Pressure ulcers in Hospitals more likely in New Jersey, Pennsylvania and New York.

Pressure ulcers in Hospitals more likely in New Jersey, Pennsylvania and New York.

Pressure ulcers, also known as bed sores, are caused by unrelieved pressure upon bony prominences on the body, such as the sacrum, heels and back. More often they are associated with the infirmed who cannot move themselves and most often occur in Nursing Homes and Assisted living facilities. However, there has been a rise in such avoidable injuries in acute hospitals which has caused CMS to institute “never event” rules disallowing reimbursement to hospitals for treating pressure ulcers they have caused. A new study by the Journal of the American Geriatrics Society has determined a national Hospital acquired pressure ulcer rate of 4.5%, with the highest rates found in New York (5.2%), New Jersey (5.3%) and Pennsylvania (5.9%).

The majority of Hospital acquired pressure ulcers were located on the coccyx or sacrum (41%) followed by hip and buttocks (23%) and heels (23%). There were multiple characteristics associated with the occurrences such as age, obesity and use of corticosteroids. Associated diagnoses included cancer, congestive heart failure, emphysema, stroke, and diabetes. This is not surprising as healthy patients with no diseases are normally not at risk for such ulcers.

This study is valuable because it provides the first reliable national benchmark rate for Hospital acquired pressure ulcer occurrence. But is this rate of 4.5% acceptable for an outcome known to be associated with deficits in quality of care? The article takes great pains in stating that the data may be acceptable and might show that the pressure ulcers have occurred in the face of good care and prevention, however this research does not supply any supportive date for the assumption that the pressure ulcers developed in the presence of preventive measures.
The study does not offer explanation for the wide geographic variation in hospital acquired pressure ulcer rates. Why is the Hospital acquired pressure ulcer rate in New Jersey nearly twice the rate in Wisconsin? The answers could include quality of prevention measures, quality of documentation, type of illness, or other population characteristics of hospitalized patients. Look for updates based on the changes in the CMS regulation regarding payment for Hospital acquired pressure ulcers which went into effect after the study period which formed the basis of this article.

The moral of this story is to constantly make sure your loved one is turned and re positioned in an acute hospital as often as possible. Always check their back, heels and sacrum area for any type of wounds. The sooner one is found, the easier it is to heal.

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