Pressure injury screening in the emergency department: A concept analysis.

Aim: This concept analysis analyzes pressure injury screening in the emergency department setting using Walker and Avant's approach.

Background: Pressure injury treatment cost in the United States totals over 11 billion dollars annually. Although a pressure injury could develop in the few hours a patient is in the emergency department, there is little guidance on how an emergency department should screen, prevent, and treat patients.

Data source: Five sources resulted from database searches of CINAHL full-text, Health Business FullTEXT, and MEDLINE with Full Text. Key search terms used to narrow the search consist of the following terminology: "pressure injury" OR "pressure ulcer" AND "screening" AND "risk factors" AND "emergency room" OR "emergency department.

Review methods: Walker and Avant's method of concept analysis was used to clarify the concept of pressure injury screening in the emergency department.

Results: The concept analysis identified two attributes of pressure injury screening in the emergency department: patient length of stay and the cost of pressure injury treatment. Antecedents identified are patient risk factors: age, mobility status, sensory perception, comorbidities, and pre-existing pressure injuries. Positive consequences identified are increased patient comfort, increased staff satisfaction, decreased hospital-acquired pressure injuries, and increased adherence to established treatment protocols.

Conclusions: This concept analysis may help to guide evidence-based practice for pressure injury screening in the emergency setting. Perhaps screening in the emergency department, if adopted globally, is the missing element needed to finally see a reduction in pressure injury rates.