Abstract
Introduction:
The widely held belief that ‘95% of pressure ulcers are preventable’ was first coined in 19881. Few studies report whether pressure damage was avoidable and therefore little evidence exists to refute this statement. The aim of this study was to retrospectively examine all reported incidents of hospital acquired pressure ulcers graded 2 and above (HAPU2+) over a two year period (April 2012- March 2014) in a U.K. based Health and Social Care Trust with a view to establishing the proportion of HAPU2+ deemed avoidable.
Methods:
Appropriate permissions were granted, data collected and entered into a statistical software package for analysis. All incidents were cross-referenced with tissue viability records, where available. Data was anonymised at source
and a unique identifier applied to each incident.
Results:
Year 1 showed 265 HAPU2+, the majority of which were grade 2 (67.2%; n=178). Full thickness pressure damage accounted for 21.5% (n=57) and in 11.3% (n=30) of cases the grade was unclear. In year 2, 342 HAPU2+ were reported with grade 2 accounting for 70.2% (n=240), full thickness damage, 21.6% (n=74) and 8.2% (n=28) of cases were unclear. Pressure ulceration was deemed avoidable in 64% (n=169) of HAPU2+ in year 1 and 73% (n=249) in year 2. When considering full thickness pressure damage, 56% (n=32) were avoidable in Year 1 and 66% (n=49) in year 2. A root cause analysis (RCA) was completed for 34% (n=89) of HAPU2+ in year 1 and 51% (n=174) in year 2.
Discussions: The findings of this study support recently published work, where 43% of pressure ulcers grade 3-4 were deemed avoidable2, decreasing to 34% when grade 2 were included3. While results in this current study are
notably higher, in this study, incidents without a corresponding RCA were deemed avoidable. This could account for the higher proportion of avoidable HAPU2+.
Clinical relevance:
Unavoidable pressure ulcers do occur and the goal of any quality improvement initiative should be a reduction in avoidable pressure ulcers. A better understanding is therefore needed of how organisations are reporting avoidable and unavoidable damage so that realistic benchmarks can be established.
References:
1. Hibbs, P. (1998) The past politics of pressure sores. Journal of Tissue Viability. 8 (4) 14-15.
2. , F., Guy, H., Gilroy, P., Royall, D. and Davies, S. (2013) Are 95% of hospital-acquired pressure ulcers avoidable?
Wounds UK. 9 (3): 16-22.
3. Downie, F., Sandoz, H., Gilroy, P., Royall, D., Davies, S., Brett, D. and Bates, J. (2014) Avoidable pressure ulcer rates in
six acute UK Trusts.
Wounds UK. 10 (3): 48-5
The widely held belief that ‘95% of pressure ulcers are preventable’ was first coined in 19881. Few studies report whether pressure damage was avoidable and therefore little evidence exists to refute this statement. The aim of this study was to retrospectively examine all reported incidents of hospital acquired pressure ulcers graded 2 and above (HAPU2+) over a two year period (April 2012- March 2014) in a U.K. based Health and Social Care Trust with a view to establishing the proportion of HAPU2+ deemed avoidable.
Methods:
Appropriate permissions were granted, data collected and entered into a statistical software package for analysis. All incidents were cross-referenced with tissue viability records, where available. Data was anonymised at source
and a unique identifier applied to each incident.
Results:
Year 1 showed 265 HAPU2+, the majority of which were grade 2 (67.2%; n=178). Full thickness pressure damage accounted for 21.5% (n=57) and in 11.3% (n=30) of cases the grade was unclear. In year 2, 342 HAPU2+ were reported with grade 2 accounting for 70.2% (n=240), full thickness damage, 21.6% (n=74) and 8.2% (n=28) of cases were unclear. Pressure ulceration was deemed avoidable in 64% (n=169) of HAPU2+ in year 1 and 73% (n=249) in year 2. When considering full thickness pressure damage, 56% (n=32) were avoidable in Year 1 and 66% (n=49) in year 2. A root cause analysis (RCA) was completed for 34% (n=89) of HAPU2+ in year 1 and 51% (n=174) in year 2.
Discussions: The findings of this study support recently published work, where 43% of pressure ulcers grade 3-4 were deemed avoidable2, decreasing to 34% when grade 2 were included3. While results in this current study are
notably higher, in this study, incidents without a corresponding RCA were deemed avoidable. This could account for the higher proportion of avoidable HAPU2+.
Clinical relevance:
Unavoidable pressure ulcers do occur and the goal of any quality improvement initiative should be a reduction in avoidable pressure ulcers. A better understanding is therefore needed of how organisations are reporting avoidable and unavoidable damage so that realistic benchmarks can be established.
References:
1. Hibbs, P. (1998) The past politics of pressure sores. Journal of Tissue Viability. 8 (4) 14-15.
2. , F., Guy, H., Gilroy, P., Royall, D. and Davies, S. (2013) Are 95% of hospital-acquired pressure ulcers avoidable?
Wounds UK. 9 (3): 16-22.
3. Downie, F., Sandoz, H., Gilroy, P., Royall, D., Davies, S., Brett, D. and Bates, J. (2014) Avoidable pressure ulcer rates in
six acute UK Trusts.
Wounds UK. 10 (3): 48-5
| Original language | English |
|---|---|
| Title of host publication | Proc 18th Annual Meeting of the European Pressure Ulcer Advisory Panel |
| Place of Publication | Ghent |
| Pages | 92 |
| Number of pages | 1 |
| Publication status | Published (in print/issue) - 16 Sept 2015 |
| Event | To 18th Annual Meeting of the European Pressure Ulcer Advisory Panel, Ghent, Belgium - Ghent, Belgium Duration: 16 Sept 2015 → 18 Sept 2015 http://WWW.EPUAP2015.ORG |
Conference
| Conference | To 18th Annual Meeting of the European Pressure Ulcer Advisory Panel, Ghent, Belgium |
|---|---|
| Abbreviated title | EPUAP 2015 |
| Country/Territory | Belgium |
| Period | 16/09/15 → 18/09/15 |
| Internet address |
Bibliographical note
Conference poster presentation arising from PhD study by Lorna SempleKeywords
- Pressure ulcer
- Prevention
