How often do at-risk long-term care residents develop new pressure ulcers?

Details

The National Pressure Ulcer Long-Term Care Study (NPULS) aimed to describe its database and provide baseline data.

This was a retrospective cohort study using convenience sampling to examine detailed resident characteristics, treatments, and outcomes. It included 109 long-term care facilities throughout the United States.

Participants were 2,420 adult residents aged 18 or older who had stayed for at least 14 days and were at risk of developing a pressure ulcer, as defined by the Braden Scale for Predicting Pressure Sore Risk. More than 500 characteristics were obtained for each resident over a 12-week period.

The database covered resident characteristics: sex, age, diagnoses, severity of illness scores, Braden Scale score, activities of daily living, cognitive ability, mobility, bowel or bladder incontinence, laboratory values, nutritional assessment, and pressure ulcer assessment documentation. Treatment variables included nutritional interventions, pressure-relieving devices, incontinence interventions, protective devices, turning schedules, and pressure ulcer treatments. Outcome variables included pressure ulcer development and healing, pressure ulcer and systemic infection, changes in nutritional status, and discharge disposition.

Descriptive statistics and bivariate associations were used for preliminary analyses of resident, treatment, and outcome characteristics.

Residents' mean age was 79.7 years, with a standard deviation of 14.2 years; 70% were female.

The study reported four groups: 53% (n = 1,293) were at risk but never developed a pressure ulcer during the study (Group 1); 19% (n = 457) developed a new pressure ulcer during the study (Group 2); 22% (n = 534) had an existing pressure ulcer (Group 3); and 6% (n = 136) had an existing pressure ulcer and developed a new ulcer during the study (Group 4).

Residents who developed a new pressure ulcer in Group 2 were more likely to be female, older, cognitively impaired, and immobile than residents with an existing pressure ulcer in Group 3.

The authors concluded that this baseline study describes the NPULS database in terms of resident, treatment, and outcome variables associated with pressure ulcers. Future studies will focus on multivariate analyses to predict risk factors for pressure ulcer development and healing. Research-based pressure ulcer prevention and treatment protocols could then be developed.