Implementing the push tool in clinical practice: revisions and results

The ability to measure outcomes is increasingly important in the practice of medicine. For wound care, the Pressure Ulcer Scale for Healing tool was developed to assess and standardize wound healing progress. However, for a variety of reasons, use of the tool to monitor an individual patient's wounds is not widespread. Following revisions to the tool for the purpose of capturing system-wide wound outcomes data, a prospective study in two long-term, acute care hospitals was conducted. Admission and discharge wound scores from 374 patients (989 wounds), representing 13,737 patient-days of care were obtained and recorded to document overall progress of healing and to calculate healing as a function of time. The results obtained are now used as a benchmark in the participating facilities and can be used by others to gauge the effectiveness of care. Although these tools cannot provide information about the effectiveness of specific interventions, and the data will always require careful interpretation by thoughtful wound providers, results of this study show that, at this time, the revised Pressure Ulcer Scale for Healing may be the best tool available for comparing healing outcomes.