Risk factors for hospital-acquired and community-acquired pressure injuries: a multicentre mixed case-control study

Investigation of factors associated with pressure ulcer in patients receiving home care services via path analysis

BACKGROUND

Recent trends indicate a rise in the number of elderly and bedridden patients enrolled in home care programs, leading to an increased occurrence of complications such as pressure ulcers within the home health care setting.

OBJECTIVE

The primary objective of this research was to ascertain the prevalence of pressure ulcers and identify the associated factors in adults who were recipients of home health care services.

METHOD

This study, adopting a cross-sectional design, encompassed a sample of 566 patients who sought services from the Home Health Care Unit in a specific province in Turkey. The timeframe for data collection spanned from August to November 2022, during which two primary instruments were employed: the "Demographic Characteristics Form" and two specific scales - the "Braden Pressure Ulcer Risk Assessment Scale" and the "ITAKI Falls Risk Scale."

FINDINGS

In this study, the average age of patients receiving home health care services was identified as 75.9 years, with a standard deviation of 15.1 years. Furthermore, 73.7 % of these patients were classified as being at risk for developing pressure ulcers. The study identified a direct correlation between the risk of BRADEN pressure ulcers and the escalation in scores across several parameters. These parameters included "Addiction Status," delineated as a spectrum from addicted to non-addicted, the "Number of Medical Diagnoses," quantified on a scale, the "State of Consciousness," categorized from clear to confused, and the scores derived from the "ITAKI" scale.

CONCLUSION

The findings of this study highlight the significance of pressure ulcers as a critical health issue among patients receiving home care services. It underscores the necessity for home care nurses to be acutely aware of the risk factors associated with pressure ulcers among high-risk patients.

Outcomes of hospital-acquired pressure injuries and present-on-admission pressure injuries: A propensity score matching analysis

BACKGROUND

Pressure injuries (PIs) continue to present significant challenges. In recent years, the number of patients with present-on-admission pressure injury (POA-PI) has increased, but researchers have devoted little attention to it, and little is known about its clinical outcome.

AIMS

To compare the clinical outcomes of POA-PI and hospital-acquired pressure injury (HAPI) patients.

METHODS

In this study, hospitalized patients with pressure injuries were divided into two groups based on whether they acquired the injury in the hospital or already present at the time of their admission. The disease prognosis, duration of stay, and healthcare costs of patients with HAPI and POA-PI were evaluated using propensity score matching analysis (PSM), t-tests, and Mann-Whitney U tests.

RESULTS

The information on 1871 patients was retrieved from the electronic case system retroactively. A total of 305 pairs of patients were effectively matched between the two groups using propensity score matching (HAPI group = 305, POA-PI group = 305). There was no statistically significant difference at characteristics between the two groups (P > 0.05). The percentage of POA-PI group patients who were discharged from the hospital was greater than that of the HAPI group (P < 0.05). Conversely, the percentage of POA-PI group patients who died, ceased receiving treatment, or transferred to the hospital was lower than that of the HAPI group. Patients in the POA-PI group had shorter hospital stays than those in the HAPI group (P < 0.05). Patients in the POA-PI group had lower healthcare costs than those in the HAPI group (P < 0.05).

CONCLUSIONS

Patients with POA-PI have superior clinical outcomes than patients with HAPI, but make up the overwhelming majority of hospitalized patients. It is imperative that future research focuses on the reduction of POA-PI and HAPI incidence and the identification of therapies that will enhance patient prevention for these conditions.