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Hospital acquired pressure ulcer

Jianghua He, Vincent S Staggs, Sandra Bergquist-Beringer, Nancy Dunton
BACKGROUND: Time trends and seasonal patterns have been observed in nurse staffing and nursing-sensitive patient outcomes in recent years. It is unknown whether these changes were associated. METHODS: Quarterly unit-level nursing data in 2004-2012 were extracted from the National Database of Nursing Quality Indicators® (NDNQI®). Units were divided into groups based on patterns of missing data. All variables were aggregated across units within these groups and analyses were conducted at the group level...
2016: BMC Nursing
Nahla Tayyib, Fiona Coyer
BACKGROUND: Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention...
October 6, 2016: Worldviews on Evidence-based Nursing
Peter R Worsley, Glenn Smith, Lisette Schoonhoven, Dan L Bader
AIM: The study aimed to characterize demographic and clinical practice factors associated with community (CAPU) and hospital acquired pressure ulcers (HAPU). DESIGN: A comparative retrospective evaluation of pressure ulcer data, collected from a district general hospital. METHODS: Demographic and pressure ulcer related data were collected from patients at risk of developing a pressure ulcer, collated by a single observer using a standardized tool...
July 2016: Nurs Open
Chantal Backman, Saskia E Vanderloo, Toba B Miller, Lisa Freeman, Alan J Forster
OBJECTIVE: This study aimed to compare classification of pressure ulcers from administrative data with a gold standard assessment, specifically; pressure ulcers confirmed by an independent physical assessment performed by trained nurse surveyors. SETTING: A retrospective analysis of pooled cross-sectional samples of inpatients assessed across 3 consecutive prevalence surveys in a large academic health sciences centre between 2012 and 2013. PARTICIPANTS: There were 2001 patients for whom physical and chart assessments were completed, and for whom a discharge abstract was also available at the time of analysis...
October 5, 2016: BMJ Open
Wendy Chaboyer, Tracey Bucknall, Joan Webster, Elizabeth McInnes, Brigid M Gillespie, Merrilyn Banks, Jennifer A Whitty, Lukman Thalib, Shelley Roberts, Mandy Tallott, Nicky Cullum, Marianne Wallis
BACKGROUND: Hospital-acquired pressure ulcers are a serious patient safety concern, associated with poor patient outcomes and high healthcare costs. They are also viewed as an indicator of nursing care quality. OBJECTIVE: To evaluate the effectiveness of a pressure ulcer prevention care bundle in preventing hospital-acquired pressure ulcers among at risk patients. DESIGN: Pragmatic cluster randomised trial. SETTING: Eight tertiary referral hospitals with >200 beds each in three Australian states...
September 23, 2016: International Journal of Nursing Studies
Diane K Boyle, Ananda Jayawardhana, Mary E Burman, Nancy E Dunton, Vincent S Staggs, Sandra Bergquist-Beringer, Byron J Gajewski
BACKGROUND: Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. OBJECTIVE: The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index. DESIGN: Two-phase measure development study...
November 2016: International Journal of Nursing Studies
Richard F Averill, John S Hughes, Richard L Fuller, Norbert I Goldfield
The Partnership for Patients (PfP) and the Agency for Healthcare Research and Quality (AHRQ) have reported a 23.5% decline in hospital-acquired pressure ulcers (HAPU) over 4 years resulting in a cumulative cost savings of more than $10 billion and 49 000 averted deaths, claiming that this significant decline may have been spurred in part by Medicare payment incentives associated with severe (stage 3 or 4) HAPUs. Hospitals with a high rate of severe HAPUs have a payment penalty imposed, creating a financial disincentive to report severe HAPUs, possibly contributing to the magnitude of the reported decline...
August 30, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
William V Padula, Robert D Gibbons, Peter J Pronovost, Donald Hedeker, Manish K Mishra, Mary Beth F Makic, John Fp Bridges, Heidi L Wald, Robert J Valuck, Adam J Ginensky, Anthony Ursitti, Laura Ruth Venable, Ziv Epstein, David O Meltzer
OBJECTIVE: Hospital-acquired pressure ulcers (HAPUs) have a mortality rate of 11.6%, are costly to treat, and result in Medicare reimbursement penalties. Medicare codes HAPUs according to Agency for Healthcare Research and Quality Patient-Safety Indicator 3 (PSI-03), but they are sometimes inappropriately coded. The objective is to use electronic health records to predict pressure ulcers and to identify coding issues leading to penalties. MATERIALS AND METHODS: We evaluated all hospitalized patient electronic medical records at an academic medical center data repository between 2011 and 2014...
August 18, 2016: Journal of the American Medical Informatics Association: JAMIA
Nahla Tayyib, Fiona Coyer
The objective of this review is to identify the effectiveness of pressure ulcer (PU) prevention strategies on the incidence of hospital-acquired PUs in the intensive care unit (ICU).More specifically, the objectives are to identify the effectiveness of utilizing PU prevention strategies such as risk assessment, skin assessment, skin care, nutrition, position and repositioning, education and training, medical devices care or other strategies designed to manage the risk factors for PU development and reduce the incidence of PUs in ICUs...
March 2016: JBI Database of Systematic Reviews and Implementation Reports
Simeon Joel Zürcher, Christa Vangelooven, Natalie Borter, Daniel Schnyder, Sabine Hahn
AIM: The aim of this study is to psychometrically test the Italian and French versions of the Care Dependency Scale. BACKGROUND: The Care Dependency Scale assesses changes in patients' level of care dependency including important functional and mental dimensions. Evaluation of the psychometric properties of the Italian version is still ongoing. The French version has to date not been validated. DESIGN: Nationwide cross-sectional point prevalence study...
