Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence

J Nurs Manag. 2022 Jul;30(5):O1-O9. doi: 10.1111/jonm.12928. Epub 2020 Feb 25.


Aim: To analyse patient factors and nurse staffing-related issues involving hospital-acquired pressure ulcers in patients at two types of hospital.

Background: Hospital-acquired pressure ulcers are important for the safety of hospitalized patients. Hospital-acquired pressure ulcers not only cause health problems, but also pose an economic burden to patients. In addition to patient factors such as mobility and skin integrity, hospital factors such as nurse staffing can also affect the management of such patients.

Methods: This study is a retrospective review of patient data and analysis of factors related to hospital-acquired pressure ulcers using stratified Cox proportional hazards regression.

Results: A total of 53,923 patients were included. The incidence of hospital-acquired pressure ulcers was 0.98 per 1,000 days. Hospital-acquired pressure ulcers were affected by gender, age, previous falls, low oxygen levels, positioning and toilet use. When the levels of nurse staffing were determined as one of the hospital factors, the daily hours of patient care was increased thereby contributing to the reduced incidents of hospital-acquired pressure ulcers.

Conclusion: Strategies for preventing hospital-acquired pressure ulcers should be based on the analysis of risk factors.

Implications for nursing management: Most individual risk factors for hospital-acquired pressure ulcers identified cannot be modified easily in a short time. Nurse staffing should be set at adequate levels to prevent hospital-acquired pressure ulcers.

Keywords: hours per patient-day; incidence; nurse staffing; pressure ulcer; risk factor.

MeSH terms

  • Humans
  • Incidence
  • Nursing Staff, Hospital*
  • Personnel Staffing and Scheduling
  • Pressure Ulcer* / epidemiology
  • Pressure Ulcer* / etiology
  • Pressure Ulcer* / prevention & control
  • Risk Factors
  • Workforce