Materiały źródłowe

• #1 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  Pressure ulcers are a significant healthcare problem worldwide, which affects several thousands of people each year. Up to 3 million adults are affected annually in the United States alone. Pressure injury management is a significant source of economic burden. In 2019, Padula and Delarmente estimated that hospital-acquired pressure injury (HAPI) costs could exceed $26.8 billion. Their study simulated an incidence of 8.3 HAPI per 100 acutely ill patients. This number is consistent with previous studies, which showed that 7.9% of at-risk patients had HAPI. […] Sacral decubitus ulcers usually occur in elderly patients. Patients who are incontinent, paralyzed, or debilitated are more prone to getting them. Patients with normal sensory status, mobility, and mental status are less likely to form these ulcers because their regular physiologic feedback system leads to frequent physical positional shifts. As stated above, older patients are more prone to sacral decubitus ulcers, and two-thirds of ulcers occur in patients older than 70 years. Some data show that 83% of hospitalized patients developed ulcers within 5 days of hospitalization.

• #2 Pressure Ulcers | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/topics/pressure-ulcers.html

  Each year, more than 2.5 million people in the United States develop pressure ulcers. These skin lesions bring pain, associated risk for serious infection, and increased health care utilization. Pressure ulcers are associated with longer hospital stays and increased morbidity and mortality. They also remain a serious problem in nursing homes despite regulatory and market approaches to encourage prevention and treatment. […] Enhancing pressure injury surveillance using natural language processing. Characteristics of United States nursing homes with high percentages of stage 2-4 pressure injuries among high-risk nursing home residents with obesity. Underreporting of quality measures and associated facility characteristics and racial disparities in US nursing home ratings.

• #3 Bedsores (Pressure Ulcers): Symptoms, Staging & Treatment

  https://my.clevelandclinic.org/health/diseases/17823-bedsores-pressure-injuries

  People who are older, immobile or bedridden are most at risk for bedsores. […] Experts estimate that 2.5 million Americans develop bedsores every year. […] Bedsores occur when pressure reduces or cuts off blood flow to your skin. […] Bedsores increase your risk of potentially life-threatening bacterial infections like cellulitis and septicemia. […] Worldwide, bedsores lead to the deaths of more than 24,000 people each year. […] Having the limited ability to move and reposition your body puts you at risk for bedsores.

• #4 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  Pressure ulcers are a significant healthcare problem worldwide, which affects several thousands of people each year. Up to 3 million adults are affected annually in the United States alone. Pressure injury management is a significant source of economic burden. In 2019, Padula and Delarmente estimated that hospital-acquired pressure injury (HAPI) costs could exceed $26.8 billion. Their study simulated an incidence of 8.3 HAPI per 100 acutely ill patients. This number is consistent with previous studies, which showed that 7.9% of at-risk patients had HAPI. […] Sacral decubitus ulcers usually occur in elderly patients. Patients who are incontinent, paralyzed, or debilitated are more prone to getting them. Patients with normal sensory status, mobility, and mental status are less likely to form these ulcers because their regular physiologic feedback system leads to frequent physical positional shifts. As stated above, older patients are more prone to sacral decubitus ulcers, and two-thirds of ulcers occur in patients older than 70 years. Some data show that 83% of hospitalized patients developed ulcers within 5 days of hospitalization.

• #5 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Mortality is also associated with pressure ulcers. Several studies noted mortality rates as high as 60 percent for older persons with pressure ulcers within 1 year of hospital discharge. Most often, pressure ulcers do not cause death; rather the pressure ulcer develops after a sequential decline in health status. Thus, the development of pressure ulcers can be a predictor of mortality. […] Studies further suggested that the development of skin breakdown postsurgery can lead elders to have major functional impairment post surgical procedure. […] The cost to treat pressure ulcers can be expensive; the HCUP study reported an average cost of $37,800. Cost data vary greatly, depending on what factors are included or excluded from the economic models (e.g., nursing time, support surfaces). It has been estimated that the cost of treating pressure ulcers is 2.5 times the cost of preventing them. Thus, preventing pressure ulcers should be the goal of all nurses.

• #6 Pressure Ulcer Prevention : Non Invasive Assessment of Bedsores | Decubitus Ulcers | Deep Tissue Injury

  https://www.longportinc.com/applications/wounds/pressure-ulcer-prevention

  Pressure ulcers, also known as decubitus ulcers or bedsores, are a common problem in any situation where patients are compromised because of immobility, nutrition, incontinence, or age. Each year, more than 2.5 million people in the United States develop pressure ulcers, which cost approximately $10 billion or between $20,000 and $150,000 to treat per wound dependent upon the severity. Further, these wounds are very painful, are the subject of 17,000 law suits annually and are considered preventable. […] Stage 3 and 4 pressure ulcers are one of the conditions that CMS now classify as never events, meaning they should never happen. CMS announced in 2007 that certain hospital-acquired conditions would no longer be covered by Medicare ad Medicaid. One of these conditions is pressure ulcers. This rule change is forcing clinicians to put greater emphasis on pressure ulcer prevention in hospitals.

• #7 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Pressure ulcers remain a major health problem affecting approximately 3 million adults. In 1993, pressure ulcers were noted in 280,000 hospital stays, and 11 years later the number of ulcers was 455,000. The Healthcare Cost and Utilization Project (HCUP) report found from 1993 to 2003 a 63 percent increase in pressure ulcers, but the total number of hospitalizations during this time period increased by only 11 percent. […] Given the aging population, increasingly fragmented care, and nursing shortage, the incidence of pressure ulcers will most likely continue to rise. […] The incidence rates of pressure ulcers vary greatly with the health care settings. The National Pressure Ulcer Advisory Panel (NPUAP) says the incidence ranges from 0.4 percent to 38 percent in hospitals, from 2.2 percent to 23.9 percent in skilled nursing facilities, and from 0 percent to 17 percent for home health agencies. There is ample evidence that the majority of pressure ulcers occur relatively early in the admissions process. For patients in the hospital, they can occur within the first 2 weeks. […] For those elderly residents admitted to long-term care, pressure ulcers are most likely to develop within the first 4 weeks of admission.

• #8 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Pressure ulcers remain a major health problem affecting approximately 3 million adults. In 1993, pressure ulcers were noted in 280,000 hospital stays, and 11 years later the number of ulcers was 455,000. The Healthcare Cost and Utilization Project (HCUP) report found from 1993 to 2003 a 63 percent increase in pressure ulcers, but the total number of hospitalizations during this time period increased by only 11 percent. […] Given the aging population, increasingly fragmented care, and nursing shortage, the incidence of pressure ulcers will most likely continue to rise. […] The incidence rates of pressure ulcers vary greatly with the health care settings. The National Pressure Ulcer Advisory Panel (NPUAP) says the incidence ranges from 0.4 percent to 38 percent in hospitals, from 2.2 percent to 23.9 percent in skilled nursing facilities, and from 0 percent to 17 percent for home health agencies. There is ample evidence that the majority of pressure ulcers occur relatively early in the admissions process. For patients in the hospital, they can occur within the first 2 weeks. […] For those elderly residents admitted to long-term care, pressure ulcers are most likely to develop within the first 4 weeks of admission.

• #9 Pressure ulcer – Wikipedia

  https://en.wikipedia.org/wiki/Pressure_ulcer

  Each year, more than 2.5 million people in the United States develop pressure ulcers. In acute care settings in the United States, the incidence of bedsores is 0.4% to 38%; within long-term care it is 2.2% to 23.9%, and in home care, it is 0% to 17%. Similarly, there is wide variation in prevalence: 10% to 18% in acute care, 2.3% to 28% in long-term care, and 0% to 29% in home care. There is a much higher rate of bedsores in intensive care units because of immunocompromised individuals, with 8% to 40% of those in the ICU developing bedsores. However, pressure ulcer prevalence is highly dependent on the methodology used to collect the data. Using the European Pressure Ulcer Advisory Panel (EPUAP) methodology there are similar figures for pressure ulcers in acutely sick people in the hospital. There are differences across countries, but using this methodology, pressure ulcer prevalence in Europe was consistently high, from 8.3% (Italy) to 22.9% (Sweden). A recent study in Jordan also showed a figure in this range. Some research shows differences in pressure-ulcer detection among white and black residents in nursing homes.

