Pressure ulcers among patients admitted to home care.
BACKGROUND
Pressure ulcers are an understudied problem in home care.


OBJECTIVE
To determine the prevalence of pressure ulcers among patients admitted to home care services, describe the demographic and health characteristics associated with pressure ulcers in this setting, and identify the percentage of these patients at risk for developing pressure ulcers.


METHODS
Cross-sectional survey of patients on admission to home care agencies.


METHODS
Forty-one home care agencies in 14 states.


METHODS
A consecutive sample of 3,048 patients admitted March 1 through April 30, 1996 (86% of all admissions). Subjects had a mean age of 75 years; 63% were female and 85% white.


METHODS
Demographic, social, and clinical characteristics, functional status (Katz activities of daily living scale and Lawton instrumental activities of daily living scale), mental status (Katzman Short Memory-Orientation-Concentration test), pressure ulcer risk (Braden Scale), pressure ulcer status (Bates-Jensen Pressure Ulcer Status Tool), and a checklist of pressure-reducing devices and wound care products being used.


RESULTS
In the total sample of 3,048 patients, 9.12% had pressure injuries: 37.4% had more than one ulcer and 14.0% had three or more ulcers. Considering the worst ulcer for each subject, 40.3% had Stage II and 27% had Stage III or IV injuries. Characteristics associated with pressure ulcers included recent institutional discharge, functional impairment, incontinence, and having had a previous ulcer. About 30% of subjects were at risk for new pressure ulcers. Pressure-relieving devices and other wound care strategies appeared to be underutilized and often indiscriminately applied.


CONCLUSIONS
There is substantial need for pressure ulcer prevention and treatment in home care settings.
Ferrell
B A
BA
Division of Geriatrics, UCLA School of Medicine, Los Angeles, California 90095-1687, USA.
Josephson
K
K
Norvid
P
P
Alcorn
H
H
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D001513:Beds; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D003668:Pressure Ulcer / Q000145:classification / Q000453:epidemiology* / Q000209:etiology* / Q000451:nursing; D015995:Prevalence; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology