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: Pathophysiology, epidemiology, risk factors, and presentation – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30664905/

  Though preventable in most cases, pressure ulcers continue to pose a major burden to the individual and society, affecting 3 million adults annually in the United States alone. […] Despite increased national attention over the past 20 years, the prevalence of pressure ulcers has largely remained unchanged, while the associated costs of care continue to increase. […] The aim of the first article in this continuing medical education series is to discuss the pathophysiology, risk factors, epidemiology, social and economic burdens, and clinical presentation of pressure ulcers.

• #3 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.

• #4 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.

• #5 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.

• #6 Products – Data Briefs – Number 14 – February 2009

  https://www.cdc.gov/nchs/products/databriefs/db14.htm

  More than 1 in 10 nursing home residents had a pressure ulcer. […] Pressure ulcer prevalence varied by age, sex, and length of time since admission to the nursing home, but not by race. […] Pressure ulcer prevalence varied by different resident clinical characteristics. […] Thirty-five percent of nursing home residents with stage 2 or higher pressure ulcers received special wound care. […] In 2004, about 159,000 current U.S. nursing home residents (11%) had pressure ulcers. […] Residents aged 64 years and under were more likely than older residents to have pressure ulcers. […] Residents of nursing homes for a year or less were more likely to have pressure ulcers than those with longer stays. […] One in five nursing home residents with a recent weight loss had pressure ulcers.

• #7 Impact of multifaceted interventions on pressure injury prevention: a systematic review | | Full Text

  https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-02558-9

  Nurses play a pivotal role in the prevention, early detection, and management of Pressure Injuries, given their frontline position in patient care. […] This systematic review aims to evaluate the impact of multifaceted interventions on the prevention of Pressure Injuries and improvements in nursing practices. […] The mean national prevalence of Pressure injuries was 17.6%, with 58.1% being community-acquired. […] Effective strategies included the use of air cushions and specific positioning techniques. […] Multifaceted interventions, including education, care bundles, and positioning strategies, are highly effective in reducing the prevalence of Pressure Injuries and improving nursing practices. […] The study’s robust methodology, large sample size, and use of established quality assessment tools (CASP and NCOS) bolster the reliability of these results, especially given the study’s majority context in Egypt.

• #8 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. […] 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. […] Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. […] A systematic review revealed that the incidence of decubitus ulcers is estimated to be approximately 12%.

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

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

  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 age-standardized prevalence and incidence rates were found in Barbados. […] The formulation of accurate, transparent, and frequently updated disease burden measures may affect different levels of healthcare and further influence the role of dermatology in global health. […] The burden of decubitus ulcers could be estimated relative to the expected burden based on the SDI when considering prevention programs.

• #10 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. […] 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. […] Pressure ulcer prevalence in the Eastern Mediterranean Region has varied between 7% and 44.4%. […] 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 policymakers must focus on improving patient safety and reducing Pressure ulcer prevalence in regions that have higher rates of Pressure ulcer prevalence.

• #11 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. […] 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. […] 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 Department is committed to sustaining its efforts in this area and achieving even greater success in the future. […] An effective pressure ulcer prevention and treatment program requires an interdisciplinary approach.

• #12 Unveiling the Burden: A Six-Year Retrospective Analysis of Pressure Ulcer Epidemiology in a ICU

