Pressure injuries and functional outcomes in older inpatients

Research Opportunity
Honours
Number of Honour Places Available
1
Department
Medicine and Radiology
Location
Royal Melbourne Hospital
Supervisor Email Number Webpage
Andrea Maier andrea.maier@unimelb.edu.au + 61383872137 Personal web page
Rebecca Iseli rebecca.iseli@mh.org.au +61383872000

Project Details

Pressure injuries (PI), defined as ‘localised damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical or other device’[1], are a common problem in hospital inpatients, with reported Australian prevalence rates ranging from 3% to 11%[2]. Pressure injuries are often painful and are associated with increased morbidity and mortality[3]. Risk assessment tools such as the Braden scale are commonly used in clinical practice to identify patients at increased risk of PI incidence[4]. The Braden scale has also been shown to predict mortality and disability in some patient cohorts[5-7].

Although age has been identified as a risk factor for development of hospital acquired PI[8], there have been limited studies examining the association between pressure injuries and functional status and discharge destination in older adults. One retrospective US study of 2902 paired patients, with a mean age of 75 years, found that presence of PI is associated with longer hospital stay and increased rates of admission to a residential care facility[3].

The aims of this study are to:

1. Determine the prevalence of PI among inpatients of Geriatric Evaluation and Management (GEM) units who are part of the Comprehensive Geriatric Assessment (CGA) study

2. Evaluate the effect of PI on functional performance, functional status and discharge destination

3. Examine the association between nutrition and PI

4. Examine the association between Braden scale scores and functional performance, functional status and discharge destination

References

1. Edsberg, L.E., et al., Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System. J Wound Ostomy Continence Nurs, 2016. 43(6): p. 585-597.

2. Coyer, F., et al., Pressure injury prevalence in intensive care versus non-intensive care patients: A state-wide comparison. Aust Crit Care, 2017. 30(5): p. 244-250.

3. Wang, H., et al., Impact of pressure ulcers on outcomes in inpatient rehabilitation facilities. Am J Phys Med Rehabil, 2014. 93(3): p. 207-16.

4. Young, J., et al., Risk factors associated with pressure ulcer development at a major western Australian teaching hospital from 1998 to 2000: secondary data analysis. J Wound Ostomy Continence Nurs, 2002. 29(5): p. 234-41.

5. Sundaram, V., et al., The Braden Scale, A standard tool for assessing pressure ulcer risk, predicts early outcomes after liver transplantation. Liver Transpl, 2017. 23(9): p. 1153-1160.

6. Valiani, V., et al., Prognostic Value of Braden Activity Subscale for Mobility Status in Hospitalized Older Adults. J Hosp Med, 2017. 12(6): p. 396-401.

7. Bandle, B., et al., Can Braden Score Predict Outcomes for Hospitalized Heart Failure Patients? J Am Geriatr Soc, 2017. 65(6): p. 1328-1332.

8. Rondinelli, J., et al., Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System. Nurs Res, 2018. 67(1): p. 16-25.


School Research Themes

Ageing



Research Opportunities

Honours
Students who are interested in joining this project will need to consider their elegibility as well as other requirements before contacting the supervisor of this research

Graduate Research application

Honours application

Key Contact

For further information about this research, please contact a supervisor.

Department

Medicine and Radiology

Research Group / Unit / Centre

@AgeMelbourne

Research Node

Royal Melbourne Hospital

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