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  • Publication # 13-RA012

New review examines pressure ulcer risk and prevention

Comparative Effectiveness Research

Commonly used instruments to assess risk of pressure ulcers, such as the Braden, Norton, and Waterlow scales, can identify patients at increased risk for ulcers when compared with clinical judgment, finds a new AHRQ Effective Health Care Program review. There is no clear difference in diagnostic accuracy between instruments, though direct comparisons were limited. 

More research is needed to understand how the use of these instruments impacts pressure ulcer incidence compared with clinical judgment. In higher-risk populations, studies consistently found advanced static support mattresses and overlays were associated with lower risk of pressure ulcers compared with standard mattresses, with no clear differences between different advanced static support surfaces. However, more research is needed to understand the effectiveness of other preventive interventions over standard care, and the comparative effectiveness of preventive interventions. Pressure ulcers are defined as localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction. They are often associated with severe pain and can create decreased function or lead to complications such as infection. In an inpatient setting, pressure ulcers are associated with increased length of hospitalization and delayed return to function. The presence of pressure ulcers is associated with poorer general prognosis and may contribute to mortality risk

These findings can be found in the research review, Pressure Ulcer Risk Assessment Prevention and: Comparative Effectiveness Review at http://go.usa/jzYB

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Page last reviewed September 2013
Internet Citation: New review examines pressure ulcer risk and prevention: Comparative Effectiveness Research. September 2013. Agency for Healthcare Research and Quality, Rockville, MD.


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