EPUAP pressure ulcer prevalence survey in Sweden: a two-year follow-up of quality indicators.
OBJECTIVE
The aim of this study was to determine the effects of quality improvement programs for pressure ulcer prevention by conducting a follow-up survey in a hospital in Sweden.


METHODS
A cross-sectional survey design with comparison between data collected in 2002 and 2004.


METHODS
All inpatient areas were surveyed in the surgical, medical, and geriatric departments in a university hospital. A total of 369 patients were included.


METHODS
The European Pressure Ulcer Advisory Panel data collection form including some additional questions.


METHODS
The 1-day survey was conducted on March 23, 2004. Each patient was visited by 2 registered nurses, who inspected the patient's skin for any pressure ulcer classified according to the EPUAP grading system.


RESULTS
There were no significant differences in gender, age, or Braden score between the patients in surgical, medical, or geriatric care in 2002 and 2004. The overall prevalence of pressure ulcers was 33.3% (grade 1 excluded: 10.9%) in 2002 and 28.2% (grade 1 excluded: 14.1%) in 2004. In surgical care, the prevalence was reduced from 26.8% to 17.3% (P = .051). In medical care, the prevalence was 23.6% in 2002 and 26.7% in 2004. Corresponding prevalence figures for geriatric care were 59.3% and 50.0%. A quarter of the patients in surgical care, a third in medical care, and more than half in geriatric care had a pressure ulcer upon arrival at the ward. The use of pressure-reducing mattresses had increased significantly from 16.0% to 42.7% in medical care (P = .000).


CONCLUSIONS
The EPUAP methodology has facilitated the introduction of pressure ulcer as a quality indicator at hospital level. Pressure ulcer prevalence surveys with a standardized methodology should be repeated on a regular basis in order to stimulate quality improvement.
Gunningberg
Lena
L
Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden. lena.gunningberg@akademiska.se
D000368:Aged; D001513:Beds; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D003668:Pressure Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D015397:Program Evaluation; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology; D017749:Total Quality Management / Q000458:organization & administration*