Pressure Ulcers Prevalence in the Acute Care Setting: A Systematic Review, 2000-2015

Abstract

Little is known about the prevalence of pressure ulcer (PrU) in acute care settings. The aim of this study is to determine the prevalence rate of PrU in acute care settings and to assess the methodological quality of the reviewed publications. The Cumulative Index to Nursing and Allied Health Literature, British Nursing Index, MEDLINE, and Cochrane Database of Systematic Reviews were searched using the keywords pressure ulcer or decubitus ulcer or bed sore or pressure sore or pressure injury, with prevalence and acute care, for studies published between January 2000 and December 2015. Nineteen publications met our criteria. These reported a prevalence range of between 7.8% and 54% for those using European Pressure Ulcer Advisory Panel methodology, 6% and 22% for those using National Pressure Ulcer Advisory Panel methodology, and 4.94% for the study that employed the Torrance system. The likely worldwide PrU prevalence rate range in acute care settings is between 6% and 18.5%. Prevalence rate varies between studies depending on the methodology of data collection. Moreover, the methodological quality of the included studies in the review was variable; therefore, it was difficult to compare the prevalence rate between the studies, settings, and countries.

The prevalence of pressure ulcers in community‐dwelling older adults: A study in an Indonesian city

“…Each item can be scored on a scale of 1 to 4 or, in the case of friction/shear, 1 to 3 . A score ≤18 on the Braden scale score was used to categorise people as being at‐risk …”

“…In the last few decades, many studies on PU prevalence and PU care have been published internationally. Systematic review studies show a wide range of PU prevalence rates among hospitalised patients: 3.1% to 30.0% in the United States (US), 1% to 54% in Europe, 6% in Australia, and 2.7% to 16.8% in Asia . To reduce the prevalence of PUs, various preventive measures and treatments have been implemented in hospitals all over the world …”

Pressure injury risk assessment in intensive care units: Comparison of the reliability and predictive validity of the Braden and Jackson/Cubbin scales

“…Intensive care units (ICUs) are one of the care settings with a high incidence of PIs, with a prevalence ranging from 14%–33.7% (Coyer et al, ; El‐Marsi, Zein‐El‐Dine, Zein, Doumit, & Badr, ; Mehta, George, Mehta, & Wangmo, ). By contrast, the prevalence of PIs is 7.8%–13.5% in all clinical settings (Mehta et al, ; VanGilder, Lachenbruch, Algrim‐Boyle, & Meyer, ) and from 3%–18.5% in acute care settings (Coyer et al, ; Tubaishat, Papanikolaou, Anthony, & Habiballah, ; Whittington & Briones, ). Similarly, the PI incidence of 13.6%–20.1% in ICUs (Becker et al, ; Manzano et al, ; Nijs et al, ) is almost three times greater than that observed in acute care settings (5.4%–9%) (Jenkins & O'Neal, ; Whittington & Briones, ).…”

Pressure injury prevention and management practices among nurses: A realist case study

“…Pressure injury (PI) is defined as “a localized damage to the skin and/or underlying soft tissue usually over a bony prominence.” Currently, the worldwide prevalence of PIs in acute settings is estimated to be between 6% and 15%, while in Singapore, the latest PI prevalence is reported to be 18.1% . This is seen to be a major concern as PIs are often highly regarded to be preventable.…”