Incontinence Management and Pressure Injury Rates in US Acute Care Hospitals: Analysis of Data From the 2018-2019 International Pressure Injury Prevalence™ (IPUP) Survey.

Purpose: The purpose of this study was to identify and describe the prevalence of incontinence (urinary and/or fecal) and incontinence management practices among patients in US adult acute care settings, with and without hospital-acquired pressure injuries (HAPIs), using the data from the 2018/2019 International Pressure Ulcer Prevalence™ (IPUP) survey.

Design: Observational, cohort study with cross-sectional data collection and retrospective data analysis.

Subjects And Setting: The sample comprised 296,014 patients hospitalized in 1801 acute care facilities in the United States that participated in 2018 and/or 2019 IPUP survey.

Pressure Injuries in Critical Care Patients in US Hospitals: Results of the International Pressure Ulcer Prevalence Survey.

Purpose: The purpose of this secondary analysis was to examine pressure injury (PI) prevalence, PI risk factors, and prevention practices among adult critically ill patients in critical care units in the United States using the International Pressure Ulcer Prevalence™ (IPUP) Survey database from 2018 to 2019.

Design: Observational, cohort study with cross-sectional data collection and retrospective data analysis.

Subjects And Setting: The sample comprised 41,866 critical care patients drawn from a sample of 296,014 patients in US acute care facilities who participated in the 2018 and/or 2019 IPUP surveys.

Pressure Injury Prevalence in Acute Care Hospitals With Unit-Specific Analysis: Results From the International Pressure Ulcer Prevalence (IPUP) Survey Database.

Purpose: The purpose of this study was to determine overall pressure injury (PI) prevalence and hospital-acquired pressure injury (HAPI) prevalence in US acute care hospitals. Additionally, analysis of patient characteristics associated with HAPIs will be presented.

Design: Observational, cross-sectional cohort study.

Pressure Injuries in the Pediatric Population: Analysis of the 2008-2018 International Pressure Ulcer Prevalence Survey Data.

Pediatric pressure injuries continue to be a worldwide healthcare problem. Studying pediatric pressure injury point prevalence may provide more insight into the problem and drive prevention strategies for at-risk pediatric patients, a truly vulnerable population. This article reports 10 years of longitudinal pediatric pressure injury prevalence data and demographics from around the world.

Examining Prevalence and Risk Factors of Incontinence-Associated Dermatitis Using the International Pressure Ulcer Prevalence Survey.

Purpose: To evaluate prevalence and risk factors of incontinence-associated dermatitis (IAD).

Design: Retrospective analysis of 2016 International Pressure Ulcer Prevalence survey data.

Subjects And Setting: Adult patients who were in acute care, long-term acute care, long-term care, and rehabilitation facilities in the United States and Canada.

Predictors of superficial and severe hospital-acquired pressure injuries: A cross-sectional study using the International Pressure Ulcer Prevalence™ survey.

Background: Prevalence of hospital-acquired pressure injuries has declined over time. However, it is unknown if this decline is consistent for different stages of pressure injuries. It is also unknown if risk factors differ between superficial (stage 1 and 2) and severe (stage 3, 4, deep tissue, and unstageable) pressure injuries.

Prevalence and Analysis of Medical Device-Related Pressure Injuries: Results from the International Pressure Ulcer Prevalence Survey.

Objective: To examine the prevalence and characteristics of medical device-related pressure injuries (MDR PIs) in a large, generalizable database.

Methods: This study is a retrospective analysis of the 2016 International Pressure Ulcer Prevalence data. Data were limited to US and Canadian facilities.

The International Pressure Ulcer Prevalence™ Survey: 2006-2015: A 10-Year Pressure Injury Prevalence and Demographic Trend Analysis by Care Setting.

Purpose: Measurement of pressure injury (PI) prevalence allows benchmarking within and across facilities; the International Pressure Ulcer PrevalenceTM (IPUP) Survey includes a variety of care settings. The purpose of this study is to present 10 years of US prevalence and limited demographic data (2006-2015) by care setting.

Methods: Facilities volunteer to participate in the IPUP Survey.

Pressure Ulcer Risk in the Incontinent Patient: Analysis of Incontinence and Hospital-Acquired Pressure Ulcers From the International Pressure Ulcer Prevalence™ Survey.

Purpose: To measure the prevalence of incontinence in the 2013-2014 International Pressure Ulcer Prevalence (IPUP) surveys and determine the relative risk of developing a facility-acquired pressure ulcers (FAPUs) by stage and by Braden Scale score groupings.

Design: The IPUP survey is an observational, cross-sectional cohort database designed to determine the frequency and severity of pressure ulcers in various populations.

Subjects And Setting: The survey includes acute care (91.

The effect of patient migration in bed on torso elevation.

Background: Elevating the hospital head of bed (HOB) to at least 30° is recommended practice to reduce the risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. However, this common practice prescribes the position of the bed and not of the patient, which could be significantly different.

Objective: The aim of this research was to determine the relationship between patient migration in bed and anatomic torso angle.

A laboratory study examining the impact of linen use on low-air-loss support surface heat and water vapor transmission rates.

Layers of linens are frequently placed under patients to manage moisture and/or assist with positioning immobile patients, including persons placed on a therapeutic surface because they are at risk for developing pressure ulcers. Because skin microclimate is believed to affect pressure ulcer risk, some therapeutic surfaces are designed to manage skin temperature and humidity (microclimate management). The purpose of this study was to measure the effects of linens and underpads on a low-air-loss (LAL) surface's ability to disperse heat and evaporate moisture.

