title: Pressure Ulcers Among Newly Admitted Nursing Home Residents: Measuring the Impact of Transferring From Hospital.
abstract: OBJECTIVE
  Pressure ulcers (PUs) are reported more often among newly admitted nursing home (NH) residents who transfer from hospital versus community. We examine for whom this increased risk is greatest, further defining hospitalized patients most in need of better PU preventive care.
  
  
  METHODS
  Retrospective observational cohort study.
  
  
  METHODS
  All NH residents (N=5617) newly admitted between April 1, 2008 and March 31, 2012 in Winnipeg, MB, Canada.
  
  
  METHODS
  RAI-MDS 2.0 data were linked to administrative health care use files capturing each person's NH admission date, their presence of a PU at this time, whether they transferred into NH from hospital or community, and their PU susceptibility (eg, amount of help needed to maneuver in bed or to transfer from one surface to another, frequency of incontinence, presence of diabetes, amount of food consistently left uneaten). Log-binomial regression with interaction terms was used to analyze data.
  
  
  RESULTS
  67.6% of our cohort transferred into a NH directly from hospital; 9.2% of these residents were reported to have a stage 1+ PU on NH admission versus 2.6% of those who transferred from community. From regression models, transferring from hospital versus community was associated with increased PU risk equally across various subgroups of less and more susceptible residents.
  
  
  CONCLUSIONS
  Transferring from hospital versus community places both more and less susceptible newly admitted NH residents at increased PU risk. Using evidence-based preventive care practices is thus needed for all subgroups of hospital patients before NH use, to help reduce PU risk.
authors.affiliation: *College of Medicine, Faculty of Health Sciences†Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB‡Postdoctoral Fellow Women's Xchange, Women's College Hospital, Toronto, Ontario§Department of Family Practice, Vancouver Coastal Health Research Institute Centre for Clinical Epidemiology & Evaluation, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC∥Department of Geriatric Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, MB¶Winnipeg Regional Health Authority, Winnipeg, MB.
authors.forename: Malcolm B
authors.initials: MB
authors.lastname: Doupe
authors.forename: Suzanne
authors.initials: S
authors.lastname: Day
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: McGregor
authors.forename: Philip St
authors.initials: PS
authors.lastname: John
authors.forename: Dan
authors.initials: D
authors.lastname: Chateau
authors.forename: Joe
authors.initials: J
authors.lastname: Puchniak
authors.forename: Natalia
authors.initials: N
authors.lastname: Dik
authors.forename: Joykrishna
authors.initials: J
authors.lastname: Sarkar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data*; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors