Pressure ulcers in 9% of new home care patients
A national chain of home care agencies found through a quality assurance report that one in 11 new home care patients enters the system with pressure ulcers. The report, published in the September issue of the Journal of the American Geriatrics Society, raises concerns about the quality of routine skin care measures for older adults in hospitals and nursing homes and points out the need for better wound care.
More than 3,000 home care patients from 14 states — 65% of whom had been discharged from a hospital or nursing home — were examined as part of the study. About 9% already had pressure ulcers at the time of their first home care visit, and of those, roughly a third had two or more pressure ulcers, while three-fourths had advanced-stage ulcers.
The report also revealed that patients who began home care after being released from a nursing home or hospital were more likely to have pressure ulcers than other patients. Fifty-four percent of those with pressure ulcers received pressure-reducing mattresses or other devices on admission to the facility, and only 18% of those at risk received pressure reduction. Other risk factors for pressure ulcers included functional impairment, incontinence, and previous ulcers.
Most ulcers were being managed by wound care products, including dry or wet-to-dry gauze dressings. The researchers recommended educational and quality improvement efforts to ensure that home care providers have the knowledge and skill to assess and manage these potentially dangerous wounds.
(Editor’s note: Next month’s issue of Hospital Home Health will provide a pressure ulcer protocol, which will detail treatment stages, care options, and useful resource information for home care professionals who deal with pressure ulcers.)
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