The Changing Prevalence of Pressure Injury among Ontarians with SCI/D at Rehabilitation Admission: Opportunities for Improvement

Healthcare, 2024 · DOI: 10.3390/healthcare12111084 · Published: May 25, 2024

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

Pressure injuries (PIs) are a significant health issue, leading to complications such as infections, impaired rehabilitation, increased pain, and prolonged hospital stays. Preventing PIs is crucial, especially for individuals with spinal cord injury/disease (SCI/D) who are more susceptible due to motor, sensory, and other impairments. This study examined the prevalence and incidence of PIs among SCI/D patients admitted for rehabilitation in Ontario, Canada, from 2020 to 2023. The goal was to identify trends and opportunities for improvement in PI prevention and care. The study found that a significant proportion of SCI/D patients had PIs at the time of rehabilitation admission, and the prevalence is increasing. However, the incidence of new PIs developing during rehabilitation has decreased since 2021 due to the implementation of regular skin checks.

Study Duration

January 2020 to July 2023

Participants

1767 discharged SCI/D patients

Evidence Level

Not specified

Key Findings

1
26% of 1767 discharged SCI/D patients had ≥1 PI, with 59% being prevalent and 41% incident.
2
Most severe PIs (stages III and IV and unstageable) were acquired prior to admission.
3
Patients with PIs experienced longer hospital stays, lower Functional Independence Measure (FIM) changes, and FIM efficiency during rehabilitation.

Research Summary

The study investigated pressure injury (PI) prevalence and incidence among spinal cord injury/disease (SCI/D) patients admitted for rehabilitation in Ontario from 2020 to 2023. Key findings included a high prevalence of PIs at admission, particularly severe sacral injuries, and a decreasing incidence of new PIs during rehabilitation following the implementation of regular skin checks. The study emphasizes the need for proactive health system interventions to reduce PI prevalence and improve patient outcomes, given the increased hospital stays and reduced functional improvement observed in patients with PIs.

Practical Implications

Health System Interventions

Proactive health system interventions are needed to reduce the prevalence of pressure injuries, especially sacral injuries, among SCI/D patients before rehabilitation admission.

Improved Skin Check Programs

Implementing and optimizing daily skin check programs can effectively reduce the incidence of pressure injuries during inpatient rehabilitation.

Resource Allocation

Allocate appropriate resources to develop innovative prevention strategies and enhance/accelerate pressure injury treatment outcomes to improve skin integrity in SCI/D patients.

Study Limitations

1
Incomplete data collection
2
Long time intervals in the interrupted time series design
3
Need for additional root cause analyses to explore the observed trends in PI prevalence and incidence

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