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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
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.
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).
- 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.
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