• #10 Pressure ulcer – Wikipedia

  https://en.wikipedia.org/wiki/Pressure_ulcer

  Each year, more than 2.5 million people in the United States develop pressure ulcers. In acute care settings in the United States, the incidence of bedsores is 0.4% to 38%; within long-term care it is 2.2% to 23.9%, and in home care, it is 0% to 17%. Similarly, there is wide variation in prevalence: 10% to 18% in acute care, 2.3% to 28% in long-term care, and 0% to 29% in home care. There is a much higher rate of bedsores in intensive care units because of immunocompromised individuals, with 8% to 40% of those in the ICU developing bedsores. However, pressure ulcer prevalence is highly dependent on the methodology used to collect the data. Using the European Pressure Ulcer Advisory Panel (EPUAP) methodology there are similar figures for pressure ulcers in acutely sick people in the hospital. There are differences across countries, but using this methodology, pressure ulcer prevalence in Europe was consistently high, from 8.3% (Italy) to 22.9% (Sweden). A recent study in Jordan also showed a figure in this range. Some research shows differences in pressure-ulcer detection among white and black residents in nursing homes.

• #11 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Pressure injuries are common among patients hospitalized in acute- and chronic-care facilities. It has been estimated that about 1 million pressure injuries occur in the United States; however, definitive information on the epidemiology and natural history of this condition is still limited. Unfortunately, studies to date have been encumbered by methodologic issues and variability in describing the lesions. […] Reported incidences of pressure injuries in hospitalized patients range from 2.7% to 29%, and reported prevalences in hospitalized patients range from 3.5% to 69%. […] Patients in critical care units have an increased risk of pressure injuries, as evidenced by a 33% incidence and a 41% prevalence. […] The fifth National Pressure Ulcer Prevalence Survey, conducted in 1999 among patients in acute care hospitals, showed an overall prevalence of 14.8%, with 7.1% of ulcers having occurred during that hospital visit.

• #12 Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis | Patient Safety in Surgery | Full Text

  https://pssjournal.biomedcentral.com/articles/10.1186/s13037-023-00383-8

  Hospital-acquired pressure injuries are a major patient safety concern in intensive care units that are considered largely preventable adverse events by adherence to nursing standards of care. […] A total of 15 articles met the inclusion criteria. Based on the random-effects model, the overall Pressure ulcer prevalence rate was 16.6% (95% CI (8.629.6)). […] This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region. […] Therefore, it is necessary for health policymakers and managers in Eastern Mediterranean Region to take necessary measures to prevent the incidence of Pressure ulcers in hospitals, especially in ICUs. […] Pressure ulcer prevalence in the Eastern Mediterranean Region has varied between 7% and 44.4%.

• #13 Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis | Patient Safety in Surgery | Full Text

  https://pssjournal.biomedcentral.com/articles/10.1186/s13037-023-00383-8

  The results of this systematic review and meta-analysis showed that the overall Pressure ulcer prevalence in ICU patients in the Eastern Mediterranean Region is 16.6%. […] Hospital managers and staff should determine the prevalence of Pressure ulcers, analyze the causes of their occurrence, and take necessary measures to prevent their recurrence. […] Hospital managers should prepare ground for reducing Pressure ulcer prevalence among patients by improving workplace safety, promoting a safety culture, improving work processes, training employees, and increasing their well-being, motivation and satisfaction. […] This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region.

• #14 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. […] We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). […] The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. […] In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the 95 age group among men and women. […] At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI.

• #15 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  More detailed information about the burden of decubitus ulcers from different regions and countries may be beneficial for decision-makers to reduce the cost burden of decubitus ulcers. […] The overall prevalence of decubitus ulcers was classified into severity categories by applying the disability weight and disfigurement with itch/pain. […] The International Classification of Diseases (ICD) version 9 code for decubitus ulcers is 707, and the ICD-10 codes are L89-L89.95. […] The age-standardized prevalence rates of decubitus ulcers ranged from 1.5 to 55.2 cases per 100,000 population at the national level. […] The largest increases were seen in Malaysia (110.3% [97.3 to 123.6%]), Saudi Arabia (100.1% [88.4 to 112.5%]), and Thailand (81.5% [69.4 to 96.5%]). […] The age-standardized incidence rates of decubitus ulcers in 2019 ranged from 5.6 to 198.4 cases per 100,000 population.

• #16 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  The largest increase in age-standardized incidence rate of decubitus ulcers from 1990 to 2019 occurred in Malaysia (105.7% [94.8 to 117.2%]), Saudi Arabia (97.4% [87.0 to 107.9%]), and Thailand (77.6% [66.2 to 92.7%]). […] The countries with the highest age-standardized prevalence rates of decubitus ulcers in 2019 also showed the highest age-standardized YLDs rate. […] The most significant increases in age-standardized YLDs rates between 1990 and 2019 were observed in Malaysia (105.7% [70.4 to 148.1%]), Saudi Arabia (93.1% [59.0 to 134.1%]), and Thailand (78.6% [44.8 to 124.2%]). […] There is a positive correction between YLDs and SDI in 21 GBD regions and 204 countries and territories regarding decubitus ulcers from 1990 to 2019. […] This means that the countries with higher socioeconomic development levels generally have a higher burden of decubitus ulcers.

• #17 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  Pressure ulcers are a significant healthcare problem worldwide, which affects several thousands of people each year. Up to 3 million adults are affected annually in the United States alone. Pressure injury management is a significant source of economic burden. In 2019, Padula and Delarmente estimated that hospital-acquired pressure injury (HAPI) costs could exceed $26.8 billion. Their study simulated an incidence of 8.3 HAPI per 100 acutely ill patients. This number is consistent with previous studies, which showed that 7.9% of at-risk patients had HAPI. […] Sacral decubitus ulcers usually occur in elderly patients. Patients who are incontinent, paralyzed, or debilitated are more prone to getting them. Patients with normal sensory status, mobility, and mental status are less likely to form these ulcers because their regular physiologic feedback system leads to frequent physical positional shifts. As stated above, older patients are more prone to sacral decubitus ulcers, and two-thirds of ulcers occur in patients older than 70 years. Some data show that 83% of hospitalized patients developed ulcers within 5 days of hospitalization.

• #18

  https://link.springer.com/article/10.2165/00002512-199202010-00006

  Pressure sores remain common, with a prevalence of 5 to 9% and more than 70% occurring in patients over 70 years of age. […] Prevention involves identification of patients at risk, appropriate nursing care measures and the use of special equipment. […] Management of the established sore involves treatment of the underlying medical condition(s), attention to hydration and nutrition, prevention of further tissue trauma and the use of special dressings and procedures which facilitate the inflammatory repair response. […] A useful starting point is to classify pressure sores into 4 clinical types depending on amount of tissue damage and depth of ulcer. […] Cavity ulcers (type 4) can be managed with silastic foam or hydrocolloid or alginate dressings. […] Systemic antibiotics are indicated only when surrounding cellulitis is present, although metronidazole is useful for malodorous sores. […] The development of pressure sores during hospitalisation.

• #19 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. […] We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). […] The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. […] In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the 95 age group among men and women. […] At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI.

• #20 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  The burden of decubitus ulcers in younger people was much lower than that of the middle-aged and older-aged groups, this does not mean that adolescent decubitus ulcer does not need attention as well as additional prevention and management measures. […] The highest burden of decubitus ulcers was observed in elderly-aged patients due to the ageing of the global population.

