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Evidenced based literature suggests increased length of stay (LOS) in the emergency department (ED) is associated with subsequent development of hospital acquired pressure ulcers (HAPU). This association was assessed in 2009, using data from a national pressure ulcer prevalence audit. Our analysis demonstrated increased LOS (≥ 2 hours) is associated with development of HAPU. Our purpose is to assess the relationship between these two variables in the 2010 national prevalence audit* and compare results to those from 2009. We will also combine 2009 and 2010 data to look at the relationship in a larger sample. We hypothesize that increased ED LOS will again be associated with HAPU development.
Methodology:
On October 21, 2010 the National Pressure Ulcer Prevalence Audit* captured data from a representative sample of acute care patients in the United States. Audit facilities (n=46) participated in standardized training sessions. On audit day, participating facilities evaluated all in-patients for the presence of pressure ulcers. Data collected includes: patient demographics, risk factors, and pressure ulcer characteristics, including location and staging, and whether the ulcers were documented as being present on admission. Audit data will be analyzed using SPSS. Using stratified analyses, the relationship between ED LOS and presence of HAPU will be assessed while controlling for such factors as patient age, gender and pressure ulcer risk assessment scores.
Limitations:
Our findings are dependent upon the skill level of clinicians completing the patient assessment on audit day and the completeness of documentation regarding ED LOS and skin assessments upon patient admission.
Results:
Data analysis is ongoing at this time.
Conclusions:
Conclusions of the data analysis will be discussed in the context of a literature review.
*National Audit Protocol is performed using a standardized methodology.