title: Pressure ulcers and prevention among acute care hospitals in the United States.
abstract: BACKGROUND
  Most pressure ulcers can be prevented with evidence-based practice. Many studies describe the implementation of a pressure ulcer prevention program but few report the effect on outcomes across acute care facilities.
  
  
  METHODS
  Data on hospital-acquired pressure ulcers and prevention from the National Database of Nursing Quality Indicators 2010 Pressure Ulcer Surveys were linked to hospital characteristics and nurse staffing measures within the data set. The sample consisted of 1,419 hospitals from across the United States and 710,626 patients who had been surveyed for pressure ulcers in adult critical care, step-down, medical, surgical, and medical/surgical units. Hierarchical logistic regression analysis was performed to identify study variables associated with hospital-acquired pressure ulcers among patients at risk for these ulcers.
  
  
  RESULTS
  The rate of hospital-acquired pressure ulcers was 3.6% across all surveyed patients and 7.9% among those at risk. Patients who received a skin and pressure ulcer risk assessment on admission were less likely to develop a pressure ulcer. Additional study variables associated with lower hospital-acquired pressure ulcer rates included a recent reassessment of pressure ulcer risk, higher Braden Scale scores, a recent skin assessment, routine repositioning, and Magnet or Magnet-applicant designation. Variables associated with a higher likelihood of hospital-acquired pressure ulcers included nutritional support, moisture management, larger hospital size, and academic medical center status.
  
  
  CONCLUSIONS
  Results provide empirical support for pressure ulcer prevention guideline recommendations on skin assessment, pressure ulcer risk assessment, and routine repositioning, but the 7.9% rate of hospital-acquired pressure ulcers among at-risk patients suggests room for improvement in pressure ulcer prevention practice.
authors.affiliation: School of Nursing, University of Kansas Medical Center, Kansas City, USA. sbergquist-beringer@kumc.edu
authors.forename: Sandra
authors.initials: S
authors.lastname: Bergquist-Beringer
authors.forename: Lei
authors.initials: L
authors.lastname: Dong
authors.forename: Jianghua
authors.initials: J
authors.lastname: He
authors.forename: Nancy
authors.initials: N
authors.lastname: Dunton
mesh_terms: D006739:Hospital Administration; D006801:Humans; D009730:Nursing Assessment / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D003668:Pressure Ulcer / Q000517:prevention & control*; D058996:Quality Improvement / Q000458:organization & administration; D018570:Risk Assessment; D014481:United States