• #21 Bedsores (pressure ulcers) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893

  Bedsores are areas of damaged skin and tissue caused by sustained pressure that reduces blood flow to vulnerable areas of the body. This pressure may be caused from being in a bed or wheelchair for a long time. […] Bedsores also are called pressure ulcers, pressure injuries and decubitus ulcers. […] The people who are most at risk of bedsores have medical conditions that keep them from changing positions or moving. Or they spend most of their time in a bed or a chair. […] Pressure against the skin that limits blood flow to the skin causes bedsores. Limited movement can make skin prone to damage and cause bedsores. […] Your risk of getting bedsores is higher if you have a hard time moving and can’t change position easily while seated or in bed. […] Medical conditions affecting blood flow. Health problems that can affect blood flow can raise the risk of tissue damage such as bedsores. Examples of these types of medical conditions are diabetes and vascular disease. […] Berlowitz D. Epidemiology, pathogenesis and risk assessment of pressure-induced skin and soft tissue injury.

• #22 Risk Factors for Pressure Ulcers

  https://www.verywellhealth.com/pressure-ulcers-knowing-the-risks-1131984

  There are several risk factors for pressure ulcers, which are now referred to as pressure injuries. They are skin sores that typically develop over bony areas, such as the lower spine, hips, and elbows. Also known as bedsores, pressure injuries are a common problem for people who have low mobility and spend most of their time in bed. […] People at the greatest risk of developing pressure injuries are those who are immobile. Once a person loses the ability to move and becomes inactive, the risk of developing bedsores increases. […] A loss of sensation as the result of spinal cord injury or neurological disease increases the risk of developing pressure injuries. […] Likewise, a person with an altered level of consciousness may not feel discomfort or may not be awake enough to physically reposition themselves if they do. […] Cardiovascular disease, peripheral vascular disease, and diabetes, all cause impaired circulation, increasing the risk of pressure injuries. […] And long stays In intensive care or long surgical procedures can lead to prolonged skin tissue pressure.

• #23 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Pressure injuries are common among patients hospitalized in acute- and chronic-care facilities. It has been estimated that about 1 million pressure injuries occur in the United States; however, definitive information on the epidemiology and natural history of this condition is still limited. Unfortunately, studies to date have been encumbered by methodologic issues and variability in describing the lesions. […] Reported incidences of pressure injuries in hospitalized patients range from 2.7% to 29%, and reported prevalences in hospitalized patients range from 3.5% to 69%. […] Patients in critical care units have an increased risk of pressure injuries, as evidenced by a 33% incidence and a 41% prevalence. […] The fifth National Pressure Ulcer Prevalence Survey, conducted in 1999 among patients in acute care hospitals, showed an overall prevalence of 14.8%, with 7.1% of ulcers having occurred during that hospital visit.

• #24 Pressure ulcers (pressure sores)

  https://www.nhs.uk/conditions/pressure-sores/

  Pressure ulcers are caused by something putting pressure on or rubbing your skin. […] You have a higher chance of getting a pressure ulcer if you: have problems moving, have had a pressure ulcer before, have been seriously ill in intensive care or have recently had surgery, are underweight, have swollen, sweaty or broken skin, have poor circulation or fragile skin, have problems feeling sensation or pain. […] If you’re being cared for at home and think you’re at risk of getting pressure ulcers, you can ask a GP for a risk assessment so your care team can make a plan to prevent them.

• #25 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Pressure ulcers remain a major health problem affecting approximately 3 million adults. In 1993, pressure ulcers were noted in 280,000 hospital stays, and 11 years later the number of ulcers was 455,000. The Healthcare Cost and Utilization Project (HCUP) report found from 1993 to 2003 a 63 percent increase in pressure ulcers, but the total number of hospitalizations during this time period increased by only 11 percent. […] Given the aging population, increasingly fragmented care, and nursing shortage, the incidence of pressure ulcers will most likely continue to rise. […] The incidence rates of pressure ulcers vary greatly with the health care settings. The National Pressure Ulcer Advisory Panel (NPUAP) says the incidence ranges from 0.4 percent to 38 percent in hospitals, from 2.2 percent to 23.9 percent in skilled nursing facilities, and from 0 percent to 17 percent for home health agencies. There is ample evidence that the majority of pressure ulcers occur relatively early in the admissions process. For patients in the hospital, they can occur within the first 2 weeks. […] For those elderly residents admitted to long-term care, pressure ulcers are most likely to develop within the first 4 weeks of admission.

• #26 Pressure Ulcer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553107/

  Pressure ulcers are a significant healthcare problem worldwide, which affects several thousands of people each year. Up to 3 million adults are affected annually in the United States alone. Pressure injury management is a significant source of economic burden. In 2019, Padula and Delarmente estimated that hospital-acquired pressure injury (HAPI) costs could exceed $26.8 billion. Their study simulated an incidence of 8.3 HAPI per 100 acutely ill patients. This number is consistent with previous studies, which showed that 7.9% of at-risk patients had HAPI. […] Sacral decubitus ulcers usually occur in elderly patients. Patients who are incontinent, paralyzed, or debilitated are more prone to getting them. Patients with normal sensory status, mobility, and mental status are less likely to form these ulcers because their regular physiologic feedback system leads to frequent physical positional shifts. As stated above, older patients are more prone to sacral decubitus ulcers, and two-thirds of ulcers occur in patients older than 70 years. Some data show that 83% of hospitalized patients developed ulcers within 5 days of hospitalization.

• #27 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Pressure ulcers remain a major health problem affecting approximately 3 million adults. In 1993, pressure ulcers were noted in 280,000 hospital stays, and 11 years later the number of ulcers was 455,000. The Healthcare Cost and Utilization Project (HCUP) report found from 1993 to 2003 a 63 percent increase in pressure ulcers, but the total number of hospitalizations during this time period increased by only 11 percent. […] Given the aging population, increasingly fragmented care, and nursing shortage, the incidence of pressure ulcers will most likely continue to rise. […] The incidence rates of pressure ulcers vary greatly with the health care settings. The National Pressure Ulcer Advisory Panel (NPUAP) says the incidence ranges from 0.4 percent to 38 percent in hospitals, from 2.2 percent to 23.9 percent in skilled nursing facilities, and from 0 percent to 17 percent for home health agencies. There is ample evidence that the majority of pressure ulcers occur relatively early in the admissions process. For patients in the hospital, they can occur within the first 2 weeks. […] For those elderly residents admitted to long-term care, pressure ulcers are most likely to develop within the first 4 weeks of admission.

• #28 Epidemiology and Therapeutics Aspects of Pressure Ulcers in Two Sub-Sahara African University Teaching Hospitals | ARC Journal of Surgery

  https://www.arcjournals.org/journal-of-surgery/volume-4-issue-2/1

  Pressure ulcers in this sample arose between day 3 and day 6 of hospitalization. This seem too early compared to reports from Germany were the delay for pressure ulcer onset following hospital admission was 2 weeks in acute care settings and 3 months in nursing homes. This early onset of pressure ulcers in our cohort, may point to the impact of nursing care in our health care institution. It is universally recognized that the prevalence of pressure sores is a good indicator of the quality of care of a health facility. […] Our results may imply a deficient nursing care in our tertiary hospital, which needs urgent attention. […] Pressure is one recognize extrinsic factor in developing ulcers. In the medical nomenclature hospital beds and supports are classified depending on their ability in handling pressure at the interface with the patients body: type 1 supports with static pressures; type 2 and type 3 supports with dynamic interface pressure and variable component in the structure of mattress.

