Pressure ulcers in community-based older adults receiving home health care. Prevalence, incidence, and associated risk factors.
OBJECTIVE
To determine the prevalence and incidence of pressure ulcers in community-based adults receiving home health care and to identify risk factors for incident Stage II to IV pressure ulcers.


METHODS
Retrospective cohort study.


METHODS
A large midwestern urban home health care agency.


METHODS
The study cohort was 1711 nonhospice, nonintravenous therapy subjects admitted between January 1995 and March 1996 who were > or = age 60 and pressure ulcer-free on admission.


METHODS
Data on risk factors were extracted from admission information. Patient records were followed forward chronologically to the outcomes: pressure ulcer development or no pressure ulcer.


RESULTS
The incidence of Stage II to IV pressure ulcers was 3.2%. Cox regression analyses revealed that limitation in activity to a wheelchair, needing assistance with the activities of daily living--dressing, bowel and/or bladder incontinence, a Braden Scale mobility subscore of very limited, anemia, adult child as primary caregiver, male gender, a recent fracture, oxygen use, and skin drainage predicted pressure ulcer development (P < or = 0.05) in this exploratory model.


CONCLUSIONS
Patients > or = age 60 who are admitted to a home health care agency with 1 or more of these risk factors require close monitoring for pressure ulcer development and should be taught preventive interventions on admission.
Bergquist
S
S
School of Nursing, University of Kansas, Kansas City, USA.
Frantz
R
R
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003152:Community Health Nursing; D005260:Female; D006699:Home Care Services; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000145:classification / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index