Pressure ulcer prevalence and quality of care in stroke patients in an Indonesian hospital

Abstract

To explore the quality of pressure ulcer (PU) care in stroke patients in an Indonesian stroke-specialised hospital. The prevalence, prevention, wound treatment and hospital facilities related to PU structural quality indicators at the ward and institutional levels were assessed. A multi-level cross-sectional survey was performed over three days in an Indonesian stroke-specialised hospital. All stroke patients present on the day of the measurement were included. The European Pressure Ulcer Prevalence Study Minimum Data Set and the Dutch National Prevalence Measurement of Care Problems (Landelijke Prevalentiemeting Zorgproblemen, LPZ) questionnaire were used. The prevalence rates of PUs, including and excluding Category I were high in this hospital (28% and 17%, respectively). More than half of the patients/families (56%) received education about PU prevention and 74% of the patients were repositioned, although irregularly, by nurses or families. No treatment was applied to Category I PUs. Category II PUs were treated by using NaCl 0.9% solution to cleanse the wound without dressings. Category III PUs were mainly treated by using anti-microbial gauze dressing. No patient suffered a Category IV PU. Only a few structural quality indicators of PU care at ward and hospital level were met. PUs were quite prevalent in these stroke patients. The quality of PU care in this hospital could be improved, especially in the areas of prevention, treatment and structural quality indicators.