• #29 Bedsores (pressure ulcers) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893

  Bedsores are areas of damaged skin and tissue caused by sustained pressure that reduces blood flow to vulnerable areas of the body. This pressure may be caused from being in a bed or wheelchair for a long time. […] Bedsores also are called pressure ulcers, pressure injuries and decubitus ulcers. […] The people who are most at risk of bedsores have medical conditions that keep them from changing positions or moving. Or they spend most of their time in a bed or a chair. […] Pressure against the skin that limits blood flow to the skin causes bedsores. Limited movement can make skin prone to damage and cause bedsores. […] Your risk of getting bedsores is higher if you have a hard time moving and can’t change position easily while seated or in bed. […] Medical conditions affecting blood flow. Health problems that can affect blood flow can raise the risk of tissue damage such as bedsores. Examples of these types of medical conditions are diabetes and vascular disease. […] Berlowitz D. Epidemiology, pathogenesis and risk assessment of pressure-induced skin and soft tissue injury.

• #30 Pressure ulcer | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/pressure-ulcer?lang=us

  Pressure ulcer incidence differs considerably by the clinical setting and the quality of care. Incidence rates varies between 3.3%-39.3% in intensive care units, 2.2% – 23.9% for long term care settings and between 0% and 17% for home care. […] More than 100 risk factors are identified in the literature, and the most important ones to assess are impaired mobility and sensory perception, moisture, malnutrition, low activity, friction, and shear. […] Pressure ulcers are classified into four grades, according to the ICD-11 (2018 version). […] The most affected sites by pressure ulcers are regions where sustained pressure is applied on bony prominence.

• #31 Bedsores (pressure ulcers) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893

  Bedsores are areas of damaged skin and tissue caused by sustained pressure that reduces blood flow to vulnerable areas of the body. This pressure may be caused from being in a bed or wheelchair for a long time. […] Bedsores also are called pressure ulcers, pressure injuries and decubitus ulcers. […] The people who are most at risk of bedsores have medical conditions that keep them from changing positions or moving. Or they spend most of their time in a bed or a chair. […] Pressure against the skin that limits blood flow to the skin causes bedsores. Limited movement can make skin prone to damage and cause bedsores. […] Your risk of getting bedsores is higher if you have a hard time moving and can’t change position easily while seated or in bed. […] Medical conditions affecting blood flow. Health problems that can affect blood flow can raise the risk of tissue damage such as bedsores. Examples of these types of medical conditions are diabetes and vascular disease. […] Berlowitz D. Epidemiology, pathogenesis and risk assessment of pressure-induced skin and soft tissue injury.

• #32 Pressure ulcer | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/pressure-ulcer?lang=us

  Pressure ulcer incidence differs considerably by the clinical setting and the quality of care. Incidence rates varies between 3.3%-39.3% in intensive care units, 2.2% – 23.9% for long term care settings and between 0% and 17% for home care. […] More than 100 risk factors are identified in the literature, and the most important ones to assess are impaired mobility and sensory perception, moisture, malnutrition, low activity, friction, and shear. […] Pressure ulcers are classified into four grades, according to the ICD-11 (2018 version). […] The most affected sites by pressure ulcers are regions where sustained pressure is applied on bony prominence.

• #33 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Mortality is also associated with pressure ulcers. Several studies noted mortality rates as high as 60 percent for older persons with pressure ulcers within 1 year of hospital discharge. Most often, pressure ulcers do not cause death; rather the pressure ulcer develops after a sequential decline in health status. Thus, the development of pressure ulcers can be a predictor of mortality. […] Studies further suggested that the development of skin breakdown postsurgery can lead elders to have major functional impairment post surgical procedure. […] The cost to treat pressure ulcers can be expensive; the HCUP study reported an average cost of $37,800. Cost data vary greatly, depending on what factors are included or excluded from the economic models (e.g., nursing time, support surfaces). It has been estimated that the cost of treating pressure ulcers is 2.5 times the cost of preventing them. Thus, preventing pressure ulcers should be the goal of all nurses.

• #34 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Elderly patients admitted to acute care hospitals for nonelective orthopedic procedures are at even greater risk for pressure injuries than other hospitalized patients are, with a 66% incidence. […] In nursing homes, the prevalence of pressure injuries is 2.6-24%; the incidence is 25% in residents admitted from an acute care hospital. […] Among patients with neurologic impairments, pressure injuries occur with an incidence of 7-8% annually, with a lifetime risk estimated to be 25-85%. […] Moreover, pressure injuries are listed as the direct cause of death in 7-8% of all individuals with paraplegia; these individuals also have the highest recurrence rate (80%). […] A study of the prevalence of pressure injuries in community residents with SCI demonstrated that those with higher-level SCI lesions carry a greater risk of developing pressure injuries than those with lower-level lesions do. […] Some authors have speculated that detecting erythema can be more difficult with skin that has darker pigmentation.

• #35 UCLA-led study finds direct correlation between hospital bedsores, patient mortality | UCLA Health

  https://www.uclahealth.org/news/release/ucla-led-study-finds-direct-correlation-between-hospital-bedsores-patient-mortality

  A new clinical study spearheaded by the dean of UCLA’s School of Nursing has found a direct correlation between pressure ulcers commonly known as bedsores and patient mortality and increased hospitalization. […] According to the study, featured as the lead article in the current issue of the Journal of the American Geriatrics Society, seniors who developed pressure ulcers were more likely to die during their hospital stay, to have longer stays in the hospital, and to be readmitted to the hospital within 30 days of their discharge. […] „Hospital-acquired pressure ulcers were shown to be an important risk factor associated with mortality,” said Dr. Courtney Lyder, lead investigator on the study and dean of the UCLA School of Nursing. […] The study found that 4.5 percent of the patients tracked acquired a pressure ulcer during their stay in the hospital.

• #36 UCLA-led study finds direct correlation between hospital bedsores, patient mortality | UCLA Health

  https://www.uclahealth.org/news/release/ucla-led-study-finds-direct-correlation-between-hospital-bedsores-patient-mortality

  The study also revealed that of the nearly 3,000 individuals who entered the hospital with a pressure ulcer, 16.7 percent developed at least one new bedsore on a different part of their body during their hospitalization. […] „This is a serious issue, and now we have data that can help the health care system address this ongoing problem,” Lyder said. […] „When individuals enter the hospital with the risk conditions that we’ve identified, it should send up an immediate warning signal that appropriate steps should be taken to minimize the chance of pressure ulcers occurring.”

• #37 Pressure Injuries – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/pressure-injury/pressure-injuries

  The updated NPIAP staging system also includes definitions for unstageable, deep-tissue, medical device-related, and mucosal membrane pressure injuries. […] Pressure injuries are a reservoir for hospital-acquired antibiotic-resistant microorganisms. High bacteria counts within the wound can hinder tissue healing. Infections are the most common complications of pressure injury. […] Diagnosis of pressure injury is based on clinical evaluation. A pressure injury is typically identified by its characteristic appearance and by its location over a bony prominence. […] Prognosis for early-stage pressure injuries is excellent with timely, appropriate treatment, but healing typically requires weeks. […] Prevention requires identification of high-risk patients, repositioning, conscientious skin care and hygiene, and avoidance of immobilization.

• #38 5. How do we measure our pressure ulcer rates and practices? | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html

  Pressure ulcer rates are the most direct measure of how well you are succeeding in preventing pressure ulcers. If your rate is low or improving, then you are likely doing a good job in preventing pressure ulcers. Conversely, if your pressure ulcer rate is high or increasing, then there might be areas in which care can be improved. You can use these data to make a case for initiating a quality improvement effort and monitoring progress to sustain your improvements. […] In measuring pressure ulcer rates, you will be counting the number of patients with pressure ulcers. It is important that you only measure and track pressure ulcers. Many other types of skin lesions may develop in hospitalized patients. Remember, pressure ulcers are areas of soft tissue damage caused by pressure or pressure and shear. Do not count skin lesions not related to pressure such as skin breaks or maceration from friction/moisture, even when found over a bony prominence.

