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Pressure Ulcers in Older Adults

A Prevalence Study

Rasero, Laura BSN, RN; Simonetti, Monica PhD, MSc; Falciani, Francesca MSN, BSN, RN; Fabbri, Cristina MSN, RN; Collini, Francesca MSc; Dal Molin, Alberto PhD, MSN

doi: 10.1097/01.ASW.0000470371.77571.5d

OBJECTIVE: The purpose of this study was to measure the prevalence of pressure ulcers (PrUs) in an older adult population.

DESIGN: A cross-sectional study.

SETTING: The study included all the individuals being cared for in the units of medicine, surgery, intensive care, and medical-surgical specialties of 47 hospitals, 57 public nursing homes, and 37 home care services.

PARTICIPANTS: The authors’ observational study included 11,957 patients older than 70 years.

MAIN OUTCOME MEASURES: Of the population, 50.75% (6067) were assessed to be at risk of developing PrUs according to the Braden Scale, and 24.66% (2949) had already developed PrUs. In addition, a significant association was found between increased risk (Braden <16) and the presence of PrUs with an odds ratio (OR) of 8.71 (confidence interval [CI], 7.52–10.10) in high-risk subjects (Braden ≤12) and an OR of 3.86 (CI, 3.36–4.44) in very high-risk patients (Braden 13–16). In the survey, 84.6% of the subjects with PrUs were incontinent, and incontinence increased the risk of developing PrUs in the authors’ sample (OR, 1.54; CI, 1.34–1.77).

CONCLUSIONS: The authors’ data reported in the literature show that the prevalence of PrUs increases as an individual ages. The authors gathered data that showed a large area of intervention in managing the prevention of PrUs, such as an adequate use of protective aids, correcting malnutrition, and controlling incontinence. These results suggest that clinicians should focus more on the prevention of PrUs in older adults.

Laura Rasero, BSN, RN, is Professor of Nursing, Department of Experimental and Clinical Medicine, University of Florence, University of Florence, Italy. Monica Simonetti, PhD, MSc, is a Statistician, Health Search, Italian College of General Practitioners, Florence, Italy. Francesca Falciani, BSN-MSN, RN, is a Wound Care Nurse Specialist, Azienda Sanitaria Firenze, Florence, Italy. Cristina Fabbri, MSN, RN, is a Wound Care Nurse Specialist, Azienda Ospedaliera Universitaria Careggi, Florence, Italy. Francesca Collini, MSc, is a Statistician, Regional Health Agency of Tuscany, Florence, Italy. Alberto Dal Molin, PhD, MSN, is Coordinator, School of Nursing, University of Eastern Piedmont, Biella and Novara, Italy. Dr Dal Molin has disclosed that he is a board member of IPASVI (National Federation of Nursing Colleges); is a member of the speakers’ bureau for the Associazione Animo, University of Eastern Piedmont, and Novara Hospital; was a member of the speakers’ bureau for the San Raffaele Hospital; and has received royalties from McGraw-Hill.

The remaining co-authors have disclosed they have no financial relationships related to this article.

Acknowledgments: This study was funded by the Regional Health Agency, Tuscany, Italy.

The authors acknowledge this study would not have been possible without the collaboration of hospital nurses in Tuscany, Italy. The authors thank Dr Stefania Rodella for her support and coordination of this project. Submitted March 18, 2014; accepted in revised form April 15, 2014.

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