title: Maintenance of skin integrity as a clinical indicator of nursing care.
abstract: OBJECTIVE
  To assess maintenance of skin integrity in hospitalized patients as a clinical indicator of quality nursing care.
  
  
  METHODS
  Descriptive correlational study.
  
  
  METHODS
  17 acute care urban and rural hospitals in Texas.
  
  
  METHODS
  723 hospitalized patients from 33 medical-surgical units.
  
  
  METHODS
  Pressure ulcers since admission and nursing care practices per unit.
  
  
  RESULTS
  Overall prevalence of pressure ulcers since admission (4.7%) was lower than previously reported for acute care settings. Prevalence of pressure ulcers in hospitalized patients (10%) was higher than found in the Texas Nurses Association feasibility study (3.7%). The skin integrity ratio was strongly correlated for several unit variables, including number of beds per unit (r = 0.623) and average daily census per unit (r = 0.909). Benchmarking data across units showed that units with subjects that maintained skin integrity had a lower percentage of patients assessed on admission and performed daily assessments less frequently than did the units with subjects that did not maintain skin integrity. In addition, the units with subjects that maintained skin integrity classified fewer patients as at risk for pressure ulcer development and did not implement a skin care protocol for these patients.
  
  
  CONCLUSIONS
  Patients who developed a pressure ulcer after admission were older and had more risk for pressure ulcers than those who maintained skin integrity. Benchmarking data detected various differences in nursing care. Significant relationships between study variables demonstrate the importance of assessing clinical indicators to monitor nursing care. Outcomes such as skin integrity, pressure ulcer since admission, and nosocomial ratio represent the quality of nursing care.
authors.affiliation: University of Texas at Austin School of Nursing, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Meraviglia
authors.forename: Heather
authors.initials: H
authors.lastname: Becker
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Grobe
authors.forename: Mary
authors.initials: M
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care / Q000592:standards*; D003668:Pressure Ulcer / Q000451:nursing / Q000517:prevention & control*; D019984:Quality Indicators, Health Care / Q000592:standards*; D018570:Risk Assessment; D017592:Skin Care / Q000379:methods / Q000451:nursing* / Q000592:standards; D014481:United States