Open AccessPressure injury identification, measurement, coding, and reporting: Key challenges and opportunities
Author(s) -
Weller Carolina D,
Gershenzon Esther R,
Evans Sue M,
Team Victoria,
McNeil John J
Publication year - 2018
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.12879
Subject(s) - benchmarking , medicine , coding (social sciences) , minimum data set , incentive , health care , identification (biology) , data quality , medical emergency , environmental health , actuarial science , operations management , nursing , statistics , nursing homes , marketing , botany , mathematics , economics , business , biology , microeconomics , economic growth , metric (unit)
Pressure injury (PI) rates are a commonly used indicator of performance of health care facilities, both in acute and subacute settings. However, measuring PI rates in an accurate and reproducible fashion has been challenging. The consequences of poor measurement may include failure to identify poorly performing institutions or incorrect accusations of poor quality care. In this article, we describe the main challenges in identification, coding, and reporting of PIs. Issues include inconsistent identification of PIs at the time of admission, variations in the intensity of PI detection, and differing approaches to coding and the adjustment for differing risks amongst different patient population. These are compounded by differences in the epidemiological approach because rates will differ according to whether patients are surveyed cross‐sectionally (eg, on a set day per month) or if the survey is undertaken at discharge. In some cases, financial incentives may also influence PI reporting. We also discuss potential strategies for improving data collection and benchmarking as an aid to reducing PI prevalence.