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The National Pressure Ulcer Long-Term Care Study: Outcomes of Pressure Ulcer Treatments in Long-Term Care

Authors

  • Nancy Bergstrom PhD, RN,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Susan D. Horn PhD,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Randall J. Smout MS,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Stacy A. Bender MS, RD,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Maree L. Ferguson PhD, RD,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • George Taler MD,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Abby C. Sauer MPH, RD,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Siohban S. Sharkey MBA,

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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  • Anne Coble Voss PhD, RD

    1. From the *School of Nursing, University of Texas at Houston, Houston, TexasInstitute for Clinical Outcomes Research, Salt Lake City, UtahRoss Products Division, Abbott Laboratories, Columbus, Ohio§Washington Hospital Center, Washington, DCISIS, Inc., Salt Lake City, Utah.
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Address correspondence to Stacy Bender, MS, RD, 12424 Pintails Circle, Pickerington, OH 43147. E-mail: stacyb@insight.rr.com

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.

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