Modeling hospital-acquired pressure ulcer prevalence on medical-surgical units: Nurse workload, expertise, and clinical processes of care

C Aydin, N Donaldson, N.A. Stotts, M Fridman, Diane Brown

    Research output: Contribution to journalArticle

    Abstract

    Objective: This study modeled the predictive power of unit/patient characteristics, nurse workload, nurse expertise, and hospital-acquired pressure ulcer (HAPU) preventive clinical processes of care on unit-level prevalence of HAPUs.

    Data Sources: Seven hundred and eighty-nine medical-surgical units (215 hospitals) in 2009.

    Study Design: Using unit-level data, HAPUs were modeled with Poisson regression with zero-inflation (due to low prevalence of HAPUs) with significant covariates as predictors.

    Data Collection/Extraction Methods: Hospitals submitted data on NQF endorsed ongoing performance measures to CALNOC registry.

    Principal Findings: Fewer HAPUs were predicted by a combination of unit/patient characteristics (shorter length of stay, fewer patients at-risk, fewer male patients), RN workload (more hours of care, greater patient [bed] turnover), RN expertise (more years of experience, fewer contract staff hours), and processes of care (more risk assessment completed).

    Conclusions: Unit/patient characteristics were potent HAPU predictors yet generally are not modifiable. RN workload, nurse expertise, and processes of care (risk assessment/interventions) are significant predictors that can be addressed to reduce HAPU. Support strategies may be needed for units where experienced full-time nurses are not available for HAPU prevention. Further research is warranted to test these finding in the context of higher HAPU prevalence.
    Original languageEnglish
    Pages (from-to)351-373
    Number of pages23
    JournalBMC Health Services Research
    Volume50
    Issue number2
    DOIs
    Publication statusPublished - Apr 2015

    Fingerprint Dive into the research topics of 'Modeling hospital-acquired pressure ulcer prevalence on medical-surgical units: Nurse workload, expertise, and clinical processes of care'. Together they form a unique fingerprint.

  • Cite this