  https://www.mdpi.com/2039-4403/14/4/239

  Unveiling the Burden: A Six-Year Retrospective Analysis of Pressure Ulcer Epidemiology in a ICU […] Objective: This study describes the epidemiological changes in pressure ulcers (PUs) in a Portuguese intensive care unit (ICU) from January 2017 to June 2023, characterizes critically ill patients with PUs, identifies specific risk factors, and assesses the effectiveness of implemented preventive measures. […] Pressure ulcers (PUs) are key quality indicators in healthcare and a major concern in intensive care units (ICUs) due to their significant impact on both patient outcomes and healthcare systems. […] Identifying the risk factors associated with their development is crucial to mitigate this burden and improve patient outcomes. […] The prevalence of hospital-acquired PUs is particularly concerning in ICU settings, where critically ill patients are highly vulnerable due to factors such as the complexity of their health conditions, limited mobility, invasive mechanical ventilation, vasopressor use, and the presence of invasive medical devices. […] Pre-COVID-19 epidemiological studies indicated that the prevalence of PUs in adult ICU patients ranged from 16.9% to 23.8%, with cumulative incidence varying between 10% and 25.9%. […] The COVID-19 pandemic significantly transformed the epidemiology of PUs. […] The unique clinical features of COVID-19, including extended hospitalizations, reduced mobility due to severe illness, increased reliance on mechanical ventilation, and the necessity for prone positioning to support respiratory function, emerged as new contributing factors to PU development. […] New factors emerged as contributors to PU development, including prolonged hospital stays, limited mobility due to severe illness, mechanical ventilation, and the need for prone positioning for respiratory support. […] The pandemic profoundly transformed key aspects of PU prevention, influenced by the pathophysiology of the COVID-19 virus, the intrinsic conditions of the patients, and the extrinsic factors of the care environment. […] The findings will serve as a valuable resource for healthcare providers, policymakers, and researchers, aiming to enhance knowledge of PU management in critical care and improve patient safety and outcomes. […] The average PU prevalence rate was 6.81%, with the highest prevalence in 2020 (11.0%) and the lowest in 2022 (3.48%). […] The average incidence rate was 3.76%, peaking at 5.71% in 2020 and declining to 2.54% in 2023. […] The study reveals a PU prevalence of 6.81% and an average incidence of 3.76%, underscoring the need for enhanced preventive strategies, especially in anatomical areas like the sacrum and heels. […] The sacrum and heels were the most commonly affected areas, with Category 2 PUs being the most frequent. […] Key intrinsic risk factors included systemic diseases and sensory deficits, with pressure identified as a significant extrinsic factor. […] Preventive measures focused on risk assessment and pressure control.

• #13 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 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.

• #14

  https://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 IPUP Survey 2010 showed an increase in ulcer prevalence with age. […] The risk a patient is in of developing a pressure ulcer can be predicted using the Braden score, and this helps reduce their prevalence.

• #15 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

  Epidemiology and Therapeutics Aspects of Pressure Ulcers in Two Sub-Sahara African University Teaching Hospitals […] Background: Pressure ulcers are frequent complications of bedridden patients. They may be responsible of prolong hospital stay and human resource consumption. We aimed to determine the cumulative incidence of pressure ulcers, investigate external factors, established the interest of surgery in the management of pressure ulcers in our resource-constraint environment […] The cumulative incidence of pressure ulcers was 20% in general and 50% in the population at risk. […] There is a considerable prevalence of pressure ulcer in our tertiary hospitals. […] The cumulative incidence in this study is 20%. In CHU it was 17.6% and 22.7% in Yaound Central Hospital. A relatively high incidence but that falls in a generally recognized range of 0.4 to 38%. […] Pressure ulcers in this sample arose between day 3 and day 6 of hospitalization. […] It is universally recognized that the prevalence of pressure sores is a good indicator of the quality of care of a health facility. […] Our study identify poor nursing care as a capital factor that can be improved in our hospitals, but also highlighted that satisfactory management needs some anticipation by acquisition of a fix ratio of type 2 or 3 bed supports since there is a known prevalence of pressure ulcer that is specific of the main pathologies in each medical specialty and implementation of modern care as Vacuum assisted closure of wounds.

• #16 Bedsores (Pressure Ulcers) — DermNet

  https://dermnetnz.org/topics/pressure-ulcer

  The most important cause of pressure ulcers is external pressure at a skin site for prolonged periods, although the exact mechanism is complex and poorly understood. […] Identifying external and internal risk factors is important to prevent or minimise pressure ulcers. […] The clinical features of pressure ulcers range from inflamed-looking, to severely ulcerated skin exposing muscle, tendon, and even bone. Commonly affected sites include the skin overlying the coccyx, vertebral column, heels, ankles, and elbows. […] Pressure ulcers remain a clinical diagnosis. […] Temperature sensing technologies such as infrared thermography (IRT) have been developed to aid early prediction and early diagnosis of pressure ulcers. […] Infection and sepsis can be severe and life-threatening; systemic antibiotic therapy may be required. […] Prevention of pressure ulcers can be classified into 3 domains: promoting movement, pressure reduction, and pressure distribution. […] Prevention strategies include: meticulous skin care eg, emollients, gentle cleansers, and avoiding friction and shearing forces.