The effect of multiple layers of linens on surface interface pressure: results of a laboratory study.

Underpads and layers of linens are frequently placed under patients who are incontinent, have other moisture-related issues, and/or are immobile and cannot reposition independently. Many of these patients are also at risk for pressure ulcers and placed on pressure-redistribution surfaces. The purpose of this study was to measure the effects of linens and incontinence pads on interface pressure.

Air-fluidized therapy in patients with suspected deep tissue injury: a case series.

Purpose: The evolution of suspected deep tissue injuries from an initial purple bruise to a significant stage III or IV pressure ulcer may be rapid, even with optimal treatment. This case series describes our experience with air-fluidized therapy (AFT) placed upon discovery of suspected deep tissue injury (sDTI) in an acute care setting.

Cases: Five patients with 10 sDTIs were placed on AFT within 12 hours of sDTI diagnosis and evaluated for an average of 9 days.

Estimates of evaporation rates from wounds for various dressing/support surface combinations.

The management of exudate is an essential aspect of wound care. The wound bed must remain moist to promote healing, but care must be taken to remove excess fluid to avoid maceration and subsequent breakdown of the periwound site, which could serve as a possible portal to infection. Excess fluid is typically absorbed into and/or evaporates through the wound dressing or may be managed by a powered vacuum-assisted closure device.

Pressure ulcer prevention in high-risk postoperative cardiovascular patients.

Background: Little has been published about how to prevent pressure ulcers in severely debilitated, immobile patients in intensive care units.

Objective: To present a possible prevention strategy for postoperative cardiovascular surgery patients at high risk for development of pressure ulcers.

Methods: Staff chose to implement air fluidized therapy beds, which provide maximal immersion and envelopment as a measure for preventing pressure ulcers in patients who (1) required vasopressors for at least 24 hours and (2) required mechanical ventilation for at least 24 hours postoperatively.

Air-fluidized therapy: physical properties and clinical uses.

Since the late 1960s, air-fluidized therapy (AFT) has been effectively used to treat patients with pressure ulcers, burns, and many other clinical problems. Much of the demonstrated efficacy is believed to be associated with the unique fluid environment provided by AFT that is fundamentally different from the support provided by surfaces made up of conventional solid materials. Fluid support maximizes the envelopment of the body while significantly reducing shear, friction, and pressure, and mechanical stress applied to the skin and subcutaneous tissue.

The demographics of suspected deep tissue injury in the United States: an analysis of the International Pressure Ulcer Prevalence Survey 2006-2009.

Objective: Suspected deep tissue injury (sDTI) was identified in 2001 and added as a staging definition by the National Pressure Ulcer Advisory Panel in 2007. Clinical data on sDTI are sparse. This article reports the overall prevalence data and describes the demographics of subjects with sDTI from the International Pressure Ulcer Prevalence survey 2006-2009.

Results of the 2008-2009 International Pressure Ulcer Prevalence Survey and a 3-year, acute care, unit-specific analysis.

The National Quality Forum has identified a pressure ulcer as a hospital-acquired condition (HAC) that is high-cost and high-volume and may be preventable with implementation of evidence-based guidelines. The Center for Medicare and Medicaid Services no longer reimburses acute care facilities for the ancillary cost of facility-acquired (FA) ulcers. Benchmarking patient safety indicators, such as FA, may help facilities reduce pressure ulcer rates.

Body mass index, weight, and pressure ulcer prevalence: an analysis of the 2006-2007 International Pressure Ulcer Prevalence Surveys.

To assess the relationships among pressure ulcer prevalence, body mass index (BMI), and weight, this report analyzed the US data from the 2006 and 2007 International Pressure Ulcer Prevalence Surveys. Findings indicated an overall reduction in pressure ulcer prevalence from 2004 and 2005 to 2006 and 2007; there was a higher prevalence of pressure ulcers in patients with low BMI and patients with both low and high weights. One in 10 patients were extremely obese.

The effect of using a low-air-loss surface on the skin integrity of obese patients: results of a pilot study.

Obese patients often are immobile, acutely ill, and at high risk for developing pressure ulcers when admitted to acute care facilities. Pressure-relieving mattresses are an integral part of a pressure ulcer prevention plan of care. Patients with a body mass index (BMI) >35, weight between 250 and 500 lb, and a minimum 3-day length of stay were recruited to participate in a pilot study to evaluate the safety and use of a new low-air-loss, continuous lateral rotation bariatric bed.

The impact of continuous lateral rotation therapy in overall clinical and financial outcomes of critically ill patients.

Background: Significant pulmonary complications are prevalent in intubated and mechanically ventilated patients.

Objectives: This study was conducted to determine the impact of continuous lateral rotation therapy (CLRT) on patients considered to be at high risk for pulmonary complications. Overall study objectives included hospital length of stay, critical care length of stay, ventilator days, and cost to treat.

Results of nine international pressure ulcer prevalence surveys: 1989 to 2005.

Pressure ulcers continue to be a significant problem for patients and healthcare facilities. Since 1989, results from the International Pressure Ulcer Prevalence surveys--observational, cross-sectional cohort studies--conducted by Hill-Rom, Batesville, Ind, have been used to document aggregate prevalence rates and provide acute care, long-term acute care, and long-term care facilities with internal and external benchmarks of process improvement. During each of the nine surveys conducted between 1989 and 2005, clinical teams in participating facilities predominantly in the US (some facilities in Canada, Saudi Arabia, and Australia participated after 2003) assessed admitted patients on assigned study dates.