• #39 5. How do we measure our pressure ulcer rates and practices? | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html

  To calculate pressure ulcer incidence or prevalence rates, whether at the unit level or at the overall facility, you need to know who has a pressure ulcer and when it developed. […] While we recommend performing a comprehensive skin inspection daily and documenting the results on a standard form as the best approach for calculating pressure ulcer rates, hospitals have found it difficult to convince staff to create a new document for recording pressure ulcer status. […] The question of how well we are we performing relative to other hospitals often arises. Are our rates lower than those at other hospitals? Unfortunately, there are no national benchmarks with which you can compare your performance. In large part this is due to the many different approaches used in studies measuring incidence and prevalence rates. Rates calculated using different approaches are not comparable.

• #40 5. How do we measure our pressure ulcer rates and practices? | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html

  To calculate pressure ulcer incidence or prevalence rates, whether at the unit level or at the overall facility, you need to know who has a pressure ulcer and when it developed. […] While we recommend performing a comprehensive skin inspection daily and documenting the results on a standard form as the best approach for calculating pressure ulcer rates, hospitals have found it difficult to convince staff to create a new document for recording pressure ulcer status. […] The question of how well we are we performing relative to other hospitals often arises. Are our rates lower than those at other hospitals? Unfortunately, there are no national benchmarks with which you can compare your performance. In large part this is due to the many different approaches used in studies measuring incidence and prevalence rates. Rates calculated using different approaches are not comparable.

• #41 5. How do we measure our pressure ulcer rates and practices? | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html

  To improve data quality, you will need to improve staff recognition and staging of pressure ulcers. Many errors are made in the recognition and staging of pressure ulcers and there are only limited opportunities to learn. Therefore, consider performing a comprehensive skin assessment every 3 months with a wound care nurse or other knowledgeable clinician from another unit.

• #42 Pressure Ulcer | National Wound Care Strategy Programme

  https://www.nationalwoundcarestrategy.net/pressure-ulcer/

  The National Wound Care Strategy Programme (NWCSP) seeks to prevent pressure damage and improve healing of pressure ulcers. […] Recognising that pressure ulcers are in the top ten harms in the NHS in England, the NWCSP is working collaboratively with our commissioning organisation, the NHS England Nursing Directorate to co-design, develop and establish a national programme to reduce pressure damage. […] Pressure Ulcer surveillance. […] Over the last 20 years, in England, there has been significant investment in the collection of PU data. This effort has made an important contribution to raising the profile of PU prevention, but data collection has placed a large burden on health professionals. […] The National Stop the Pressure Programme is now developing a new national PU data system to replace the National Safety Theromometer, to support quality improvement for people at risk of pressure damage.

• #43 Pressure Ulcer | National Wound Care Strategy Programme

  https://www.nationalwoundcarestrategy.net/pressure-ulcer/

  Secondary Care Pressure Ulcer Surveillance using Model Health System metrics Download. […] For a number of years, the National Wound Care Strategy Programme has collaborated with the Society of Tissue Viability to fund, create and deliver campaigns for Stop the Pressure week. […] Stop the Pressure week aims to raise awareness of the impact of pressure ulcers and demonstrate how they can be prevented.

• #44

  http://www.omjournal.org/articleDetails.aspx?coType=1&aId=709

  Pressure ulcers are a multifactorial, prevalent, and preventable morbidity. […] Pressure ulcers cause a huge burden, financially and emotionally, to the patient, caregivers, and society as a whole. […] The Wound Care Surveillance Program has been a very effective strategy for the prevention and management of pressure ulcers. […] Pressure ulcers, also known as pressure sores, decubitus ulcers, and bedsores, are areas of localized damage to the skin and underlying tissue. […] We calculated a prevalence rate of 3.1%, which is among the lowest reported prevalence rate in the literature. […] The risk a patient is in of developing a pressure ulcer can be predicted using the Braden score, and this helps reduce their prevalence. […] Our findings highlight the need to improve the home care of pressure ulcers. […] Healing was adversely affected by the severity of the spinal injury, associated organ injuries, and the presence of a tracheostomy. […] The Wound Care Surveillance Program has been an effective strategy in the management of pressure ulcers.

• #45 DAL NH 15-08: Subject: Pressure Ulcer Care

  https://www.health.ny.gov/professionals/nursing_home_administrator/dal_nh_15-08_pressure_ulcer_care.htm

  The Gold STAMP (Success Through Assessment, Management and Prevention) Program is a coalition of organizations convened in New York State to provide resources and education across the continuum of care to improve the assessment, management and prevention of pressure ulcers. […] The Gold STAMP mission and goals, as well as a wealth of education and other resources to improve the assessment, management and prevention of pressure ulcers, are available at www.goldstamp.org. […] The Department is committed to sustaining its efforts in this area and achieving even greater success in the future. […] In SFY 2015, special emphasis is being placed on the pivotal role that physicians play. This effort is a targeted follow up to the Guidelines on Medical Direction and Medical Care in Nursing Homes that were issued by the Department in 2012. […] An effective pressure ulcer prevention and treatment program requires an interdisciplinary approach. […] If your facility/agency is not already involved in the Gold STAMP Program, please visit www.goldstamp.org.

• #46 Quick Safety 25: Preventing pressure injuries (Updated March 2022) | The Joint CommissionfacebookXlinkedin

  https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-25-preventing-pressure-injuries/preventing-pressure-injuries/

  Pressure injuries are significant health issues and one of the biggest challenges organizations face on a day-to-day basis. […] Preventing pressure injuries has always been a challenge, both for caregivers and for the health care industry, because the epidemiology of pressure injuries varies by clinical setting and is a potentially preventable condition. […] Pressure injuries are commonly seen in high-risk populations, such as the elderly and those who are very ill. […] In 2008, the U.S. Centers for Medicare and Medicaid Services (CMS) announced it will not pay for additional costs incurred for hospital-acquired pressure injuries. […] In 2019, the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP), and the Pan Pacific Pressure Injury Alliance (PPPIA) published The International Guideline (Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline).

• #47 Pressure Ulcer Prevention : Non Invasive Assessment of Bedsores | Decubitus Ulcers | Deep Tissue Injury

  https://www.longportinc.com/applications/wounds/pressure-ulcer-prevention

  Pressure ulcers, also known as decubitus ulcers or bedsores, are a common problem in any situation where patients are compromised because of immobility, nutrition, incontinence, or age. Each year, more than 2.5 million people in the United States develop pressure ulcers, which cost approximately $10 billion or between $20,000 and $150,000 to treat per wound dependent upon the severity. Further, these wounds are very painful, are the subject of 17,000 law suits annually and are considered preventable. […] Stage 3 and 4 pressure ulcers are one of the conditions that CMS now classify as never events, meaning they should never happen. CMS announced in 2007 that certain hospital-acquired conditions would no longer be covered by Medicare ad Medicaid. One of these conditions is pressure ulcers. This rule change is forcing clinicians to put greater emphasis on pressure ulcer prevention in hospitals.

• #48 Epidemiology and Therapeutics Aspects of Pressure Ulcers in Two Sub-Sahara African University Teaching Hospitals | ARC Journal of Surgery

  https://www.arcjournals.org/journal-of-surgery/volume-4-issue-2/1

  Pressure ulcers in this sample arose between day 3 and day 6 of hospitalization. This seem too early compared to reports from Germany were the delay for pressure ulcer onset following hospital admission was 2 weeks in acute care settings and 3 months in nursing homes. This early onset of pressure ulcers in our cohort, may point to the impact of nursing care in our health care institution. It is universally recognized that the prevalence of pressure sores is a good indicator of the quality of care of a health facility. […] Our results may imply a deficient nursing care in our tertiary hospital, which needs urgent attention. […] Pressure is one recognize extrinsic factor in developing ulcers. In the medical nomenclature hospital beds and supports are classified depending on their ability in handling pressure at the interface with the patients body: type 1 supports with static pressures; type 2 and type 3 supports with dynamic interface pressure and variable component in the structure of mattress.

