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Prevalence of pressure ulcers in Canadian healthcare settings.
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2004
Year
Health PolicyPressure Ulcer PrevalenceClinical EpidemiologyPatient SafetyInternational HealthPressure Ulcer CarePressure Ulcer PreventionOutcomes ResearchLower Extremity WoundEpidemiologic ResearchInjury PreventionMixed Healthcare SettingsPublic HealthMedicineEmergency MedicinePressure Ulcers
Pressure ulcer prevalence data are well documented in the US and other countries, but Canada lacks such information, hindering assessment of scope, costs, and policy development. This study aimed to estimate the prevalence of pressure ulcers in Canada by compiling data from 1990–2003 across multiple healthcare settings. The authors critically appraised existing peer‑reviewed and unpublished studies using a modified quality criteria set, excluding retrospective chart audits without direct patient assessment. The pooled estimate was 26.0% (95% CI 25.2–26.8%), with rates of 25.1% in acute care, 29.9% in non‑acute care, 22.1% in mixed settings, and 15.1% in community care—higher than figures reported in the US and the Netherlands, indicating a significant national concern.
Although statistics regarding the number of pressure ulcers in the US and other countries are available, little information is known about the number of individuals in Canada who have pressure ulcers. Such information is important to assess the scope and healthcare costs of pressure ulcers and develop public policies. To obtain estimated pressure ulcer prevalence rates in Canada, existing data (gathered between 1990 and 2003) from different healthcare settings across the country were obtained from peer-reviewed published studies and from unpublished studies provided by individuals and pressure ulcer support surface manufacturers. Methods used to gather and report prevalence data in each study were critically appraised using a modified version of published criteria. Retrospective chart audit studies that did not involve direct patient assessment were excluded. The data included information from 18 acute care facilities involving 4,831 patients, 23 non-acute care facilities with 3,390 patients, 19 mixed healthcare settings with 4,200 patients, and five community care agencies that surveyed 1,681 patients. Estimates of pressure ulcer prevalence were 25.1% (95% Confidence Interval, 23.8% to 26.3%) for acute care settings, 29.9% (95% Confidence Interval, 28.3% to 31.4%) in non-acute care settings, 22.1% (95% Confidence Interval, 20.9% to 23.4%) in mixed health settings, and 15.1% (95% Confidence Interval, 13.4% to 16.8%) in community care. The overall estimate of the prevalence of pressure ulcers in all healthcare institutions across Canada was 26.0% (95% Confidence Interval, 25.2% to 26.8%). The Canadian prevalence estimates differed among the healthcare settings and were higher than those reported in the US and the Netherlands. Although additional studies are needed, the data suggest that pressure ulcers are a significant concern in all healthcare settings in Canada.