Pressure ulcers remain a common medical problem in nursing homes, despite the development of clinical guidelines for prevention and treatment. Prevention involves low technology but vigilant care. If the disease progresses, infections can develop, and surgery may be necessary to prevent death. This article examines pressure ulcer correlates in a representative sample of 15,121 nursing home residents in 1994 in the state of Ohio. The prevalence of pressure ulcers was 12%, 8% for Stage 2 or greater. The study found that many nursing home residents remain at great risk of developing pressure ulcers. Important risk factors included a history of cured pressure ulcers, new admission and readmissions, dependencies in activities of daily living, weight loss and dehydration, diabetes, edema, and incontinence. After controlling for clinical factors, residents in rural facilities were less likely to have a pressure ulcer. These findings suggest that the quality of pressure ulcer care in nursing homes could improve.
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