• #49 Quick Safety Issue 25: Preventing pressure injuries (Updated March 2022) | The Joint Commission

  https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-25-preventing-pressure-injuries/

  Pressure injury prevention and treatment requires multi-disciplinary collaborations, good organizational culture and operational practices that promote safety. […] Per the International Guideline, risk assessment is a central component of clinical practice and a necessary first step aimed at identifying individuals who are susceptible to pressure injuries. […] The prevention of pressure injuries is a great concern in health care today.

• #50 Nursing Homes: Pressure Ulcer/Injury Information | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/regulations/nh/pressure-ulcer.htm

  Pressure Ulcer/Injury (PU/PI) refers to localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device. […] CMS often refers to the National Pressure Ulcer Advisory Panel’s (NPUAP) terms and definitions, which it has adapted, within its patient and resident assessment instruments and corresponding assessment manuals, which includes the Minimum Data Set (MDS). […] One way CMS aims to reduce pressure injuries is through the annual survey process. […] DQA strongly recommends that all nursing home medical directors and Quality Assessment Process Improvement (PDF) programs monitor their pressure injury data. […] Pressure Ulcer/Injury Critical Element Pathway is used for a resident having, or at risk of developing, a pressure ulcer/injury to determine if facility practices are in place to identify, evaluate, and intervene to prevent and/or heal pressure ulcers/injuries.

• #51 DAL NH 15-08: Subject: Pressure Ulcer Care

  https://www.health.ny.gov/professionals/nursing_home_administrator/dal_nh_15-08_pressure_ulcer_care.htm

  DAL NH 15-08: Pressure Ulcer Care […] This letter is a call to New York State’s hospitals, nursing homes and home care agencies for a sustained commitment to pressure ulcer performance improvement. […] In addition to alignment with the State’s health care delivery system reforms, pressure ulcers have also been identified as a cross-setting quality measure as part of the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act). […] Over the past eight years, we have made great progress in responding to this serious patient and resident safety issue. As the National pressure ulcer rate among high risk residents in nursing homes has shown a steady decline, New York State’s rate decreased dramatically from 14.2% (in 2010) to 7.4%* by the beginning of SFY 2015. […] More important, however, is the improved quality of life for our patients and residents.

• #52 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Pressure ulcers remain a major health problem affecting approximately 3 million adults. In 1993, pressure ulcers were noted in 280,000 hospital stays, and 11 years later the number of ulcers was 455,000. The Healthcare Cost and Utilization Project (HCUP) report found from 1993 to 2003 a 63 percent increase in pressure ulcers, but the total number of hospitalizations during this time period increased by only 11 percent. […] Given the aging population, increasingly fragmented care, and nursing shortage, the incidence of pressure ulcers will most likely continue to rise. […] The incidence rates of pressure ulcers vary greatly with the health care settings. The National Pressure Ulcer Advisory Panel (NPUAP) says the incidence ranges from 0.4 percent to 38 percent in hospitals, from 2.2 percent to 23.9 percent in skilled nursing facilities, and from 0 percent to 17 percent for home health agencies. There is ample evidence that the majority of pressure ulcers occur relatively early in the admissions process. For patients in the hospital, they can occur within the first 2 weeks. […] For those elderly residents admitted to long-term care, pressure ulcers are most likely to develop within the first 4 weeks of admission.

• #53 Pressure Injuries – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/pressure-injury/pressure-injuries

  Pressure injuries affect up to 3 million adults in the United States annually, with a prevalence among hospitalized patients of 5% to 15%, with the percentage considerably higher in some long-term care environments and intensive care units. […] Between 1993 and 2006, the number of hospitalized patients with pressure ulcers increased by 75%, a rate over 5 times the increase of hospital admissions overall, and older adults in particular were affected. The rate increased most in patients who developed pressure ulcers during hospitalization. […] Pressure injury has also been reported in children with severe neurologic impairments such as spina bifida, cerebral palsy, and spinal cord injury. […] Several scales (eg, The Norton Scale for Predicting Pressure Ulcer Risk, the Braden Scale) have been developed to predict risk.

• #54 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. […] We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). […] The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. […] In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the 95 age group among men and women. […] At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI.

• #55 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. […] In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries. […] The prevalence of decubitus ulcers in hospitalized patients in the United States is between 5 and 15%, and the prevalence in the intensive care unit is even higher. […] To date, little is known about the estimates of cause-specific years lived with disability (YLDs) for decubitus ulcers at the global, regional, and national levels. […] Therefore, considering the impact of decubitus ulcers on physical, social, and public health, it is important to understand the prevalence of decubitus ulcers and ensure that adequate resources are allocated for disease management and prevention.

• #56 Pressure ulcer – Wikipedia

  https://en.wikipedia.org/wiki/Pressure_ulcer

  Each year, more than 2.5 million people in the United States develop pressure ulcers. In acute care settings in the United States, the incidence of bedsores is 0.4% to 38%; within long-term care it is 2.2% to 23.9%, and in home care, it is 0% to 17%. Similarly, there is wide variation in prevalence: 10% to 18% in acute care, 2.3% to 28% in long-term care, and 0% to 29% in home care. There is a much higher rate of bedsores in intensive care units because of immunocompromised individuals, with 8% to 40% of those in the ICU developing bedsores. However, pressure ulcer prevalence is highly dependent on the methodology used to collect the data. Using the European Pressure Ulcer Advisory Panel (EPUAP) methodology there are similar figures for pressure ulcers in acutely sick people in the hospital. There are differences across countries, but using this methodology, pressure ulcer prevalence in Europe was consistently high, from 8.3% (Italy) to 22.9% (Sweden). A recent study in Jordan also showed a figure in this range. Some research shows differences in pressure-ulcer detection among white and black residents in nursing homes.

• #57 Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis | Patient Safety in Surgery | Full Text

  https://pssjournal.biomedcentral.com/articles/10.1186/s13037-023-00383-8

  Hospital-acquired pressure injuries are a major patient safety concern in intensive care units that are considered largely preventable adverse events by adherence to nursing standards of care. […] A total of 15 articles met the inclusion criteria. Based on the random-effects model, the overall Pressure ulcer prevalence rate was 16.6% (95% CI (8.629.6)). […] This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region. […] Therefore, it is necessary for health policymakers and managers in Eastern Mediterranean Region to take necessary measures to prevent the incidence of Pressure ulcers in hospitals, especially in ICUs. […] Pressure ulcer prevalence in the Eastern Mediterranean Region has varied between 7% and 44.4%.

• #58 Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis | Patient Safety in Surgery | Full Text

  https://pssjournal.biomedcentral.com/articles/10.1186/s13037-023-00383-8

  The results of this systematic review and meta-analysis showed that the overall Pressure ulcer prevalence in ICU patients in the Eastern Mediterranean Region is 16.6%. […] Hospital managers and staff should determine the prevalence of Pressure ulcers, analyze the causes of their occurrence, and take necessary measures to prevent their recurrence. […] Hospital managers should prepare ground for reducing Pressure ulcer prevalence among patients by improving workplace safety, promoting a safety culture, improving work processes, training employees, and increasing their well-being, motivation and satisfaction. […] This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region.

• #59 Pressure Ulcer | National Wound Care Strategy Programme

  https://www.nationalwoundcarestrategy.net/pressure-ulcer/

  The National Wound Care Strategy Programme (NWCSP) seeks to prevent pressure damage and improve healing of pressure ulcers. […] Recognising that pressure ulcers are in the top ten harms in the NHS in England, the NWCSP is working collaboratively with our commissioning organisation, the NHS England Nursing Directorate to co-design, develop and establish a national programme to reduce pressure damage. […] Pressure Ulcer surveillance. […] Over the last 20 years, in England, there has been significant investment in the collection of PU data. This effort has made an important contribution to raising the profile of PU prevention, but data collection has placed a large burden on health professionals. […] The National Stop the Pressure Programme is now developing a new national PU data system to replace the National Safety Theromometer, to support quality improvement for people at risk of pressure damage.

