The Prevalence Rate of Pressure Ulcers in the Acute Hospital Setting and Investigating Three Methods of Prevalence Measurement.
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Aim: The aim of this study is to determine the prevalence of pressure ulcers in an acute hospital setting and investigate the value of using 3 different methods of pressure ulcer prevalence measurement.
Method: A prospective quantitative research method was used. Pressure ulcers prevalence and risk was measured using Waterlow scores with visual inspection (using EPUAP guidelines), sub epidermal moisture measurement (using the S.E.M scanner) and pain associated with pressure ulcer development. A cohort of patients in acute hospital, who were mainly short stay surgical patients, were followed over a three day period with the measures of prevalence being taken each day.
Results / Discussion: Of the 31 participants who took part the mean (±SD) of the Waterlow score was 6.8 (±4.0) indicating that 93.5% of participants were deemed low risk of pressure ulcer development. 2 patients (6.4%) showed visible signs of pressure ulcer (grade 1) development. The S.E.M. scanner revealed that 16 (51.4%) participants demonstrated signs of pressure injury. Pain was reported at all anatomical sites. All pain was reported as 'mild'. On average 12.8% (n=4) of participants verbalised pain at one or more of the anatomical sites. Correlational statistics demonstrate statistically significant association between immobility and S.E.M scores (r=.527, p=.010) and between EPUAP score s and S.E.M reading on the sacrum (r=.762, p=.000). No associations were found between pain and EPUAP scores or S.E.M scores.
Conclusion: The result of this study indicate that there a possible underestimation of pressure ulcer prevalence rates when using Waterlow and visual inspection and that sub epidural moisture scanning is more sensitive in picking up early pressure damage. Pain measurement as a method of detecting pressure ulcers is not well supported in this study. The results call in to the question current methodologies in pressure ulcer risk assessment and detection particularly in short stay surgical patients.