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The AHCPR pressure ulcer infection control recommendations revisited
1Johns Hopkins University School of Nursing, USA.
Abstract:
The 1994 AHCPR Pressure Ulcer Treatment Guideline had five recommendations on infection control topics. A review of the literature since mid-1993 when the evidence to support these recommendations was undertaken is reported on here. The author suggests that the recommendations be revisited in light of two recent quasi-experimental studies, but since no randomized controlled trials were found, the strength-of-evidence ratings should remain at C for all five recommendations. Infection control for chronic wound care is a complex issue and is clearly in need of further research. In the meantime, common-sense, reasonably prudent, do-no-harm interventions should be considered best practice.
Insights
The 1994 Agency for Healthcare Research and Quality (AHCPR) guideline on pressure ulcer infection control needs reassessment. Current evidence, lacking randomized controlled trials, supports maintaining a strength-of-evidence rating of C for its recommendations.
Area of Science:
- Wound care research
- Infection control in healthcare
- Evidence-based practice in medicine
Background:
- The 1994 AHCPR Pressure Ulcer Treatment Guideline offered five infection control recommendations.
- A literature review was conducted to assess evidence published since mid-1993, the cutoff for the original guideline's evidence base.
Framework:
- The review examined evidence supporting the guideline's infection control recommendations.
- Two quasi-experimental studies were identified, prompting a suggestion to revisit the guideline's recommendations.
Implementation:
- No randomized controlled trials (RCTs) were found in the literature review.
- The absence of RCTs necessitates maintaining the original strength-of-evidence rating of C for all five recommendations.
Implications:
- Infection control in chronic wound care is complex and requires further research.
- Pending further research, common-sense, "do-no-harm" interventions are recommended as best practice for pressure ulcer care.