Epidemiological issues in monitoring pressure damage

Abstract

A discussion of a reporting system on the prevalence and incidence of pressure sores

Reliability of pressure ulcer classification and diagnosis

“…The difficulties in monitoring clinical performance using prevalence and incidence have been highlighted in National Guidelines (AHCPR 1992) and by a number of authors (Dealey 1991, Clark & Cullum 1992, Clark & Watts 1994, Bridel et al. 1996, McGough 1998). Problems associated with interpretation of clinical performance measures include different inclusion and exclusion criteria and definition of the population ‘at risk’ (that is, the denominator population); difficulties in establishing the denominator population from patient information systems, particularly in areas with a high patient through‐put and ward transfers; the use of various classification scales with inclusion and exclusion of Grade/Stage 1 pressure ulcers; reliability of data sources, ranging from direct observation of patients by trained researchers to retrieval of data from patient records; and insufficient knowledge of risk factors to allow case‐mix adjustment.…”

Impact of prevention structures and processes on pressure ulcer prevalence in nursing homes and acute‐care hospitals

“…Other studies show no statistically significant reduction over time [12,13]. Especially if the methodological issues [14,15] in monitoring prevalence rates are considered, a reduction of annually monitored prevalence rates in standardized groups could be observed [16]. For several years now, the existence of pressure ulcers in hospitalized persons has been a much‐discussed topic in the Federal Republic of Germany.…”