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Implementation of Pressure Ulcer Prevention Programs: An Opportunity to Improve Value in Healthcare
Soban L, Finley E, Miltner R. Implementation of Pressure Ulcer Prevention Programs: An Opportunity to Improve Value in Healthcare. Paper presented at: International Nursing Administration Research Conference; 2014 Nov 13; Dallas, TX.
Purpose: To identify similarities and differences in the implementation of key elements of hospital pressure ulcer prevention programs.
Background: Guidelines for pressure ulcer pressure ulcer prevention are well-established and specify nursing processes of care (e.g., use of pressure relieving devices, assessment of patient risk). Integration of these processes into routine clinical care remains a challenge; studies consistently report suboptimal use of these processes. Key elements of pressure ulcer prevention programs such as policies, staff education, and wound care specialists serve as important supports for assuring consistent delivery of pressure ulcer preventive care.
Methods: Qualitative, comparative case methodology was used in a purposive sample of 6 diverse hospitals.
Results: Program elements consistently in place included: a policy, the use of performance data, and the presence of certified wound care specialists. In contrast, program elements not consistently in place included: ongoing staff education, unit champions, interprofessional rounds, and the use of handoff tools. Across all program elements, a high degree of variation in the operationalization of each feature was noted.
Conclusions: Development of evidence-based guidance is needed to inform implementation of value-driven pressure ulcer prevention programs. This requires examination of how key elements of pressure ulcer programs are operationalized and their relationship to nursing processes of care and patient outcomes.