• #17

  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. […] Pressure ulcers are classified into four stages according to the depth of tissue involvement as per the National Pressure Ulcer Advisory Panel (NPUAP). […] The problem is even if we can treat the patient while in the hospital; he may again develop the ulcer once he is discharged. […] Among the 2,974 patients admitted to the neurosurgery ward of the trauma center in 2012, 92 developed a pressure sore, and we calculated a prevalence of 3.1%. […] Most studies document stage one pressure sores as being most prevalent, but we found stage two to be most prevalent. […] The IPUP Survey 2010 showed an increase in ulcer prevalence with age.

• #18 Clinical staging and general management of pressure-induced skin and soft tissue injury – UpToDate

  https://www.uptodate.com/contents/clinical-staging-and-general-management-of-pressure-induced-skin-and-soft-tissue-injury

  Pressure-induced skin and soft tissue injuries are localized areas of damage to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure or pressure in combination with shear (eg, sacrum, calcaneus, ischium) (figure 1). […] The pathogenesis, risk assessment, and preventive strategies are discussed elsewhere. (See „Epidemiology, pathogenesis, and risk assessment of pressure-induced skin and soft tissue injury” and „Prevention of pressure-induced skin and soft tissue injury”.) […] Changes were made to the National Pressure Injury Advisory Panel (NPIAP) system favoring the use of the term „pressure injury” instead of „pressure ulcer” to recognize the fact that lesser degrees of skin damage due to pressure may not be associated with skin ulceration (stage 1) and that deep tissue pressure injury can occur without overlying skin ulceration (table 1). […] However, the generalized term „pressure injury” does not address the many other types of injury that can result from pressure, such as rhabdomyolysis in an unconscious patient.

• #19 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. […] There are a number of ongoing initiatives to determine pressure ulcer rates using a standardized method across a large number of hospitals. These include the NDNQI and periodic surveys by some of the large manufacturers of pressure relief devices, including Hill-Rom and KCI. In addition, as present on admission (POA) coding is implemented for pressure ulcers, the Centers for Medicare Medicaid Services (CMS) databases will likely become a more accurate and useful source of data on national rates of pressure ulcer development in hospitals.

• #20 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

  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.

• #21 Validation of two case definitions to identify pressure ulcers using hospital administrative data | BMJ Open

  https://bmjopen.bmj.com/content/7/8/e016438

  Pressure ulcer development is a quality of care indicator, as pressure ulcers are potentially preventable. Yet pressure ulcer is a leading cause of morbidity, discomfort and additional healthcare costs for inpatients. […] The main study aim was to validate hospital discharge abstract database (DAD) in recording pressure ulcers against nursing consult reports, and to calculate prevalence of pressure ulcers in Alberta, Canada in DAD. […] DAD underestimate pressure ulcer prevalence. Since various codes are used to record pressure ulcers in DAD, the case definition with more codes captures more pressure ulcer cases, and may be useful for monitoring facility trends. […] The development of a pressure ulcer (also called pressure injury) has been considered an indicator for quality of care, as pressure ulcers are potentially preventable, a leading cause of morbidity for inpatients, and is a cause of substantial discomfort, prolonged hospitalisations, additional healthcare costs and, in some cases, death.

• #22

  https://journals.lww.com/lww-medicalcare/fulltext/2022/10000/accuracy_of_pressure_ulcer_events_in_us_nursing.7.aspx

  The correlation coefficients between the claims-based pressure ulcer rates and NHC 5-star ratings were exceedingly low (0.151 and 0.029 for the overall and quality ratings, respectively), as were the correlations with the MDS-based pressure ulcer quality measures (0.319 and 0.040 for the long-stay and short-stay measures, respectively). […] Nursing homes substantially underreported pressure ulcers between 2011 and 2017, making CMS patient safety measures based on these data highly inaccurate. […] This is the first national assessment of the accuracy of nursing home-reported data on pressure ulcers to CMS and coupled with previous findings on underreporting of falls, indicates an urgent need for an alternative approach to measuring patient safety in nursing homes.

