Abstract
Pressure ulcers (PU) are common in all care settings, although most ulcers are preventable. Much evidence exists on Hospital Acquired Pressure Ulcers (HAPU), however, few studies describe PU in community care. From a Norwegian perspective, little is known about pressure ulcer prevalence and prevention strategies across the variety of healthcare sectors. Therefore, this study explored PU prevalence and preventive care in home care, nursing homes and hospitals. Seventeen postgraduate wound care students collected data. A data collection instrument by Jordan O’Brien and Cowman was used together with an online forum in which students described how to improve practice to reduce PU incidence. This study showed that pressure ulcers are a problem across all care settings in Norway; however, nursing homes had the highest proportion of at risk patients and the highest prevalence. By implementing the care bundle provided by the Patient Safety Programme across all care settings, increasing staff competency and make sure that access to appropriate equipment for beds and chairs is readily available, a structured and evidence based approach to prevention could be ensured.
Highlights
A pressure ulcer is defined as “localized injury to the skin and/or underlying tissue usually over a bony prominence, resulting from sustained pressure
This study only provides a snapshot of the problem of pressure ulcers across different care sites in Norway, the results indicate that pressure ulcers constitute an unnecessary burden on patients and as such it can be concluded that these wounds contribute to a financial drain on both hospitals and community care
This study found that pressure ulcers constitute a considerable problem across all care sites; nursing homes were found to have the highest proportion of at risk patients and the highest prevalence figures
Summary
A pressure ulcer is defined as “localized injury to the skin and/or underlying tissue usually over a bony prominence, resulting from sustained pressure (including pressure associated with shear). A number of contributing or confounding factors are associated with pressure ulcers; the primary of which is impaired mobility” [1]. As indicated by the definition, pressure ulcers commonly occur in individuals who have activity or mobility problems and as such are exposed to prolonged periods of exposure to sustained pressure/shear forces [2]. The elderly, those with spinal cord injury, and those who are sedated following trauma or surgery are at risk of developing pressure ulcers [3,4,5,6]. Prevalence is a determination of the number of people with an existing pressure ulcer at a given point in time, whereas incidence is a determination of the number of people that develop a new pressure ulcer over a given time period [8]
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