Prevalence of pressure ulcers in three university teaching hospitals in Ireland.
OBJECTIVE
Pressure ulceration is a significant, but preventable, cause of morbidity and resource utilisation in hospital populations. Data on pressure ulcer prevalence in Ireland are limited. This study aims to determine (i) the point-prevalence of pressure ulcers in three teaching hospitals in Ireland and (ii) risk factors for their development.


METHODS
Eight teams of one doctor and one nurse visited 672 adult patients over a 2-day period in three teaching hospitals. Each patient was examined and pressure ulcers graded with the European Pressure Ulcer Advisory Panel system. Mental test score, Barthel index, type of support surface, length of stay, documentation of risk assessment and serum albumin were recorded.


RESULTS
Point-prevalence of pressure ulceration was 18.5%. Seventy-seven percent of pressure ulcers were hospital-acquired, 49% grade 1, 37% grade 2, 11% grade 3 and 3% grade 4. Reduced mobility, urinary incontinence, cognitive impairment, low serum albumin and length of stay were significantly associated with pressure ulcers. Multivariate logistic regression analysis found reduced mobility (odds ratio 8.84; 95% CI 5.04-15.48, p<0.0001) and length of stay (odds ratio 1.02; 95% CI 1.01-1.02, p<0.0001) to be predictive of the presence of pressure ulcers. Age, gender and risk assessment documentation were not associated with pressure ulcers. Sixty-five percent of patients with pressure ulcers were positioned on appropriate support surfaces.


CONCLUSIONS
Point-prevalence of pressure ulceration was 18.5%, similar to international data. Regular audit of prevalence, prevention and management strategies may raise awareness, influence resource allocation and ultimately improve patient care.
Gallagher
Paul
P
Department of Geriatric Medicine, Cork University Hospital, and School of Nursing and Midwifery, University College Cork, Wilton, Cork, Ireland. pfgallagher77@eircom.net
Barry
Pat
P
Hartigan
Irene
I
McCluskey
Pat
P
O'Connor
Kieran
K
O'Connor
Mike
M
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000150:complications; D005260:Female; D006785:Hospitals, University; D006801:Humans; D034141:Hypoalbuminemia / Q000150:complications; D007494:Ireland / Q000453:epidemiology; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009730:Nursing Assessment; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D003668:Pressure Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014549:Urinary Incontinence / Q000150:complications