Collecting pressure ulcer prevention and management outcomes: 1

Abstract

This article, the first of two parts, presents the argument that a combination of efficacy and effectiveness is required to assess fully the impact of interventions such as pressure-redistributing beds and mattresses. The methodology adopted within a multinational, multicentre, prospective, non-randomized cohort study, designed to record the occurrence and characteristics of patients vulnerable to, or with, established pressure ulcers, is described. General demographic data and the characteristics of the pressure ulcers experienced by the 2507 UK subjects recruited to the study across four UK hospitals between July 1996 and May 1998 are presented, with pressure ulcers affecting 218 subjects of whom 100 presented with ulcers on admission to hospital. Fourteen subjects developed severe ulcers, while a further 24 were admitted with full-thickness pressure ulcers. The second part of this article will report further details of the characteristics of the UK sample. Future articles will consider the subjects examined in greater detail and will also discuss the combination of this dataset with similar data collected in the USA.

Pressure ulcer prevalence across Welsh orthopaedic units and community hospitals: surveys based on the European Pressure Ulcer Advisory Panel minimum data set

“…Despite investment in pressure ulcer prevention practices and interventions, pressure ulcers remain common (1–10). Part of this apparent contradiction stems from confusion over appropriate methods for recording pressure ulcer occurrence (11) while the lack of robust baseline data against which changes in pressure ulcer occurrence can be compared also prohibits examination of any trends in the number of people affected by pressure ulcers.…”

Modeling the economic losses from pressure ulcers among hospitalized patients in Australia

“…However, any cost saving should be compared to the additional investments required to implement programs that reduce the risks of PU. The international literature reports incidence rates of PU between 1.51 and 11% 2–13 . PUs fall into one of four categories: 14 Stage I is the least severe and Stage IV the most severe (definitions in Appendix 1).…”

The value of systematic evaluation in determining the effectiveness and practical utility of a pressure-redistributing support surface

“…Ambiguity exists in the understanding of these two terms; efficacy can only be determined if the effect of an intervention is measured against something else such as a control treatment whereas effectiveness relates to performance of the intervention under the usual conditions of care [20,21]. Therefore effectiveness research frequently calls for study designs other than the randomised controlled trial and more naturalistic study designs following patient outcomes are an alternative approach [15].…”