title: Prevalence and incidence density of unavoidable pressure ulcers in elderly patients admitted to medical units.
abstract: To describe the prevalence and incidence density of hospital-acquired unavoidable pressure sores among patients aged ≥65 years admitted to acute medical units. A secondary analysis of longitudinal study data collected in 2012 and 2013 from 12 acute medical units located in 12 Italian hospitals was performed. Unavoidable pressure ulcers were defined as those that occurred in haemodynamically unstable patients, suffering from cachexia and/or terminally ill and were acquired after hospital admission. Data at patient and at pressure ulcer levels were collected on a daily basis at the bedside by trained researchers. A total of 1464 patients out of 2080 eligible (70.4%) were included. Among these, 96 patients (6.5%) hospital-acquired a pressure ulcer and, among 19 (19.7%) were judged as unavoidable. The incidence of unavoidable pressure ulcer was 8.5/100in hospital-patient days. No statistically significant differences at patient and pressure ulcers levels have emerged between those patients that acquired unavoidable and avoidable pressure sores. Although limited, evidence on unavoidable pressure ulcer is increasing. More research in the field is recommended to support clinicians, managers and policymakers in the several implications of unavoidable pressure ulcers both at the patient and at the system levels.
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy. Electronic address: alvisa.palese@uniud.it.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Trevisani
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Guarnier
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Barelli
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zambiasi
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Allegrini
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Bazoli
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Casson
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Meri
authors.initials: M
authors.lastname: Marin
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Padovan
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Picogna
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Taddia
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Salmaso
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiari
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Oliva
authors.initials: O
authors.lastname: Marognolli
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Canzan
authors.initials: C
authors.lastname: Federica
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Saiani
authors.affiliation: ESAMED, Evaluating Nursing Sensitive Outcomes in Patients Admitted in MEDical wards, Italian Research Network, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ambrosi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D003668:Pressure Ulcer / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors
keywords: Acute care; Avoidable; Hospital; Incidence density; Italy; Pressure ulcer; Prevalence; Unavoidable