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Rates of Pressure Ulcers Drop Sharply in U.S. Hospitals

BATESVILLE, IN — Thanks to preventive practices, rates of new pressure injuries in U.S. hospitals and other acute care settings have plummeted, according to a new survey.

A report published in the Journal of Wound, Ostomy and Continence Nursing documents about a 50% drop over the past decade. The article was based on data from the International Pressure Ulcer Prevalence (IPUP) Survey, which was led by Catherine VanGilder, MBA, BS, MT, CCRA, of Hill-Rom in Batesville, IN.

Researchers suggest that at least some of the reductions were spurred by changes in Medicare/Medicaid payment policy.

For the study conducted between 2006 and 2015, researchers analyzed data on more than 918,000 U.S. patients reported to the IPUP, which is the largest global running pressure injury database, with more than 1,000 facilities contributing data in excess of 100,000 patients each year.

Results indicate that overall prevalence of pressure injuries decreased from 13.5% in 2006 to 9.3% in 2015, representing a relative reduction of 31% across all care settings.

As for "facility-acquired prevalence" (FAP), which measures new pressure injuries developing after patients are admitted to the hospital or other reporting facility, the rate decreased about 50%, from 6.2% in 2006 to a range of 3.1% to 3.4% in 2013-2015.

The FAP declined from 6.4% in 2006 to 2.9% in 2015 in the more than 90% of patients who were reported from acute care settings, such as academic medical centers and community hospitals, the report points out.

The period between 2008 and 2009 demonstrated the greatest decline, possibly because of a change in payment policy by the Centers for Medicare & Medicaid Services (CMS), study authors noted. In 2008, the CMS discontinued acute care payments for ancillary care of hospital-acquired pressure injuries.

The prevalence of pressure injuries varied in other settings — long-term care, long-term acute care, and rehabilitation — with no clear-cut directional trends, according to the study.

"Pressure injuries are a significant clinical complication for patients and a financial and quality issue for health care facilities," the researchers wrote.