Pressure ulcers in four Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics, prevention and treatment

The objective of this article was to study characteristics of pressure ulcer patients and their ulcers, pressure ulcer preventive and treatment measures in four Indonesian general hospitals. A multicentre cross-sectional design was applied to assess pressure ulcers and pressure ulcer care in adult patients in medical, surgical, specialised and intensive care units. Ninety-one of the 1132 patients had a total of 142 ulcers. Half (440%) already had pressure ulcers before admission. The overall prevalence of category I-IV pressure ulcers was 80% (95% CI 64-96), and the overall nosocomial pressure ulcer prevalence was 45% (95% CI 33-57). Most pressure ulcer patients had friction and shear problems, were bedfast, had diabetes and had more bedridden days. Most ulcers (423%) were category III and IV. One third of the patients had both pressure ulcers and moisture lesions (363%) and suffered from pain (451%). The most frequently used prevention measures were repositioning (615%), skin moisturising (473%), patient education (363%) and massage (352%). Most pressure ulcer dressings involved saline-impregnated or antimicrobial gauzes. This study shows the complexities of pressure ulcers in Indonesian general hospitals and reveals that the quality of pressure ulcer care (prevention and treatment) could be improved by implementing the recent evidence-based international guideline.