National improvements in falls and pressure injuries in Swiss hospitals from 2011 to 2022: A secondary data analysis of national quality monitoring data = Nationale Entwicklungen bezüglich Sturz und Dekubitus in Schweizer Spitälern von 2011 bis 2022: eine Sekundärdatenanalyse der nationalen Qualitätsmessung

Introduction
National quality monitoring in healthcare and, in particular, the (transparent) comparison of results can trigger improvements at the structural and procedural levels and, thus, improve the outcome. In Switzerland, this kind of monitoring was conducted between 2011 and 2022 (except 2020 and 2021 due to the COVID-19 pandemic) for falls and pressure injuries in the hospital setting. The aim of this study was to examine the improvements in the quality of care for falls and pressure injuries in Swiss hospitals during the monitoring period.
Method
A secondary data analysis was conducted of the Swiss national quality monitoring data on falls and pressure injuries based on a multicenter cross-sectional design. Descriptive data analysis was performed.
Results
The hospital-acquired pressure injury prevalence rate varied between 3.6% and 5.8%, and the in-hospital fall rate was between 3.0% and 4.6%. The prevalence rates showed their greatest decrease after the first monitoring, with only a slight decrease/stagnation observed thereafter. An increase in prevalence rates was revealed after the two-year monitoring break due to the COVID-19 pandemic. The structural conditions improved (e.g., implementation of guidelines) and more processes were implemented at the patient level (e.g., use of preventive measures) over the monitoring period. At the same time, patients tended to be older, more multimorbid, and more at risk of pressure injuries.
Conclusion
Considering the change in the patient population (higher risk) and the findings on the structure and process indicators, the improvement in quality of care is likely to be more pronounced than the prevalence rates suggest.