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

Abstract

By the WoundSource Editors

Hospital-acquired pressure ulcers/injuries (HAPU/I) have been a major focus of research but information about community-acquired pressure ulcer/injuries (CAPU/I) is limited. Purpose: The aim of this study was to compare HAPU/I and CAPU/I in a 620-bed academic medical center in the western United States. Methods: This descriptive study involved prospective/retrospective data collected from the National Data for Nursing Quality Indicators, including pressure ulcer stage (January 1, 2015 through December 31, 2017), the hospital’s incident reporting system (January 1, 2017 through December 31, 2017), electronic medical records (EMR) as needed for verification, and the pressure ulcer registry (January 1, 2012 through December 31, 2017) for the hospital as developed by both EMR and manual extraction. Point prevalence, length of stay (LOS), source of admission, ulcer stage and frequency of hospital encounters data from patients at least 18 years of age with a pressure ulcer/injury documented in their records were abstracted. OK Data from pregnant or incarcerated persons and persons with missing or incomplete information on staging or origin of admission were excluded. Variables were analyzed using descriptive statistics. Results: The number of patients surveyed in the study for point prevalence was for 2015 (n=1787), 2016 (n=1989) and 2017 (n=1917) The average CAPU/I point prevalence for 2015 was 6.6%, HAPU/I 0.8%; for 2016 CAPU/I was 6.0%; HAPU/I was 1.5%, for 2017 CAPU was 6.9%; and for HAPU/I 0.9%. The average LOS for patients analyzed for 2017 admitted with a CAPU/I was 10.5 days and for patients with a HAPU/I was 38.9 days. Hospital encounters were more frequent in the CAPU/I than in the HAPU/I group with 821 encounters compared to 45 HAPU/I encounter. The majority of patients with a HAPU/I (80%) or CAPU/I (65.4%) were admitted from home. Conclusion: In this study, CAPU/I were more prevalent than HAPU/I and most patient encounters originated from home. More descriptive research to include staging and source of admission is needed to document the rate of CAPU/I and characteristics of HAPU/I compared to CAPU/I in order to optimize PU/I practices across the continuum of care.

About the Presenter

I have worked as a Nurse Practitioner for over 20 years in the Sacramento community. Although trained in the US as an RN, I spent my early career working as a nurse and midwife in England and Ireland. I travelled to Africa, Haiti, and Belize to work in disaster relief and in promoting safe maternal-child care in rural areas. I now work at UC Davis Medical Center as the Director of Wound Care and have led the interdisciplinary team initiatives to train NPs/ nurses/ and physicians in street medicine and wound care in a low resource setting. We here at UCDMC are training nurses and PTs from China, Thailand, and the US through the WTA.

I started the wound team here at UCDMC and am involved in public speaking on wound research, technology, and teaching wound care.

I am the current President for the California Association of Nurse Practitioners and have served on the policy committee for several terms. I have spoken at several international meetings on research and technology involving wounds.