Factors Associated With Physician and Nurse Practitioner Pressure Ulcer Staging Practices in Rehabilitative and Long Term Care

Pressure ulcer (PrU) documentation is a common clinical challenge in long term care and rehabilitative settings. This pilot observational study examined PrU staging documentation practices by physicians and nurse providers in two long term care facilities with short-term rehabilitative units. The study enrolled 57 subjects with PrUs, and only 30 (52.6%) of them had PrU staging documentation by the physician or nurse practitioner. Use of powered mattresses (adjusted relative risk (RR) 2.43 with 95% CI 1.19, 4.97) and physical therapy documentation (RR 1.72 with 95% CI 1.04, 2.81) were factors significantly associated with providers documenting the PrU stage. Inadequate statistical power, due to the small study sample size, may have prevented detecting of other significant associations between patient factors and documentation practices. Future research that is adequately powered is needed to replicate these results and detect other potential factors associated with documentation.