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Clinical Research
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Prevalence and incidence studies from an 8 hospital urban healthcare system Wesley Valdes, DO, Cindy Sheehan, RN, Marianne Gainer, RN, Patricio Meneses, PhD, William J. Ennis, DO Introduction: More frequently, pressure ulcer development within the hospital and sub acute care settings is considered a benchmark for quality. Prevalence and incidence studies have historically been one mechanism for tracking pressure ulcers. Single day prevalence studies however rely on documentation to infer the incidence or nosocomial pressure ulcer rate Methods: Over 7 quarters, an 8 hospital not-for-profit system in Chicago, studied all patients with a prevalence and incidence study for all medical-surgical patients. All patients were examined by in house Òwound care teamsÓ that were trained at a central corporate site. Patients seen on the Monday exam who were free of ulcers and still in the hospital on Friday, were re-evaluated for a ÒtrueÓ incidence analysis. The goal of this clinical excellence initiative was to bring nosocomial pressure ulcer formation under the 7% nationally accepted standard, and to improve documentation. We have previously presented the financial impact of replacing all medical-surgical beds throughout the system with self-powered air mattresses.1 In this presentation we will present the results from over 2,500 patients evaluated on the Friday incidence studies taken from a much larger pool of hospital patients evaluated on the Monday prevalence study. Findings include location and stage of pressure ulcers, patient age, sex, insurance status, and medical co-morbidities Results: The overall incidence rate for the entire system dropped from 7% to 5% during the course of the study. The documentation rate for pressure ulcers improved from 22% at the start of the study to 59% by the conclusion of the trial. The overall program was considered both a clinical and economic success and 2 of the facilities received Magnet nursing certification during the process. Details and statistics from this 2 year system wide quality improvement/ clinical excellence initiative will be presented.. Valdes W, Sheehan C, Meneses P, Ennis WJ. Pressure ulcer prevention: an aggressive quality improvement initiative centered on a hospital-wide bed replacement program. Wound Rep Regen. 2005;13(2):A46.. |
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