Not at risk — Nevertheless a pressure ulcer |
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Authors: | Nils A Lahmann Ruud JG Halfens Theo Dassen |
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Institution: | 1. Department of Nursing Science, Charité-Universit?tsmedizin Berlin, Berlin, Germany 2. Health Care Studies / Section Nursing Science, Faculty of Health Sciences, Universiteit Maastricht, Maastricht, The Netherlands
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Abstract: | When conducting prevalence surveys pressure ulcers were found in participants clearly identified not to be at risk. This article
determines and analyses persons in German hospitals and nursing homes who suffer from pressure ulcers but are not at risk.
In the years 2002, 2003 and 2004 there were 7,097 nursing home residents and 23,966 hospital patients examined in annual pressure
ulcer prevalence surveys. A risk assessment according to the Braden Scale was performed for each participant on the day of
the survey. “Not at risk” participants were defined by Braden score cut-off > 20 points. There were 440 of 3,012 (14.6%) persons
with pressure ulcer who were considered not to be at risk. In hospitals, 16.1% of all patients with pressure ulcers were not
at risk, in nursing homes it was 8.2%. A high variance between medical specialties and individual institutions was found in
the number of those not at risk but with pressure ulcer. In the group not at risk, persons with and without a pressure ulcer
differed regarding activity and friction and shear in nursing homes. In hospitals those persons differed regarding age and
all single items of the Braden scale apart from sensory perception. Pressure ulcers that are more severe, located at the hip
or lower back or the origin of which is unknown are more likely to be considered to be at risk by the Braden risk assessment
tool.
The results may indicate insufficient abilities of the Braden scale for certain kind of pressure ulcer wounds. |
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Keywords: | Pressure ulcers prevalence Braden scale germany risk assessment not at risk |
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