indicators. One possible reason is that knowledge about risk factors for pressure ulcers is still fragmentary. Studies of risk factors for pressure ulcers have been more often conducted in nursing homes7-13 than in general hospitals.13-16 Because hospitals and nursing homes receive different types of patients, findings from one setting do not necessarily translate to the other. Incomplete knowledge about risk factors for pressure ulcers in acute care hospitals would preclude appropriate adjustments for patient case mix when facilities are compared.7 We conducted our study to identify risk factors for pressure ulcers in adult patients in a general hospital, to evaluate the impact of case-mix adjustments on comparisons of hospital wards, and to estimate the frequency and correlates of use of preventive devices.

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