July 19, 2016: Journal of Advanced Nursing
AnneMarie Walker-Czyz
OBJECTIVES: The purpose of this study was to measure the impact of an integrated electronic health record (EHR) innovation adoption on the quality of nursing care delivered, including hospital-acquired falls, hospital-acquired pressure ulcers, ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and costs measured in nursing hours. The impact on quality, cost, and nurse satisfaction measured in turnover rates before, during, and after implementation of EHR tools was also investigated...
July 2016: Journal of Nursing Administration
Paul Peter Schneider, Max Geraedts
In this study, we investigated the association between nurse and physician staffing and the incidence of hospital-acquired pressure ulcers in acute care hospitals in Germany. The study population, derived from the Quality Reports of German Hospitals and the Hospital Directory, consisted of 710 hospitals covering 716,281 cases in the first quarter of 2010, and 672 hospitals covering 757,665 cases in the first quarter of 2012. The relationship between staffing variables and the standardized incidence ratios of pressure ulcers was examined using bivariate and multivariable linear regression models...
July 3, 2016: Nursing & Health Sciences
Dan Li
AIMS AND OBJECTIVES: To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. BACKGROUND: Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation...
August 2016: Journal of Clinical Nursing
A M Van Dishoeck, C W N Looman, E W Steyerberg, R J G Halfens, J P Mackenbach
AIM: To explore the relation between the occurrence of pressure ulcers or incontinence dermatitis and the quality of preventive care provided. BACKGROUND: Performance measurements using indicators has become standard practice in recent years. The prevalence of pressure ulcers with or without incontinence dermatitis is widely used as an indicator of the quality of nursing care. DESIGN: Matched case-control study. METHODS: We collected information on 132 patients selected from a prevalence study (April 2010)...
June 13, 2016: Journal of Advanced Nursing
Vincent S Staggs, Emily Cramer
Hospital performance reports often include rankings of unit pressure ulcer rates. Differentiating among units on the basis of quality requires reliable measurement. Our objectives were to describe and apply methods for assessing reliability of hospital-acquired pressure ulcer rates and evaluate a standard signal-noise reliability measure as an indicator of precision of differentiation among units. Quarterly pressure ulcer data from 8,199 critical care, step-down, medical, surgical, and medical-surgical nursing units from 1,299 US hospitals were analyzed...
August 2016: Research in Nursing & Health
William D Spector, Rhona Limcangco, Pamela L Owens, Claudia A Steiner
BACKGROUND: Patients who develop hospital-acquired pressure ulcers (HAPUs) are more likely to die, have longer hospital stays, and are at greater risk of infections. Patients undergoing surgery are prone to developing pressure ulcers (PUs). OBJECTIVE: To estimate the hospital marginal cost of a HAPU for adults patients who were hospitalized for major surgeries, adjusted for patient characteristics, comorbidities, procedures, and hospital characteristics. RESEARCH DESIGN AND SUBJECTS: Data are from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and the Medicare Patient Safety Monitoring System for 2011 and 2012...
September 2016: Medical Care
Kerry A Wilder, Brittany Wall, David Haggard, Tiffany Epperson
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are the most common hospital-acquired infections costing hospitals millions of dollars annually. An evidence-based practice literature review revealed that utilizing a systematic team approach for proper line maintenance is effective in reducing CLABSI rates. PURPOSE: The purpose of this quality improvement initiative was to reduce the CLABSI rate in the neonatal intensive care unit from 3.9 per 1000 line days in 2011 by at least 50% in 2014...
June 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Nicole M Coomer, Amy M G Kandilov
BACKGROUND: Hospital-acquired conditions (HACs) can increase the financial liabilities faced by patients when the HACs require additional treatment both in the hospital and in subsequent health care encounters. This article estimates incremental effects of 6 HACs on Medicare beneficiary financial liabilities. METHODS: Descriptive and multivariate analyses were used to examine the differences in beneficiary liability between care episodes with and without HACs. Episodes included the index hospitalization in which the HAC occurred and all inpatient, outpatient, and physician claims within 90 days of index hospital discharge...
May 9, 2016: American Journal of Infection Control
Charlie Lachenbruch, David Ribble, Kirsten Emmons, Catherine VanGilder
PURPOSE: To measure the prevalence of incontinence in the 2013-2014 International Pressure Ulcer Prevalence (IPUP) surveys and determine the relative risk of developing a facility-acquired pressure ulcers (FAPUs) by stage and by Braden Scale score groupings. DESIGN: The IPUP survey is an observational, cross-sectional cohort database designed to determine the frequency and severity of pressure ulcers in various populations. SUBJECTS AND SETTING: The survey includes acute care (91...
May 2016: Journal of Wound, Ostomy, and Continence Nursing
Jaime Byrne, Patricia Nichols, Marzena Sroczynski, Laurie Stelmaski, Molly Stetzer, Cynthia Line, Kristen Carlin
BACKGROUND: Patients in intensive care units are likely to have limited mobility owing to hemodynamic instability and activity orders for bed rest. Bed rest is indicated because of the severity of the disease process, which often involves intubation, sedation, paralysis, surgical procedures, poor nutrition, low flow states, and poor circulation. These patients are predisposed to the development and/or the progression of pressure ulcers not only because of their underlying diseases, but also because of limited mobility and deconditioned states of health...
May 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
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