OBJECTIVE: To establish length of stay incidence as a standard for Health Care Organizations to measure pressure ulcer incidence on an ongoing basis.

PURPOSE:  In December 2006, the Institute for Healthcare Improvement (IHI) launched the “5 Million Lives” Campaign. Identifying the Prevention of Pressure Ulcers as one of 12 interventions that improve quality of care for patients.

METHODOLOGY:   Since 1999, KCI has provided facilities with a standardized methodology for conducting Pressure Ulcer Prevalence and Incidence studies.   Facilities conduct a point prevalence study and complete the data collection form for patients with pressure ulcers including whether or not the pressure ulcer was documented on admission.  The separate incidence study is conducted days later – based on the unit's average length of stay.  Patients who were intact on Prevalence but are still in the facility are assessed for pressure ulcers.  The completed data collection forms are submitted to KCI for data analysis and report generation

RESULTS:  Participating facilities receive facility specific results and a National database report for comparison.  423 facilities conducted Prevalence and Incidence Studies in 2006.  Over 71,000 patients were assessed on Prevalence and over 21,000 patients were assessed on Incidence.

CONCLUSION:  The compiled Acute Care data reports 63% of pressure ulcers documented on prevalence were not noted on the admission form or nursing note. Conducting the second observation of patients in  “length of stay” incidence studies is a more accurate method of determining facility acquired pressure ulcers than using chart review as a method for obtaining incidence data.

REFERENCES: 

National Pressure Ulcer Advisory Panel.  Cuddigan, J., Ayello, E.A., & Sussman, C. (Eds.) (2001).  Pressure Ulcers in America:  Prevalence, Incidence and Implications for the Future.  Reston, VA: NPUAP.

Whittington, K, Patrick M, Roberts JL. A National Study of Pressure Ulcer Prevalence and Incidence in Acute Care Hospitals.  JWOCN 2000;27(4): 209-15

Whittington, K, Briones, Robin. National Prevalence and Incidence Study: 6-Year Sequential Acute Care Data. Advances in Skin & Wound Care, Vol. 17 No. 9.

Wound Ostomy and Continence Nurses Society (WOCN). Prevalence and Incidence: A Toolkit for Clinicians. Glenview, ILL: WOCN; 2004. 

IHI Protecting 5 Million Lives form Harm, Getting Started Kit: Prevent Pressure Ulcers How To Guide (2006) IHI.org.

Calianno,C. Pressure ulcers a quality issue. Nursing Management, May 2007.