title: Documentation of preventive care for pressure ulcers initiated during annual evaluations in SCI.
abstract: Community-acquired pressure ulcers (PrUs) are a frequent cause of hospitalization of Veterans with spinal cord injury (SCI). The Veterans Health Administration (VHA) recommends that SCI annual evaluations include assessment of PrU risk factors, a thorough skin inspection and sharing of recommendations for PrU prevention strategies. We characterized consistency of preventive skin care during annual evaluations for Veterans with SCI as a first step in identifying strategies to more actively promote PrU prevention care in other healthcare encounters.
  
  
  
  Retrospective cross-sectional observational design, including review of electronic medical records for 206 Veterans with SCI admitted to 2 VA SCI centers from January-December, 2011.
  
  
  
  Proportion of applicable skin health elements documented (number of applicable elements/skin health elements documented).
  
  
  
  Our sample was primarily white (78%) male (96.1%), and mean age = 61 years. 40% of participants' were hospitalized for PrU treatment, with a mean of 294 days (median = 345 days) from annual evaluation to the index admission. On average, Veterans received an average of 75.5% (IQR 68-86%) of applicable skin health elements. Documentation of applicable skin health elements was significantly higher during inpatient vs. outpatient annual evaluations (mean elements received = 80.3% and 64.3%, respectively, P > 0.001). No significant differences were observed in documentation of skin health elements by Veterans at high vs. low PrU risk.
  
  
  
  Additional PrU preventive care in the VHA outpatient setting may increase identification and detection of PrU risk factors and early PrU damage for Veterans with SCI in the community, allowing for earlier intervention.
authors.affiliation: a Center of Innovation for Complex Chronic Healthcare (CINCCH) , Edward Hines Jr. VA Hospital , Hines , IL , USA.|b Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI) , Edward Hines Jr. VA Hospital , Hines , IL , USA.|c Department of Physical Medicine and Rehabilitation , Feinberg School of Medicine, Northwestern University , Chicago , IL , USA.
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.affiliation: a Center of Innovation for Complex Chronic Healthcare (CINCCH) , Edward Hines Jr. VA Hospital , Hines , IL , USA.
authors.forename: Deidre
authors.initials: D
authors.lastname: Murphy
authors.affiliation: a Center of Innovation for Complex Chronic Healthcare (CINCCH) , Edward Hines Jr. VA Hospital , Hines , IL , USA.
authors.forename: Thea J
authors.initials: TJ
authors.lastname: Rogers
authors.affiliation: d Spinal Cord Injury Service , Edward Hines Jr. VA Hospital , Hines , IL , USA.
authors.forename: Ramadevi
authors.initials: R
authors.lastname: Parachuri
authors.affiliation: d Spinal Cord Injury Service , Edward Hines Jr. VA Hospital , Hines , IL , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Sae Richardson
authors.affiliation: e Clement J. Zablocki VA Medical Center , Spinal Cord Injury Center , Milwaukee , WI , USA.
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Lee
authors.affiliation: b Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI) , Edward Hines Jr. VA Hospital , Hines , IL , USA.|f UCLA School of Nursing & David Geffen School of Medicine , Los Angeles , CA , USA.
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Bates-Jensen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D003668:Pressure Ulcer / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011315:Preventive Medicine / Q000379:methods / Q000592:standards; D017592:Skin Care / Q000379:methods* / Q000592:standards; D013119:Spinal Cord Injuries / Q000150:complications*; D014728:Veterans / Q000706:statistics & numerical data
keywords: Pressure ulcers; Prevention; Spinal cord injury; Veterans