A Comparative Analysis of Hospital Acquired Pressure Ulcer/Injuries and Community Acquired Pressure Ulcer/Injuries

Introduction

Pressure ulcers/injuries (PU/I) occur in all settings. Once a PU/I develops, it can be hard to heal—even with the best of nursing care. This research study used data collected to compare hospital acquired PU/I to those PU/I that develop in the community. For community acquired PU/I, we further analyzed the data to examine the patient’s origin of admission, primary diagnosis, stage of pressure ulcer, and length of stay.

Problem

No previous comparative studies existed on hospital acquired PU/I as compared to community acquired PU/I, when examining the differences in pressure ulcers that develop in hospital, home and long term care facilities.

Methods

Quarterly point prevalence survey data was examined over 6 years on the hospital acquired PU/I as compared to the community acquired PU/I. Further data was collected from the incident reporting system from January 2017 to Jan 2018, Excel spreadsheets on past hospital acquired PU/I, and the electronic medical record of each patient admitted to the hospital.

Results

The automated EMR data collection using a BPA provided a valid and reliable data collection method. Many more patients are admitted to this acute care hospital from the community with PU/I on admission than the number of patients who develop hospital acquired PU/I. Up to 35% of patients admitted to hospital with identified PU/I did not have a stage listed in EMR for coding and billing. More patients were admitted from home with stage 3 and above pressure ulcers than patients admitted from skilled or long term care nursing facilities.

Conclusion

Focus has been on hospital acquired PU/I, while the greatest number of patients developing PU/I come from the community. patients who developed hospital acquired PU/I had closed the wound before discharge and were never re-admitted, patients with community acquired PU/I were admitted up to 16 times a year.