Incidence of Pressure Injury Among Older Adults Transitioning from Long-term Care to the ED

Abstract

ABSTRACT OBJECTIVE To identify sociodemographic, health condition, and organizational/process factors associated with pressure injury (PI) incidence during older adults’ emergency transitions from long-term care (LTC) to the ED. METHODS Emergency transitions were tracked for older adults within included LTC facilities to participating EDs in two urban centers located in provinces in Canada. Binary logistic regression was used to examine the influence of sociodemographic, service use, and client health and function factors on the incidence of PIs during transitions from LTC facilities to EDs. RESULTS Having a mobility issue (odds ratio [OR], 4.318; 95% CI, 1.344–13.870), transitioning from a publicly owned versus a nonprofit volunteer LTC facility (OR, 4.886; 95% CI, 1.157–20.634), and time from ED arrival to return to LTC being 7 to 9 days (OR, 41.327; 95% CI, 2.691–634.574) or greater than 9 days (OR, 77.639; 95% CI, 5.727–1,052.485) significantly increased the odds of experiencing a new skin injury upon return to LTC. A higher number of reported reasons for emergency transition (up to 4) significantly decreased the odds of a new PI upon return to LTC (OR, 0.315; 95% CI, 0.113-0.880). CONCLUSIONS The study findings can be used to identify LTC residents at increased risk for developing new skin injuries during an emergency transition, namely, those with mobility impairment, those requiring inpatient care for 6 or more days, and those transitioning from publicly owned LTC facilities. Evaluating the uptake and effectiveness of single-pronged and multipronged interventions such as visual cues for patient turning through online monitoring, consistent risk assessments, and improved nutrition in all care settings are vital next steps in preventing skin injuries in this population.