Pressure Ulcers: Scientific & Mathematical Analysis


Pressure ulcers constitute a complicated but preventable healthcare issue that has a high prevalence. In order to approach this problem effectively, it is crucial to analyze the statistical data and investigate the possible methods of eliminating the issue. The present paper discusses level 1 and 2 research questions for the mathematical/analytical and scientific perspectives.

The first perspective involves such questions as “What are the statistical facts related to the prevention and treatment of pressure ulcers?” and “What is the cost and financial burden associated with the prevention and treatment of pressure ulcers?” The scientific perspective will investigate the questions “What are the epidemiological issues related to the prevention and treatment of pressure ulcers?” and “What populations and body systems are the most affected by pressure ulcers?” The paper will be divided by the levels of inquiry.

Level 1 Research Questions

The level 1 research question of the mathematical/analytical perspective is focused on the statistics of pressure ulcers prevention and treatment. The study by Gardiner et al. (2016) can be employed to find the answer to this inquiry. A population-based cohort study that scholars performed indicated that out of 242,745 hospital discharges within 2009 and 2010, 2.68% of patients experienced bedsores during their stay at a hospital (Gardiner et al., 2016).

Such factors as gender, comorbidity, age, BMI, and race are reported to contribute to the development of pressure ulcers. The likelihood of bedsores increases if an individual has a negative interaction between the mentioned factors.

Another study analyzing the research question is focused on tracheostomy-related hospital-acquired pressure ulcers. In their research, O’Toole et al. (2017) note that there has been a decrease in bedsore incidence over the period between 2014 and 2015. In particular, the authors remark that the percentage of cases of pressure ulcers fell from 10.93% in 2014 to 1.29% in 2015 (O’Toole et al., 2017). Researchers note that the major reason for such a positive change is the introduction of a standardized care bundle. Also, scholars emphasize the importance of keeping a quality improvement protocol as a factor that can mitigate the problem and reduce its incidence.

The level 1 research question of the scientific perspective is concerned with the epidemiology of pressure ulcers. Lam et al. (2018) note that the annual number of people developing bedsores in the US varies between 1 and 3 million. Approximately 2.5 million cases are treated every year in emergency care units. What is more, about 60,000 people die yearly due to the complications they develop from pressure ulcers (Lam et al., 2018). The national incidence of the analyzed healthcare issue is 0-6% in rehabilitative care, 0-17% in home care, and 2.3-23.9% in long-term care (Lam et al., 2018). Scholars mention that the detailed investigation of the problem’s epidemiology can help reduce the incidence.

Pressure ulcers develop due to the immobility of a patient and are manifested through the damage of tissue. There are four stages of bedsores:

  1. sores are not open wounds yet,
  2. the skin breaks open and forms a painful ulcer,
  3. the sore progresses to the tissue,
  4. the ulcer damages muscles and bones.

To reduce the likelihood of bedsore development, Lam et al. (2018) offer such strategies as the use of pressure-reducing beds, obligatory repositioning of patients, patient education, and checking the spots by highly-skilled wound care nurses. Early surgical interventions and the enhanced and protocolized nutritional support are also recommended. Scholarly papers that have been found in databases with the help of Boolean search helped to answer level 1 questions of the mathematical/analytical and scientific perspectives.

Level 2 Research Questions

The level 2 research question of the mathematical/analytical perspective deals with the problem of the financial burden associated with the treatment and prevention of bedsores. Demarré et al. (2015) investigate this issue and mention that pressure ulcers impose a considerable financial burden. Scholars emphasize that high-quality nursing care can reduce expenditures while increasing patients’ condition. Since the study involved the review of articles from various countries, including the USA, Demarré et al. (2015) suggest the estimated numbers in euros.

It is noted that both the prevention and treatment of bedsores are costly. Demarré et al. (2015) remark that the effect of pressure ulcer prevention cost ranges between €12.58 million and €240.94 across different settings and countries. Even the minimal number is a substantial burned on the healthcare system and the government. The total cost per one patient varies between from €13.15 to €7 988.47 across different settings (Demarré et al., 2015). Therefore, the authors emphasize the importance of finding solutions to managing the incidence of pressure ulcers in order to reduce the financial burden imposed on the healthcare system.

The level 2 research question of the scientific perspective concerns the populations and body systems most frequently impacted by bedsores. Research by Coleman et al. (2013) offers relevant data on this issue. The body parts that suffer from bedsores are those that are under pressure. Therefore, the most vulnerable populations are elderly people and those who are immobile for a long time (Coleman et al., 2013). Scholars note that there is no single factor that could explain the risk of pressure ulcers development. Instead, Coleman et al. (2013) suggest that there exists a “complex interplay of factors” that intensifies the probability of bedsore (p. 975).

The primary risk factors, as identified by Coleman et al. (2013), are activity/mobility, skin/pressure ulcer status, and perfusion. Other risk aspects that can serve as predictors of bedsore development are age, nutrition, skin moisture, and hematological measures (Coleman et al., 2013). However, the three major factors should receive the most attention of the healthcare workers and caregivers.


The problem reflected in the paper is the analysis of level 1 and 2 research questions on pressure ulcers. The level 1 question of the mathematical/analytical perspective was concerned with the statistics of bedsore prevention and treatment. The level 2 question of the same perspective was focused on the financial burden associated with the healthcare problem. The level 1 question of the scientific dimension was related to the epidemiology of the disease.

The level 2 inquiry at that perspective dealt with the populations and body systems affected by pressure ulcers. As a result of the scholarly search that was performed with the help of the Boolean approach, relevant literature was found. Scholars that investigate the problem note that the statistics of bedsores is too high, which leads to the substantial financial burden. Also, the analysis of literature indicates that pressure ulcers develop due to immobility and frequently prevail in elderly citizens. The project gives an insight into the understanding of pressure ulcers as a serious healthcare concern and discusses the possible interventions that can mitigate the problem.


Coleman, S., Gorecki, C., Nelson, E. A., Closs, J. C., Defloor, T., Halfens, R., … Nixon, J. (2013). Patient risk factors for pressure ulcer development: Systematic review. International Journal of Nursing Studies, 50(7), 974-1003.

Demarré, L., Van Lancker, A., Van Hecke, A., Verhaeghe, S., Grypdonck, M., Lemey, … J., Beeckman, D. (2015). The cost of prevention and treatment of pressure ulcers: A systematic review. International Journal of Nursing Studies, 52(11), 1754-1774.

Gardiner, J. C., Reed, P. L., Bonner, J. D., Haggerty, D. K., & Hale, D. G. (2016). Incidence of hospital-acquired pressure ulcers ― A population-based cohort study. International Would Journal, 13(5), 809-820.

Lam, C., Elkbuli, A., Benson, B., Young, E., Morejon, O., Boneva, D.,… McKenney, M. (2018). Implementing a novel guideline to prevent hospital-acquired pressure ulcers in a trauma population: A patient-safety approach. Journal of the American College of Surgeons, 226(6), 1122-1127.

O’Toole, T. R., Jacobs, N., Hondorp, B., Crawford, L., Boudreau, L. R., Jeffe, J.,… LoSavio, P. (2017). Prevention of tracheostomy-related hospital-acquired pressure ulcers. Otolaryngology – Head and Neck Surgery, 156(4), 642-651.