Pressure ulcer risk assessment: risk factors and risk screening in older persons – a validation study

<p></p><p></p><p><br></p><p></p><p>Background: Mobility is acknowledged in the literature as the highest predictor</p><p>of pressure ulcer development, however most of clinical studies assess mobility</p><p>subjectively. The few studies that have analysed mobility objectively using</p><p>technology have the limitation of not measuring small postural changes, which</p><p>are important for pressure relief. A more comprehensive analysis of mobility,</p><p>including all types of movement is needed to better understand mobility and</p><p>pressure ulcer development, and to further correlate it with other risk factors.</p><p>Therefore, a quantitative, prospective, non-experimental study among the elderly</p><p>population was undertaken.</p><p>Aim: The primary objective of the study was to explore how activity and mobility,</p><p>along with other risk factors lead to pressure ulcer development in older persons</p><p>cared for in long-term facilities. The secondary objectives of the study were firstly</p><p>to report pressure ulcer incidence among the study participants using visual skin</p><p>assessment and sub-epidermal moisture (SEM) measurement. Secondly, to</p><p>explore mobility in healthy volunteers using a mobility sensor in order to compare</p><p>to mobility levels of older people cared for in long-term settings.</p><p>Methods: Ethical approval was received. The chosen explanatory variables were</p><p>included as they are common to the three most widely used risk assessment tools</p><p>(Waterlow, Norton and Braden), namely, mobility, activity, nutritional status and</p><p>incontinence. Following statistical advice and after the results of the pilot study of</p><p>48 participants, the sample size was recalculated based on the two causal factors</p><p>that varied over the 20-day follow-up, namely mobility and activity. Therefore, a</p><p>total of 150 participants were included. The pilot study also identified the need to</p><p>include healthy participants to better determine mobility among a healthy</p><p>population, in order to enhance the understanding of the older participants’</p><p>movements. Following ethical approval, a total of 22 healthy participants were</p><p>included and their mobility were assessed over a 2-night period, using the same</p><p>motion sensor employed within the main study.</p><div><br></div>