The impact of a risk assessment tool on hospital pressure injury prevalence and prevention: a quantitative pre-post evaluation

Abstract

Background

Pressure injuries are preventable adverse events, and their prevalence is established as a quality indicator in healthcare. They are a notable healthcare problem worldwide, as they have a significant impact on the quality of life of affected individuals and are associated with high costs for healthcare systems. The use of an evidence-based risk assessment instrument is, therefore, crucial to enable efficient, effective, and reliable assessments.

Objective

The evidence-based pressure injury risk assessment instrument PURPOSE T was widely introduced at a university hospital in 2021, replacing another commonly used assessment tool, the Modified Norton Scale. In this study, we quantified the prevalence of pressure injuries before and after the introduction of PURPOSE T to measure the tool’s impact.

Settings

At a university hospital in Sweden with about 900 beds.

Methods

We adopted a cross-sectional research design and analysed records from point prevalence measurements carried out between September 2018 and 2023. The number of patients included in each point prevalence measurement varied between 474 and 633. Prevalence of all pressure injuries and prescribed prevention interventions over a 5-year period was calculated, compared, and analysed.

Results

We observed notable increases in the use of preventive interventions, particularly pressure-reducing chair cushions (+28.6 %) and position adjustments in chairs (+24.2 %). Additionally, we found an average increase of +23.0 % in the prevalence of category I pressure injuries after the introduction of PURPOSE T while observing a decrease in most severe pressure injury categories:35.5 % in category III and -35.3 % in category IV.

Conclusions

We found that the introduction of PURPOSE T contributed to the increased use of preventive interventions. This, in turn, was associated with a decrease or modification in the prevalence of pressure injuries, suggesting a positive impact on pressure injury within this facility.