Document Detail


Use of pressure-redistributing support surfaces among elderly hip fracture patients across the continuum of care: adherence to pressure ulcer prevention guidelines.
MedLine Citation:
PMID:  19587108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To estimate the frequency of use of pressure-redistributing support surfaces (PRSS) among hip fracture patients and to determine whether higher pressure ulcer risk is associated with greater PRSS use.
DESIGN AND METHODS: Patients (n = 658) aged >or=65 years who had surgery for hip fracture were examined by research nurses at baseline and on alternating days for 21 days. Information on PRSS use and pressure ulcer risk factors was recorded at each assessment visit. Other information was obtained by interview and chart review.
RESULTS: A PRSS was observed at 36.4% of the 5,940 study visits. The odds of PRSS use were lower in the rehabilitation setting (adjusted odds ratio [OR] 0.4, 95% confidence interval [CI] 0.3-0.6), in the nursing home (adjusted OR 0.2, 95% CI 0.1-0.3), and during readmission to the acute setting (adjusted OR 0.6, 95% CI 0.4-0.9) than in the initial acute setting. There was wide variation in frequency of PRSS use by admission hospital, even after adjusting for pressure ulcer risk factors. The relationships between PRSS use and pressure ulcer risk factors were not strong.
IMPLICATIONS: In this study of hip fracture patients, adherence to guidelines for PRSS use was low and was based more on facility-related factors than on patient risk. There is an urgent need for health care providers to improve strategies for the prevention of pressure ulcers in high-risk patients.
Authors:
Mona Baumgarten; David Margolis; Denise Orwig; William Hawkes; Shayna Rich; Patricia Langenberg; Michelle Shardell; Mary H Palmer; Patrick McArdle; Robert Sterling; Patricia S Jones; Jay Magaziner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-07-08
Journal Detail:
Title:  The Gerontologist     Volume:  50     ISSN:  1758-5341     ISO Abbreviation:  Gerontologist     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-07-09     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0375327     Medline TA:  Gerontologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  253-62     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 West Redwood Street, Suite 200, Baltimore, MD 21201, USA. mbaumgar@epi.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Baltimore
Cohort Studies
Continuity of Patient Care*
Female
Guideline Adherence*
Hip Fractures*
Humans
Interviews as Topic
Male
Medical Audit
Pressure Ulcer / prevention & control*
Grant Support
ID/Acronym/Agency:
5R01 AR 47711/AR/NIAMS NIH HHS; M01 RR 16500/RR/NCRR NIH HHS; M01 RR016500-01/RR/NCRR NIH HHS; P30 AG028747/AG/NIA NIH HHS; P30 AG028747-01/AG/NIA NIH HHS; R01 AR047711-01A1/AR/NIAMS NIH HHS; R01 AR047711-02/AR/NIAMS NIH HHS; R01 AR047711-03/AR/NIAMS NIH HHS; R01 AR047711-04/AR/NIAMS NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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