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Related Experiment Videos

Translating pressure ulcer guidelines into practice: it's harder than it sounds.

G C Xakellis1, R A Frantz, A Lewis

  • 1University of California at Davis, Department of Family and Community Medicine, Sacramento, USA.

Advances in Skin & Wound Care
|March 22, 2002
PubMed
Summary

A pressure ulcer prevention protocol showed initial success in reducing incidence but this effect diminished over time. However, ulcer healing improved and treatment costs decreased, highlighting implementation challenges.

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Area of Science:

  • Gerontology
  • Healthcare Management
  • Clinical Nursing

Background:

  • Pressure ulcers represent a significant challenge in long-term care settings, impacting patient well-being and healthcare costs.
  • Effective prevention and treatment strategies are crucial for improving patient outcomes and resource utilization.

Purpose of the Study:

  • To evaluate the long-term cost-effectiveness of a guideline-based pressure ulcer prevention protocol.
  • To assess changes in pressure ulcer incidence, healing time, and associated costs over a three-year period.

Main Methods:

  • A quasi-experimental longitudinal design was employed in a 77-bed long-term-care facility.
  • Data were collected retrospectively and prospectively over three periods: pre-implementation (1994), immediately post-implementation (1995), and two years post-implementation (1997).

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  • The protocol included specific policies, staff education, and performance monitoring.

    • Main Results:

    • While initial reductions in pressure ulcer incidence were observed, these gains were not sustained by 1997.
    • The time required for pressure ulcer healing significantly decreased over the study period.
    • Total costs remained stable, but treatment costs declined while prevention costs increased.

    Conclusions:

    • The pressure ulcer prevention protocol demonstrated mixed results, with initial improvements in incidence not maintained long-term.
    • Clinical outcomes for ulcer treatment improved, accompanied by a significant reduction in treatment costs.
    • Successful implementation of preventive programs requires strong leadership and sustained effort.