Evaluating pressure injury and time of risk assessment for adults with hip fractures: A retrospective analysis

Background

Pressure injuries are a worldwide concern for patients in the acute hospital setting. They are a common hospital-acquired complication and Australian national standards, state policies, and local procedures have been developed to reduce incidence. Risk assessment is purported to be the gold standard in prevention.

This study examined the association between the time of pressure injury risk assessment, the presence of a pressure injury prevention management plan, and the development of hospital-acquired pressure injury(s) in the high-risk cohort of hip fracture patients at a regional base hospital in New South Wales.

Method

A retrospective descriptive study was conducted from routinely collected data, extracted from the electronic medical record and the incident management system. Patients with hospital-acquired pressure injuries were matched to those without and comparisons were made.

Results

Four hundred and eighty patients presented with a primary diagnosis of hip fracture. Twenty-four (5 %) developed at least one pressure injury during admission. Eight (33 %) of the study group and four (16.5 %) of the comparison group had a risk assessment completed within 8 h per hospital procedure. There was no correlation between risk assessment within 8 h and development of a pressure injury. Patients who developed pressure injuries were older than those who did not (mean 86 vs 80 years, p = 0.021).

Conclusion

There was no correlation between early pressure injury risk assessment and pressure injury development for hip fracture patients. Formal risk assessment by nurses did not prevent pressure injuries in patients with high-risk presentation of hip fracture. Maximum prevention strategies should be routinely implemented by nurses.