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October 4, 1995

Nursing Care and Development of Pressure Ulcers-Reply

JAMA. 1995;274(13):1014-1015. doi:10.1001/jama.1995.03530130020017

In Reply.  —My coauthors and I agree with Dr Olshansky that practice patterns and activities of health care staff are tremendously important in preventing pressure ulcers, but the primary purpose of our study was to describe patient characteristics associated with pressure ulcer development. However, we also examined nurse staffing patterns as a potential predictor of pressure ulcer development in our study population. Among subjects admitted to nursing units that did not meet the study hospital's target staffing levels, the 3-week cumulative incidence of pressure ulcers was similar to the incidence observed on units that had staff levels exceeding hospital goals (18.7% vs 15.1%; P=.21 by log rank test). We were unable to observe staff behavior directly, but nurses' self-reports of infrequent repositioning and the failure to use other preventive interventions were not associated with a higher pressure ulcer incidence.Additional studies of pressure ulcer risk factors need to be

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