NA: Tracking quality over time: what do pressure ulcer data show

Objective. To compare the prevalence of pressure ulcers and prevention before and after a quality improvement program; determine whether patient characteristics differed for those who did and did not develop pressure ulcers; identify pressure ulcer prevention implemented at admission and whether prevention and risk factors varied by pressure ulcer severity. Design. Descriptive comparative study based on two cross-sectional pressure ulcer surveys conducted in 2002 and 2006, complemented with a retrospective audit of the electronic health record and administrative system for patients identified with pressure ulcers. Setting. 1100-bed Swedish university hospital. Participants. 612 hospitalized patients in 2002 and 632 in 2006. Main outcome measures. Prevalence of pressure ulcers and prevention (pressure-reducing mattresses; planned repositioning; chair, heel and 308 lateral positioning cushions). Results. Pressure ulcer prevalence was 23.9 % in 2002 and 22.9 % in 2006. When non-blanchable erythema was excluded, the prevalence was 8.0 and 12.0%, respectively. The use of pressure-reducing mattresses increased while planned repositioning decreased. Those who developed ulcers were older, at-risk for ulcers, incontinent and had longer length of stay. Little preven-tion was documented at admission. Some prevention strategies and risk factors were related to severity of ulcers