Abstract:

Rationale: Pressure ulcers have been increasingly recognized as both a patient safety issue and a nurse-sensitive outcome indicator of patient care.  In the near future, health care organizations will be required to report on more outcomes of care including the prevalence (P) and incidence (I) of pressure ulcers. For the most part, hospitals in Canada report  P & I of pressure ulcers by retrospective chart audits.  A few hospitals conduct prospective, observational data primarily through the use of existing data collection tools and processes sponsored by industry partners.  It is needed to develop a surveillance tool with validity and reliability.

Objective: To develop a valid and reliable evidence-based pressure ulcer surveillance tool and program that can be used by all acute care hospitals.

Methodology:  Based on a literature review, data elements were selected and a data collection tool was developed and piloted at the three teaching hospital sites with a sample population of more than 3,000 patients. The statistical multivariate model was applied in identifying factors significantly associated with pressure ulcer based on the data collected in the preliminary study. The validation sample was collected to measure the overall percentage of subjects correctly classified. Results: An accompanying instructional manual and educational process for data collection was developed to ensure consistency at the three teaching hospitals.

The data collection tool examines associated risk factors for developing PU and whether preventative and management treatments have been initiated.   

Discussions: The tool will be further evaluated through statistical analysis to confirm whether the data elements are associated with pressure ulcer development based on data collected in more hospitals. An evidence-based surveillance toll will help hospital staffs well manage pressure ulcer prevention.