• #60 5. How do we measure our pressure ulcer rates and practices? | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html

  To calculate pressure ulcer incidence or prevalence rates, whether at the unit level or at the overall facility, you need to know who has a pressure ulcer and when it developed. […] While we recommend performing a comprehensive skin inspection daily and documenting the results on a standard form as the best approach for calculating pressure ulcer rates, hospitals have found it difficult to convince staff to create a new document for recording pressure ulcer status. […] The question of how well we are we performing relative to other hospitals often arises. Are our rates lower than those at other hospitals? Unfortunately, there are no national benchmarks with which you can compare your performance. In large part this is due to the many different approaches used in studies measuring incidence and prevalence rates. Rates calculated using different approaches are not comparable.

• #61 Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/190115-overview

  Pressure injuries are common among patients hospitalized in acute- and chronic-care facilities. It has been estimated that about 1 million pressure injuries occur in the United States; however, definitive information on the epidemiology and natural history of this condition is still limited. Unfortunately, studies to date have been encumbered by methodologic issues and variability in describing the lesions. […] Reported incidences of pressure injuries in hospitalized patients range from 2.7% to 29%, and reported prevalences in hospitalized patients range from 3.5% to 69%. […] Patients in critical care units have an increased risk of pressure injuries, as evidenced by a 33% incidence and a 41% prevalence. […] The fifth National Pressure Ulcer Prevalence Survey, conducted in 1999 among patients in acute care hospitals, showed an overall prevalence of 14.8%, with 7.1% of ulcers having occurred during that hospital visit.

• #62 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. […] In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries. […] The prevalence of decubitus ulcers in hospitalized patients in the United States is between 5 and 15%, and the prevalence in the intensive care unit is even higher. […] To date, little is known about the estimates of cause-specific years lived with disability (YLDs) for decubitus ulcers at the global, regional, and national levels. […] Therefore, considering the impact of decubitus ulcers on physical, social, and public health, it is important to understand the prevalence of decubitus ulcers and ensure that adequate resources are allocated for disease management and prevention.

• #63 The global burden of decubitus ulcers from 1990 to 2019 | Scientific Reports

  https://www.nature.com/articles/s41598-021-01188-4

  More detailed information about the burden of decubitus ulcers from different regions and countries may be beneficial for decision-makers to reduce the cost burden of decubitus ulcers. […] The overall prevalence of decubitus ulcers was classified into severity categories by applying the disability weight and disfigurement with itch/pain. […] The International Classification of Diseases (ICD) version 9 code for decubitus ulcers is 707, and the ICD-10 codes are L89-L89.95. […] The age-standardized prevalence rates of decubitus ulcers ranged from 1.5 to 55.2 cases per 100,000 population at the national level. […] The largest increases were seen in Malaysia (110.3% [97.3 to 123.6%]), Saudi Arabia (100.1% [88.4 to 112.5%]), and Thailand (81.5% [69.4 to 96.5%]). […] The age-standardized incidence rates of decubitus ulcers in 2019 ranged from 5.6 to 198.4 cases per 100,000 population.

• #64 5. How do we measure our pressure ulcer rates and practices? | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html

  To improve data quality, you will need to improve staff recognition and staging of pressure ulcers. Many errors are made in the recognition and staging of pressure ulcers and there are only limited opportunities to learn. Therefore, consider performing a comprehensive skin assessment every 3 months with a wound care nurse or other knowledgeable clinician from another unit.

• #65 Pressure Ulcers: A Patient Safety Issue – Patient Safety and Quality – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2650/

  Mortality is also associated with pressure ulcers. Several studies noted mortality rates as high as 60 percent for older persons with pressure ulcers within 1 year of hospital discharge. Most often, pressure ulcers do not cause death; rather the pressure ulcer develops after a sequential decline in health status. Thus, the development of pressure ulcers can be a predictor of mortality. […] Studies further suggested that the development of skin breakdown postsurgery can lead elders to have major functional impairment post surgical procedure. […] The cost to treat pressure ulcers can be expensive; the HCUP study reported an average cost of $37,800. Cost data vary greatly, depending on what factors are included or excluded from the economic models (e.g., nursing time, support surfaces). It has been estimated that the cost of treating pressure ulcers is 2.5 times the cost of preventing them. Thus, preventing pressure ulcers should be the goal of all nurses.

• #66 Quick Safety 25: Preventing pressure injuries (Updated March 2022) | The Joint CommissionfacebookXlinkedin

  https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-25-preventing-pressure-injuries/preventing-pressure-injuries/

  Pressure injuries are significant health issues and one of the biggest challenges organizations face on a day-to-day basis. […] Preventing pressure injuries has always been a challenge, both for caregivers and for the health care industry, because the epidemiology of pressure injuries varies by clinical setting and is a potentially preventable condition. […] Pressure injuries are commonly seen in high-risk populations, such as the elderly and those who are very ill. […] In 2008, the U.S. Centers for Medicare and Medicaid Services (CMS) announced it will not pay for additional costs incurred for hospital-acquired pressure injuries. […] In 2019, the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP), and the Pan Pacific Pressure Injury Alliance (PPPIA) published The International Guideline (Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline).

• #67 Pressure Ulcer Prevention : Non Invasive Assessment of Bedsores | Decubitus Ulcers | Deep Tissue Injury

  https://www.longportinc.com/applications/wounds/pressure-ulcer-prevention

  Pressure ulcers, also known as decubitus ulcers or bedsores, are a common problem in any situation where patients are compromised because of immobility, nutrition, incontinence, or age. Each year, more than 2.5 million people in the United States develop pressure ulcers, which cost approximately $10 billion or between $20,000 and $150,000 to treat per wound dependent upon the severity. Further, these wounds are very painful, are the subject of 17,000 law suits annually and are considered preventable. […] Stage 3 and 4 pressure ulcers are one of the conditions that CMS now classify as never events, meaning they should never happen. CMS announced in 2007 that certain hospital-acquired conditions would no longer be covered by Medicare ad Medicaid. One of these conditions is pressure ulcers. This rule change is forcing clinicians to put greater emphasis on pressure ulcer prevention in hospitals.

• #68

  https://link.springer.com/article/10.2165/00002512-199202010-00006

  Pressure sores remain common, with a prevalence of 5 to 9% and more than 70% occurring in patients over 70 years of age. […] Prevention involves identification of patients at risk, appropriate nursing care measures and the use of special equipment. […] Management of the established sore involves treatment of the underlying medical condition(s), attention to hydration and nutrition, prevention of further tissue trauma and the use of special dressings and procedures which facilitate the inflammatory repair response. […] A useful starting point is to classify pressure sores into 4 clinical types depending on amount of tissue damage and depth of ulcer. […] Cavity ulcers (type 4) can be managed with silastic foam or hydrocolloid or alginate dressings. […] Systemic antibiotics are indicated only when surrounding cellulitis is present, although metronidazole is useful for malodorous sores. […] The development of pressure sores during hospitalisation.

• #69 Quick Safety Issue 25: Preventing pressure injuries (Updated March 2022) | The Joint Commission

  https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-25-preventing-pressure-injuries/

  Pressure injury prevention and treatment requires multi-disciplinary collaborations, good organizational culture and operational practices that promote safety. […] Per the International Guideline, risk assessment is a central component of clinical practice and a necessary first step aimed at identifying individuals who are susceptible to pressure injuries. […] The prevention of pressure injuries is a great concern in health care today.

• #70 Quick Safety Issue 25: Preventing pressure injuries (Updated March 2022) | The Joint Commission

  https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-25-preventing-pressure-injuries/

  Pressure injuries are significant health issues and one of the biggest challenges organizations face on a day-to-day basis. […] Preventing pressure injuries has always been a challenge, both for caregivers and for the health care industry, because the epidemiology of pressure injuries varies by clinical setting and is a potentially preventable condition. […] The presence of pressure injuries is a marker of poor overall prognosis and may contribute to premature mortality in some patients. […] Pressure injuries are commonly seen in high-risk populations, such as the elderly and those who are very ill. […] In 2008, the U.S. Centers for Medicare and Medicaid Services (CMS) announced it will not pay for additional costs incurred for hospital-acquired pressure injuries. […] In 2019, the European Pressure Ulcer Advisory Panel (EPUAP), the National Pressure Injury Advisory Panel (NPIAP), and the Pan Pacific Pressure Injury Alliance (PPPIA) published The International Guideline (Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline).

