title: Risk Factors for Pressure Ulcers Including Suspected Deep Tissue Injury in Nursing Home Facility Residents: Analysis of National Minimum Data Set 3.0.
abstract: OBJECTIVE
  To provide information on risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home residents in the United States.
  
  
  BACKGROUND
  This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.
  
  
  OBJECTIVE
  After participating in this educational activity, the participant should be better able to:1. Examine the literature related to risk factors for the development of PrUs.2. Compare risk factors associated with the prevalence of PrUs and sDTI from the revised Minimum Data Set 3.0 2012 using a modified Defloor's conceptual model of PrUs as a theoretical framework.
  
  
  
  OBJECTIVE
  This study aims to characterize and compare risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home (NH) residents in the United States.
  
  
  METHODS
  Secondary analysis of the 2012 Minimum Data Set (MDS 3.0).
  
  
  METHODS
  Medicare- or Medicaid-certified NHs in the United States.
  
  
  METHODS
  Nursing home residents (n = 2,936,146) 18 years or older with complete PrU data, who received comprehensive assessments from January to December 2012.
  
  
  METHODS
  Pressure ulcer by stage was the outcome variable. Explanatory variables (age, gender, race and ethnicity, body mass index, skin integrity, system failure, disease, infection, mobility, and cognition) from the MDS 3.0 were aligned with the 4 elements of Defloor's conceptual model: compressive forces, shearing forces, tissue tolerance for pressure, and tissue tolerance for oxygen.
  
  
  RESULTS
  Of 2,936,146 NH residents who had complete data for PrU, 89.9% had no PrU; 8.4% had a Stage 2, 3, or 4 or unstagable PrU; and 1.7% had an sDTI. The MDS variables corresponding to the 4 elements of Defloor's model were significantly predictive of both PrU and sDTI. Black residents had the highest risk of any-stage PrU, and Hispanic residents had the highest risk of sDTI. Skin integrity, system failure, infection, and disease risk factors had larger effect sizes for sDTI than for other PrU stages.
  
  
  CONCLUSIONS
  The MDS data support Defloor's model and inform clinicians, educators, researchers, and policymakers on risk factors associated with PrUs and sDTI in NH residents in the United States participating in Medicare and Medicaid.
authors.affiliation: Hyochol Ahn, PhD, ARNP, ANP-BC • Assistant Professor • University of Florida College of Nursing • Gainesville Linda Cowan, PhD, ARNP, FNP-BC, CWS • Research Health Scientist • North Florida/South Georgia Veterans Health System • Gainesville Cynthia Garvan, PhD • Research Associate Professor • University of Florida College of Nursing • Gainesville Debra Lyon, PhD, RN, FAAN • Professor and Executive Associate Dean • University of Florida College of Nursing • Gainesville Joyce Stechmiller, PhD, ACNP-BC, FAAN • Department Chair and Associate Professor • Department of Biobehavioral Nursing Science, University of Florida College of Nursing • Gainesville.
authors.forename: Hyochol
authors.initials: H
authors.lastname: Ahn
authors.forename: Linda
authors.initials: L
authors.lastname: Cowan
authors.forename: Cynthia
authors.initials: C
authors.lastname: Garvan
authors.forename: Debra
authors.initials: D
authors.lastname: Lyon
authors.forename: Joyce
authors.initials: J
authors.lastname: Stechmiller
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D003668:Pressure Ulcer / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology