Smith, IL, Nixon, J, Brown, S et al. (2 more authors) (2016) Pressure Ulcer and Wounds Reporting in NHS Hospitals in England Part 1: Audit of Monitoring Systems. Journal of Tissue Viability, 25 (1). pp. 3-15. ISSN 0965-206X
Abstract
Internationally, health-care systems have attempted to assess the scale of and demonstrate improvement in patient harms. Pressure ulcer (PU) monitoring systems have been introduced across NHS in-patient facilities in England, including the Safety Thermometer (STh) (prevalence), Incident Reporting Systems (IRS) and the Strategic Executive Information System (STEIS) for serious incidents. This is the first of two related papers considering PU monitoring systems across NHS in-patient facilities in England and focusses on a Wound Audit (PUWA) to assess the accuracy of these systems. Part 2 of this work and recommendations are reported pp *-*. The PUWA was undertaken in line with ‘gold-standard’ PU prevalence methods in a stratified random sample of NHS Trusts; 24/34(72.7%) invited NHS Trusts participated, from which 121 randomly selected wards and 2239 patients agreed to participate. Prevalence of existing PUs: The PUWA identified 160(7.1%) patients with an existing PU, compared to 105(4.7%) on STh. STh had a weighted sensitivity of 48.2%(95%CI 35.4%-56.7%) and weighted specificity of 99.0%(95%CI 98.99%-99.01%). Existing/healed PUs: The PUWA identified 189(8.4%) patients with an existing/healed PU compared to 135(6.0%) on IRS. IRS had an unweighted sensitivity of 53.4%(95%CI 46.3% to 60.4%) and unweighted specificity of 98.3% (95%CI 97.7% to 98.8%). 83 patients had one or more potentially serious PU on PUWA and 8(9.6%) of these patients were reported on STEIS. The results identified high levels of under-reporting for all systems and highlighted data capture challenges, including the use of clinical staff to inform national monitoring systems and the completeness of clinical records for PUs.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Pressure ulcer; Prevalence; Sensitivity; Incident Reporting; Adverse Event; Patient Safety |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Clinical Trials Research (LICTR) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Nov 2015 11:53 |
Last Modified: | 08 Nov 2018 18:56 |
Published Version: | http://dx.doi.org/10.1016/j.jtv.2015.11.001 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.jtv.2015.11.001 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:92090 |