• #71 DAL NH 15-08: Subject: Pressure Ulcer Care

  https://www.health.ny.gov/professionals/nursing_home_administrator/dal_nh_15-08_pressure_ulcer_care.htm

  The Gold STAMP (Success Through Assessment, Management and Prevention) Program is a coalition of organizations convened in New York State to provide resources and education across the continuum of care to improve the assessment, management and prevention of pressure ulcers. […] The Gold STAMP mission and goals, as well as a wealth of education and other resources to improve the assessment, management and prevention of pressure ulcers, are available at www.goldstamp.org. […] The Department is committed to sustaining its efforts in this area and achieving even greater success in the future. […] In SFY 2015, special emphasis is being placed on the pivotal role that physicians play. This effort is a targeted follow up to the Guidelines on Medical Direction and Medical Care in Nursing Homes that were issued by the Department in 2012. […] An effective pressure ulcer prevention and treatment program requires an interdisciplinary approach. […] If your facility/agency is not already involved in the Gold STAMP Program, please visit www.goldstamp.org.

• #72 Pressure Ulcer | National Wound Care Strategy Programme

  https://www.nationalwoundcarestrategy.net/pressure-ulcer/

  The National Wound Care Strategy Programme (NWCSP) seeks to prevent pressure damage and improve healing of pressure ulcers. […] Recognising that pressure ulcers are in the top ten harms in the NHS in England, the NWCSP is working collaboratively with our commissioning organisation, the NHS England Nursing Directorate to co-design, develop and establish a national programme to reduce pressure damage. […] Pressure Ulcer surveillance. […] Over the last 20 years, in England, there has been significant investment in the collection of PU data. This effort has made an important contribution to raising the profile of PU prevention, but data collection has placed a large burden on health professionals. […] The National Stop the Pressure Programme is now developing a new national PU data system to replace the National Safety Theromometer, to support quality improvement for people at risk of pressure damage.

• #73 Pressure Ulcer | National Wound Care Strategy Programme

  https://www.nationalwoundcarestrategy.net/pressure-ulcer/

  Secondary Care Pressure Ulcer Surveillance using Model Health System metrics Download. […] For a number of years, the National Wound Care Strategy Programme has collaborated with the Society of Tissue Viability to fund, create and deliver campaigns for Stop the Pressure week. […] Stop the Pressure week aims to raise awareness of the impact of pressure ulcers and demonstrate how they can be prevented.

• #74 DAL NH 15-08: Subject: Pressure Ulcer Care

  https://www.health.ny.gov/professionals/nursing_home_administrator/dal_nh_15-08_pressure_ulcer_care.htm

  The Gold STAMP (Success Through Assessment, Management and Prevention) Program is a coalition of organizations convened in New York State to provide resources and education across the continuum of care to improve the assessment, management and prevention of pressure ulcers. […] The Gold STAMP mission and goals, as well as a wealth of education and other resources to improve the assessment, management and prevention of pressure ulcers, are available at www.goldstamp.org. […] The Department is committed to sustaining its efforts in this area and achieving even greater success in the future. […] In SFY 2015, special emphasis is being placed on the pivotal role that physicians play. This effort is a targeted follow up to the Guidelines on Medical Direction and Medical Care in Nursing Homes that were issued by the Department in 2012. […] An effective pressure ulcer prevention and treatment program requires an interdisciplinary approach. […] If your facility/agency is not already involved in the Gold STAMP Program, please visit www.goldstamp.org.

• #75

  http://www.omjournal.org/articleDetails.aspx?coType=1&aId=709

  Pressure ulcers are a multifactorial, prevalent, and preventable morbidity. […] Pressure ulcers cause a huge burden, financially and emotionally, to the patient, caregivers, and society as a whole. […] The Wound Care Surveillance Program has been a very effective strategy for the prevention and management of pressure ulcers. […] Pressure ulcers, also known as pressure sores, decubitus ulcers, and bedsores, are areas of localized damage to the skin and underlying tissue. […] We calculated a prevalence rate of 3.1%, which is among the lowest reported prevalence rate in the literature. […] The risk a patient is in of developing a pressure ulcer can be predicted using the Braden score, and this helps reduce their prevalence. […] Our findings highlight the need to improve the home care of pressure ulcers. […] Healing was adversely affected by the severity of the spinal injury, associated organ injuries, and the presence of a tracheostomy. […] The Wound Care Surveillance Program has been an effective strategy in the management of pressure ulcers.

• #76 Quick Safety 25: Preventing pressure injuries (Updated March 2022) | The Joint CommissionfacebookXlinkedin

  https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-25-preventing-pressure-injuries/preventing-pressure-injuries/

  The prevention of pressure injuries is a great concern in health care today. […] Pressure injury prevention and treatment requires multi-disciplinary collaborations, good organizational culture and operational practices that promote safety. […] Per the International Guideline, risk assessment is a central component of clinical practice and a necessary first step aimed at identifying individuals who are susceptible to pressure injuries. […] The majority of the following strategies are based on the NPIAP’s “Pressure Injury Prevention Points.” […] Monitor the prevalence and incidence of pressure injuries.

• #77 Bedsores (pressure ulcers) | PPT

  https://www.slideshare.net/AhmedThanin/bedsores-pressure-ulcers

  Bedsores are caused by pressure against the skin that limits blood flow to the skin. Limited movement can make skin vulnerable to damage and lead to development of bedsores. Three primary contributing factors for bedsores are: Pressure. Friction. Shear. […] Risk factors include poor health, spinal cord injury, immobility, incontinence, lack of sensory perception, poor nutrition and hydration, and medical conditions affecting blood flow. […] Prevention of Pressure Ulcer frequently involves repositioning to avoid stress on the skin, maintaining good nutrition and fluid intake, and managing moisture. […] Hospital-Acquired Pressure Ulcer Prevention requires conducting skin/risk assessments and managing moisture to minimize pressure. […] Pressure ulcers can cause harm to patients, causing pain, infections and extended lengths of stay.

• #78 Pressure sores | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/pressure-sores

  Anyone confined to a bed or chair for a long time is at risk of developing a pressure sore. […] Pressure sores can be difficult to treat and can lead to serious complications. […] A pressure sore is caused by constant pressure applied to the skin over a period of time. […] The skin of older people tends to be thinner and more delicate, which means an older person has an increased risk of developing a pressure sore during a prolonged stay in bed. […] If you are confined to a bed or chair for any period of time, it’s important to be aware of the risk of pressure sores. […] Pressure injury monitoring devices that measure the skin moisture content, body motion and the pressure in-between may be used to prevent pressure sores and injuries. […] A routine nursing assessment may be required if you’re at high risk of pressure sores. […] Daily checks are needed to look for early warning signs including red, purple or blue torn or swollen skin, especially over bony areas. […] There are a variety of treatments available to manage pressure sores and promote healing, depending on the severity of the pressure sore.

• #79 Pressure ulcers (pressure sores)

  https://www.nhs.uk/conditions/pressure-sores/

  Pressure ulcers are caused by something putting pressure on or rubbing your skin. […] You have a higher chance of getting a pressure ulcer if you: have problems moving, have had a pressure ulcer before, have been seriously ill in intensive care or have recently had surgery, are underweight, have swollen, sweaty or broken skin, have poor circulation or fragile skin, have problems feeling sensation or pain. […] If you’re being cared for at home and think you’re at risk of getting pressure ulcers, you can ask a GP for a risk assessment so your care team can make a plan to prevent them.

Zobacz więcej