• #23 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. […] 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. […] AHRQ’s Patient Safety Network features pressure ulcer-related studies ranging from use of wound care teams for prevention and treatment of pressure ulcers to organizational strategies to implement hospital pressure ulcer prevention programs. […] Enhancing pressure injury surveillance using natural language processing.

• #24 A new national Pressure Ulcer Surveillance system using The Model Hospital System: Phase 1 – Wounds UK

  https://wounds-uk.com/journal-articles/new-national-pressure-ulcer-surveillance-system-using-model-hospital-system-phase-1/

  Improving pressure ulcer (PU) prevention has been a key quality driver for over a decade within all NHS provider organisations (Fletcher et al, 2021) with PU data being used to measure improvement. […] In that time, PU data collection and reporting has become a time-consuming priority for many tissue viability specialist nurses who have been required to be responsible for PU classification, validation and allocation of attribution (Fletcher et al, 2021). […] This results in significant variation, so it is difficult to understand the true size of the problem at a national level.

• #25 Epidemiology, pathogenesis, and risk assessment of pressure-induced skin and soft tissue injury – UpToDate

  https://www.uptodate.com/contents/epidemiology-pathogenesis-and-risk-assessment-of-pressure-induced-skin-and-soft-tissue-injury

  Epidemiology, pathogenesis, and risk assessment of pressure-induced skin and soft tissue injury […] Pressure-induced skin and soft tissue injuries are among the most common conditions encountered in acutely hospitalized patients or those requiring long-term residential care. The incidence varies widely by clinical setting. An estimated 2.5 million pressure-induced injuries are treated each year in acute care facilities in the United States alone. […] […] Pressure-induced injuries impose a significant burden not only on the patient but on the entire health care system. Reducing their frequency is an important component of current goals for patient safety, as evidenced by the decision by the United States Center for Medicare and Medicaid Services to not reimburse hospitals for the treatment of hospital-acquired pressure-related injuries.

• #26 Pressure Ulcers in the Nursing Home Setting | Guide for Attorneys

  https://www.expertinstitute.com/resources/litigation-guides/an-attorneys-guide-to-pressure-ulcers/

  Pressure ulcers currently affect nearly 3 million adults in the United States. […] The Agency for Healthcare Research and Quality (AHRQ) estimates a median annual pressure ulcer prevalence of 7.5 percent in nursing homes; other studies estimate that up to 20 percent of nursing home residents have at least one pressure ulcer. […] Pressure ulcer treatment costs about $11 billion yearly in the United States. […] Evidence for prevention of pressure ulcers: HIGH. […] Evidence for treatment of pressure ulcers: MODERATE. […] Pressure sores: epidemiology, medico-legal implications and forensic argumentation concerning causality. Study on the frequency and grading of pressure sores and discussion of aspects of forensic argumentation concerning causality.

• #27

  https://www.who.int/news-room/fact-sheets/detail/patient-safety

  Pressure ulcers affect more than 1 in 10 adult patients admitted to hospitals and, despite being highly preventable, they have a significant impact on the mental and physical health of individuals, and their quality of life. […] Pressure ulcers are injuries to the skin or soft tissue. They develop from pressure to particular parts of the body over an extended period. If not promptly managed, they can have fatal complications.

