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Wiley InterScience

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 53 Issue 10, Pages 1721 - 1729

Published Online: 4 Aug 2005

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.



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The National Pressure Ulcer Long-Term Care Study: Outcomes of Pressure Ulcer Treatments in Long-Term Care
Nancy Bergstrom, PhD, RN * , Susan D. Horn, PhD , Randall J. Smout, MS , Stacy A. Bender, MS, RD , Maree L. Ferguson, PhD, RD , George Taler, MD § , Abby C. Sauer, MPH, RD , Siohban S. Sharkey, MBA , and Anne Coble Voss, PhD, RD
From the  *School of Nursing, University of Texas at Houston, Houston, Texas;  Institute for Clinical Outcomes Research, Salt Lake City, Utah;  Ross Products Division, Abbott Laboratories, Columbus, Ohio;  §Washington Hospital Center, Washington, DC; and  ISIS, Inc., Salt Lake City, Utah.
 Address correspondence to Stacy Bender, MS, RD, 12424 Pintails Circle, Pickerington, OH 43147. E-mail: stacyb@insight.rr.com
Copyright © 2005 by the American Geriatrics Society
KEYWORDS
pressure ulcers • treatment • nutrition • older adults • nursing homes • long-term care

ABSTRACT

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 (R2)=0.06, P<.001; Stage II, F=40.28, R2=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.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1532-5415.2005.53506.x About DOI

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