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The National Pressure Ulcer Long‐Term Care Study: Outcomes of Pressure Ulcer Treatments in Long‐Term Care
Author(s) -
Bergstrom Nancy,
Horn Susan D.,
Smout Randall J.,
Bender Stacy A.,
Ferguson Maree L.,
Taler George,
Sauer Abby C.,
Sharkey Siohban S.,
Voss Anne Coble
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53506.x
Subject(s) - medicine , antiseptic , medical record , stage (stratigraphy) , retrospective cohort study , minimum data set , gastroenterology , surgery , nursing homes , paleontology , nursing , pathology , biology
Objectives: To identify resident, wound, and treatment characteristics associated with pressure ulcer (PrU) healing in long‐term care residents. Design: Retrospective cohort study with convenience sampling. Setting: Ninety‐five long‐term care facilities participating in the National Pressure Ulcer Long‐Term Care Study throughout the United States. Participants: Eight hundred eighty‐two residents, aged 18 and older, with length of stay of 14 days or longer, who had at least one Stage II to IV PrU. Measurements: Data collected for each resident over a 12‐week period included resident characteristics, treatment characteristics, and change in PrU area. Data were obtained from medical records, Minimum Data Set, and other records. Results: Two multiple regression models, one for each stage grouping (Stage II, Stage III and IV), were completed. The area of Stage II PrU was reduced more with moist ( F =21.91, P <.001) than with dry ( F =13.41, P <.001) dressings. PrUs cleaned with saline or soap showed less decrease in area ( F =12.34, P <.001) than PrUs cleaned with other cleansers such as antiseptic, antibiotic, or commercial cleansers. Change in area of Stage III and IV PrUs was related to sufficient enteral feeding ( F =5.23, P= .02), enteral feeding without higher acuity levels ( F =3.94, P= .048), size of PrU (very large ( F =120.89, P= .001) and large ( F =27.82, P= .001)), and type of dressing (moist ( F =14.70, P< .001) and dry ( F =5.88, P= .02)). Stage III and IV PrUs increased in area when debrided ( F =5.97, P= .02). The overall models were significant (Stage III and IV, F =20.30, coefficient of determination ( R 2 )=0.06, P< .001; Stage II, F =40.28, R 2 =0.13, P< .001) but explained little of the variation in change in PrU area. Conclusion: In this sample of nursing facility residents, use of moist dressings (Stage II, Stage III and IV) and adequate nutritional support (Stage III and IV) are strong predictors of PrU healing.