• #28 Pressure Ulcer Wound Care for Elderly in Home: A Case Report | ClinMed International Library | Journal of Dermatology Research and Therapy

  https://clinmedjournals.org/articles/ijdrt/journal-of-dermatology-research-and-therapy-ijdrt-2-028.php

  The reoccurrence of pressure ulcers can be frequent, and pressure ulcers are difficult to heal once they develop, especially in the elderly who are immobilized. […] Previous researchers have proven that the rate of complete healing of pressure ulcers is as low as 10% and less than 13% of those in acute hospital settings heal in two weeks. […] There is also consensus that pressure ulcers are common in bedridden elderly patients who are in the community, nursing homes or hospitals. […] Researchers have reported that 159,000 nursing home residents (11%) in the US had a pressure ulcer in 2004. […] One fourth of all pressure ulcers in hospitalized patients begin in the operating room during surgery and more than 80% of hospitalized patients with pressure ulcers developed them in the first five days of their hospitalization. […] In order to prevent and treat pressure ulcers, different methods are adopted to determine the appropriate prevention interventions including facility-specific standardized protocols, individualized care plans and orders from physicians or nurses.

• #29 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. […] Advanced bedsores (stages 3 or 4) are more difficult to treat. These pressure sores increase your risk of infection and life-threatening issues.

• #30 Pressure ulcers and skin tone – Wounds International

  https://woundsinternational.com/made-easy/pressure-ulcers-and-skin-tone/

  It has been acknowledged that skin tone variance may affect early detection of pressure ulcers (Dhoonmoon et al, 2021). Many of the signs and symptoms that clinicians have been educated to look for may present differently depending on the patients skin tone; for example, it has been found that dark skin rarely shows the blanching response that clinicians are trained to look out for, and erythema may also be hard to detect (Grimes, 2009). […] Research has shown a pattern of underdiagnosis of category 1 pressure ulcers in dark skin tones (Oozageer Gunowa et al, 2018). Risk assessment is an important component of clinical practice that enables quick and efficient identification of patients at risk (Fletcher, 2023). It is important to note that standard risk assessment tools for pressure ulcers often rely on visual inspection and categorisation of skin tone; however, these tools may not adequately capture the specific risk factors and characteristics of dark skin.

• #31 Pressure ulcers and skin tone – Wounds International

  https://woundsinternational.com/made-easy/pressure-ulcers-and-skin-tone/

  There is evidence to show that there are differences in staff knowledge around pressure ulcers (Gunningberg et al, 2017). It is widely acknowledged that there is an underrepresentation of diverse skin tones in education on all skin conditions, including pressure ulcers, and there is an ongoing need for the inclusion of dark skin tones in case studies and photographs, to address the gap in bias around light skin tones and lack of understanding of how to assess different skin tones. […] While pressure ulcers are preventable in most cases, they pose a substantial economic, health-related and social burden, and can significantly diminish patients quality of life (Demarr et al, 2015; Mervis and Phillips, 2019). There is a need for improved healthcare practices and practitioners who can deliver equitable care in order to address the unique challenges faced by patients with dark skin tones.

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

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

  Prognosis for early-stage pressure injuries is excellent with timely, appropriate treatment, but healing typically requires weeks. After 6 months of treatment, most stage 2 pressure injuries, about half of stage 3 injuries, and some stage 4 injuries resolve. […] Prevention requires identification of high-risk patients, repositioning, conscientious skin care and hygiene, and avoidance of immobilization.

• #33 Impact of multifaceted interventions on pressure injury prevention: a systematic review | | Full Text

  https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-02558-9

  The implementation of multifaceted interventions for pressure injury prevention has significant implications for healthcare. […] These interventions, which combine risk assessment, skin care, nutritional support, patient repositioning, and specialized equipment, can greatly enhance clinical practice by providing a comprehensive approach to prevention. […] The success of such interventions also fosters interdisciplinary collaboration, ensuring holistic patient care and effective communication among healthcare professionals. […] The findings underscore the importance of educational interventions, evidence-based practices, and comprehensive care protocols in mitigating Pressure injury risks and improving patient outcomes.

• #34 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. […] The majority of the following strategies are based on the NPIAP’s “Pressure Injury Prevention Points.” […] Protecting and monitoring the condition of the patient’s skin is important for preventing pressure sores and identifying Stage 1 sores early so they can be treated before they worsen. […] Hospitalized individuals are at great risk for undernutrition. […] Immobility can be a big factor in causing pressure injuries. […] Monitor the prevalence and incidence of pressure injuries.

• #35

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

  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.

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