A Comparative Analysis of Hospital-Acquired Pressure Ulcer/Injuries and Community Acquired Pressure Ulcer/Injuries

Introduction: Pressure ulcers/injuries (PU/I) occur in all settings. Once a PU/I develops, it can be hard to heal—even with the best of nursing care.

Purpose and Methods: This research study used data collected to compare hospital-acquired PU/I to those PU/I that develop in the community. For community-acquired PU/I, we further analyzed the data to examine the patient’s origin of admission, primary diagnosis, stage of pressure ulcer, and length of stay. No previous comparative studies existed on hospital-acquired PU/I as compared to community-acquired PU/I, when examining the differences in pressure ulcers that develop in hospital, home, and long-term care facilities. Quarterly point prevalence survey data was examined over six years on the hospital-acquired PU/I as compared to the community-acquired PU/I. Further data was collected from the incident reporting system from January 2017 to January 2018, Excel spreadsheets on past hospital-acquired PU/I, and the electronic medical record of each patient admitted to the hospital. The automated EMR data collection using a BPA provided a valid and reliable data collection method.

Results: Many more patients are admitted to this acute care hospital from the community with PU/I on admission than the number of patients who develop hospital-acquired PU/I. Up to 35% of patients admitted to hospital with identified PU/I did not have a stage listed in EMR for coding and billing. More patients were admitted from home with stage 3 and above pressure ulcers than patients admitted from skilled or long-term care nursing facilities.

Conclusion: Focus has been on hospital-acquired PU/I, while the greatest number of patients developing PU/I come from the community. Patients who developed hospital-acquired PU/I had closed the wound before discharge and were never readmitted, patients with community-acquired PU/I were admitted up to 16 times a year.