Prevalence of pressure ulcer and associated risk factors in middle- and older-aged medical inpatients in Norway.
AIMS AND OBJECTIVES
To describe the prevalence of pressure ulcers among middle- and older-aged patients in a general medical hospital in Norway and to describe the associations between pressure ulcers and potential risk factors additional to the Braden risk score.


BACKGROUND
Degrees of mobility, activity, perfusion and skin status are risk factors for development of pressure ulcer. Nurses' clinical judgements combined with risk assessment tools are effective to detect pressure ulcer risk.


DESIGN
Cross-sectional study.


METHODS
The study was performed as part of a research project conducted between September 2012-May 2014 in a general hospital in the capital of Norway. Registered nurses and nursing students collected data from all eligible patients on 10 days during the students' clinical practice studies. The Braden scale was used to measure pressure ulcer risk, and skin examinations were performed to classify the skin area as normal or as indicative of pressure ulcer according to the definitions by the National Pressure Ulcer Advisory Panel. Comorbidities were collected by patient's self-report. This analysis focused on the 255 inpatients at the medical wards ≥52 years of age, most of whom had more than one comorbidity.


RESULTS
The prevalence of pressure ulcers was 14.9% in this sample. Higher age, underweight, diabetes and worse Braden scores were factors associated with pressure ulcer, and pressure ulcer was most frequently sited at the sacrum or heel.


CONCLUSION
Adding age, weight and diabetes status to pressure ulcer risk assessment scales may improve identification of patients at risk for pressure ulcers.


RELEVANCE TO CLINICAL PRACTICE
Knowledge about strengths and limitations of risk assessment tools is important for clinical practice. Age, weight and diabetes status should be considered for inclusion in risk assessment tools for pressure ulcers in medical wards.
['Børsting|Tove E|TE|http://orcid.org/0000-0002-2124-2127', 'Tvedt|Christine R|CR|', 'Skogestad|Ingrid J|IJ|', 'Granheim|Tove I|TI|', 'Gay|Caryl L|CL|', 'Lerdal|Anners|A|http://orcid.org/0000-0002-7144-5096']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D001835:Body Weight D015897:Comorbidity D003430:Cross-Sectional Studies D048909:Diabetes Complications D005260:Female D006801:Humans D007297:Inpatients D008297:Male D008875:Middle Aged D009664:Norway D003668:Pressure Ulcer D015995:Prevalence D018570:Risk Assessment D012307:Risk Factors D057566:Self Report
pressure ulcer Braden risk score clinical judgement risk assessment acute care