Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

J Clin Nurs. 2019 Nov;28(21-22):4119-4127. doi: 10.1111/jocn.14967. Epub 2019 Aug 8.

Abstract

Aims and objective: To describe the prevalence and predictors of pressure injuries among older adults with limited mobility, within the first 36 hr of their hospital admission in Australia.

Background: Pressure injuries are significant health, safety and quality of care issues for patients and healthcare organisations. The early implementation of the recommended pressure injury prevention international clinical practice guidelines is a way to reduce hospital-acquired pressure injuries. There is a paucity of evidence on the number of older persons who are admitted hospital with a pre-existing pressure injury.

Design: Prospective correlational study conducted in eight tertiary referral hospitals across Australia. Our sample comprised of 1,047 participants aged ≥65 years with limited mobility, drawn from a larger Australian pragmatic cluster randomised trial.

Methods: Using the STROBE statement, observational data were collected on participants' age, gender, presence of a pressure injury, Body Mass Index score, number of comorbidities and place of residence. These variables were analysed as potential predictors for pressure injuries within the first 36 hr of hospitalisation.

Results: From our sample, 113/1047 (10.8%) participants were observed to have a pressure injury within the first 36 hr of hospital admission. Age, multiple comorbidities and living in an aged care facility predicted the prevalence of pressure injury among older people within the first 36 hr of hospitalisation.

Conclusions: Our findings confirm that older adults, those with multiple comorbidities and individuals living in aged care facilities are more likely to come to hospital with a pre-existing pressure injury or develop one soon after admission.

Relevance to clinical practice: Many older patients come to hospital with a community-acquired pressure injury or develop a pressure injury soon after admission. This highlights the importance of the early detection of pressure injuries among older persons so that timely management strategies can be implemented along with the potential to reduce unnecessary financial penalties.

Keywords: aged care; community-acquired; gerontology; penalties; pressure injury; pressure ulcer; prevalence; risk assessment.

Publication types

  • Multicenter Study
  • Observational Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Early Diagnosis
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Pressure Ulcer / diagnosis
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / therapy
  • Prevalence
  • Prospective Studies
  • Risk Assessment