Pressure Injury Incidents

A pressure injury is a sore, break or blister of the skin caused by unrelieved pressure or friction on an area of the body over a period of time. The depth of skin damage can vary from shallow to very deep. Pressure injuries can be very painful and take a long time to heal. They may also reduce a patient’s mobility.

Older people are at most risk of pressure injuries, but they can occur in any patient or in any setting, including:

  • acute areas such as operating theatres
  • during transportation to a hospital
  • intensive care units.

The majority of pressure injuries are preventable; however those at greater risk include the frail, elderly or people who have:

  • been confined to a bed or chair
  • poor bladder or bowel control
  • diabetes, poor circulation or a history of smoking
  • reduced mental awareness due to illness, medications or anaesthetics
  • poor diet or fluid intake.

Pressure injuries may impact significantly on a patient’s:

  • length of hospital stay
  • comfort and quality of life
  • cost of care and health outcomes.

Measuring pressure injury incidents

The international pressure injury classification systems provide a consistent and accurate means to communicate and document the severity of a pressure injury between clinical staff. The classification system grades these types of wounds in stages depending on:

  • changes in the patient’s skin
  • the depth of the injury
  • whether there is any fluid draining from the wound.

Pressure injury-related clinical incidents are those pressure injuries that were not present on the patient’s admission to hospital and are therefore considered hospital-acquired.

The measure used to describe the rate of pressure injury occurrence in patients admitted to hospital focusses on the patient rather than the pressure injury. This is called an incidence rate, and we calculate the rate using the number of patients who developed one or more Stage 2 or greater pressure injuries (a Stage 2 injury is when there is a break in the skin or a blister forms) during their hospital stay, divided by the number of beds occupied by patients each day (occupied bed days).

As there is currently no national or state agreed inpatient pressure injury rate benchmark, EMHS sites and services use the Australian Council for Healthcare Standards (ACHS) annual peer rate as the benchmark.

The ACHS annual peer rate provides a comparison based on a yearly average across all Australia/New Zealand health service organisations participating in the ACHS Clinical Indicator Program. The most recently published ACHS annual rate is for 2017 and equates to 0.7 patients with hospital-acquired pressure injuries per 1,000 occupied bed days.

How do we measure up

The graph below shows the combined inpatient pressure injury rate for the EMHS hospitals:

  • Armadale Health Service
  • Kalamunda Hospital
  • Bentley Hospital
  • Royal Perth Hospital

Chart: Rate of inpatients with one or more pressure injuries (≥Stage 2) per 1,000 occupied bed days (OBD).

Graph: rate of inpatients with one or more pressure injuries per 1,000 OBD

What the figures mean

EMHS fosters a culture that encourages the reporting of clinical incidents to drive quality improvement.

The graph shows the incidence of inpatients with one or more pressure injuries (≥Stage 2) per 1,000 occupied bed days by quarter across EMHS.

A lower incidence is desirable.

EMHS overall pressure injury incidence rate is consistently better than the benchmark and continues to decrease.

Last Updated: 24/09/2019