Incidence, Prevalence, And Complications of Pressure Ulcers In General Medical and Surgical Units Using A Multidisciplinary Model (Prospective Cohort)

Abstract

Objectives: To measure the prevalence and incidence of pressure ulcers, describe their complications, and identify the proportions of patients followed by the multidisciplinary clinical services at King Abdulaziz Medical City (KAMC) -Jeddah-Saudi Arabia. Methodology:A prospective cohort designed with weekly visits to all general medical and surgical units during the month of August 2016. Patients with new or preexisting pressure ulcers were included. Patients and wounds related variables were followed and recorded weekly. In addition, the clinical disciplines involved in pressure-ulcer's care and their follow-up visits were documented.Results: A total of 370 patients were admitted, and only 21 patients were found to have ulcers. During the total hospital stay for all the patients (2440 days), only 4 new ulcers were developed in the units; the rest developed either at home or in the intensive care unit. The estimated prevalence and incidence of pressure ulcers were 5.7% (95% CI 3.4 -8.0) and 1.6 ulcer/1000 patient-days (95% CI 1.1-2.1) respectively. Sixteen patients, 76%, were bedridden and with urinary catheters. Also, seven patients, 33%, received antibiotics for infected ulcers, and two of them died during the study period due to sepsis. In addition, twenty patients, 95%, were anemic, but only three of them had low body mass index. The proportion of patients, who were seen during the study by dietitians, wound care nurses, occupational therapists and plastic surgery during the study period, was 75%, 33%, 17%, and 17% respectively. Conclusion:Pressure ulcers prevalence and incidence was 5.7% and 1.6 ulcer/1000 patient-days respectively. Majority of pressure ulcer patients were anemic, bedridden, incontinent, and needed home care on hospital discharge. Further research is needed to clarify the best team approach to manage patients with pressure ulcers.

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“…The Agency for Healthcare Research and Quality estimates that more than 2.5 million individuals in the United States develop PIs annually 5. Reported PI prevalence in the acute care setting varies from 4% to 49%, whereas incidence rates in critical care units vary from 3.8% to 12.4% 2,6. The average cost to heal a PI varies from $5000 to $151,700 7,8.…”

“…5 Reported PI prevalence in the acute care setting varies from 4% to 49%, whereas incidence rates in critical care units vary from 3.8% to 12.4%. 2,6 The average cost to heal a PI varies from $5000 to $151,700. 7,8 Pressure injuries impact patients negatively, causing pain, declined mobility, and reduced quality of life.…”

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“…The Methicillin-resistant Staphylococcus aureus (MRSA) prevalence in the hospitals of Saudi Arabia was found to be around 40% which commonly affects the prognosis of the afflicted population in the region ( El Amin and Faidah, 2012 ). To add further the increased hospital stay due to prevalence of infections and pressure ulcers is another factor that may delay the recovery of the patients and increase the chances for mortality and morbidity ( Al-Hashemi, 2019 ).…”