Pressure ulcer prevalence and prevention practices in care of the older person in the Republic of Ireland

Abstract

The aim of this study was to establish pressure ulcer prevalence and prevention in the long-term care setting. There is no information on pressure ulcers prevalence in care of the older person in Ireland; therefore, a prevalence study was undertaken to investigate key aspects related to current practices in pressure ulcer prevention. A cross-sectional survey design was employed. Ethical approval was received. Participants included 1100 older individuals residing in 12 long-term care settings. Data were collected using the Braden scale, the European Pressure Ulcer Advisory Panel minimum data set and pressure ulcer grading system. All participants were Irish and white, 70% were women, and 75% were aged 80 years or older. Prevalence was 9%, with 28% of pressure ulcers grade 1, 33% grade 2, 15% grade 3 and 24% grade 4, mainly located on the sacrum (58%) and the heel (25%). Seventy-seven per cent scored Braden low risk or not at risk; however, 53% were completely immobile/very limited mobility and 58% were chair/bedfast. There was a significant association between activity and mobility and pressure ulcer development (χ(2) = 45·50, p < 0·001 and χ(2) = 46·91, p = 0·0001, respectively). Fifty per cent had a pressure redistribution device in bed, and 48% had one in use on the chair; however, 9% had a repositioning regime planned for when in bed and 5% planned for when seated in the chair. This paper reports on the first ever pressure ulcer prevalence survey conducted in long-term care in Ireland, and results provide significant insights into decision-making and use of resources in the prevention of pressure ulcers. Pressure ulcers are common, costly and impact negatively on individuals. Current practices in prevention show several areas for improvement, namely, risk assessment, care planning and documentation.