Pressure injury point prevalence: state-wide survey to identify variability in Western Australian hospitals

Abstract

Objective: A point prevalence survey was conducted across Western Australia to monitor adherence to national safety and quality health service standards, and to create baseline data on which to improve. The study identified significant areas for targeted interventions.

Design: A state-wide point prevalence survey of patients and their medical records.

Setting: Public hospitals in Western Australia (WA).

Subjects: Data was collected from 2,281 inpatients.

Main outcome measure(s): The aim of the study was to determine pressure injury prevalence and characteristics, adherence to guidelines, significant related factors and their attributable burdens.

Results: 8.7% of patients had pressure injuries. 6.3% were hospital-acquired (HAPIs). Over 1,000 HAPIs per year were attributed to being older, a long-term patient, having acute renal failure or volume depletion. 65% of patients had a skin inspection; less likely in birthing mothers and long-term patients. 70% of patients were screened with a risk assessment tool. 36% of patients were identified as at risk of a pressure injury; and of these, 71% had prevention plans in place. One third of all adults with HAPIs were not identified as at risk using current practices.

Conclusion: The prevalence and characteristics of pressure injuries and HAPIs was comparable with prior state-wide results. The survey identified variations in rates of: skin inspections, using risk assessment tools; and applying plans for those at risk of pressure injuries. Multivariable logistic regression identified areas for improvement: the main groups at risk of pressure injuries; and patient groups with lower rates of skin inspections and screening.