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Related Experiment Videos

Pressure ulcers: implementation of evidence-based nursing practice.

Heather F Clarke1, Chris Bradley, Sandra Whytock

  • 1Health & Nursing Policy, Research & Evaluation Consulting, 1575 Trafalgar Street, Vancouver, BC, Canada V6K 3R4. heather.clarke@shaw.ca

Journal of Advanced Nursing
|March 2, 2005
PubMed
Summary

Implementing computer-assisted strategies for clinical practice guidelines improved knowledge of pressure ulcer prevention. Barriers included leadership, time, and computer system issues, highlighting the need for sustained support.

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Area of Science:

  • Healthcare Management
  • Clinical Informatics
  • Nursing Practice

Background:

  • Pressure ulcers represent a significant financial and time burden on healthcare systems.
  • Treatment costs per pressure ulcer range from $10,000 to $86,000.
  • Limited empirical evidence exists on the effectiveness of implementing clinical practice guidelines for pressure ulcers.

Purpose of the Study:

  • To evaluate multi-component, computer-assisted strategies for implementing clinical practice guidelines over two years.
  • To describe the implementation process and identify lessons learned.
  • To assess the impact on pressure ulcer prevention and treatment strategies.

Main Methods:

  • A 2-year project implemented computer-assisted strategies across primary, secondary, and tertiary care settings in a Canadian urban Health Region.

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  • Seven healthcare organizations (acute, home, extended care) participated.
  • Registered Nurses surveyed patients to determine pressure ulcer prevalence and incidence.
  • A computerized decision-support system aided staff in selecting evidence-based care, recording data, and analyzing outcomes.

    • Main Results:

    • Increased staff knowledge regarding pressure ulcer prevention, treatment, resource needs, and interdisciplinary team roles.
    • Identified barriers included lack of senior nurse leadership, time for computer skill acquisition and guideline implementation, and computer system difficulties.

    Conclusions:

    • A comprehensive, supported, and sustained approach is crucial for implementing evidence-based practice in pressure ulcer care.
    • Understanding and addressing organization-specific barriers is essential for successful guideline implementation.
    • Mechanisms are needed to overcome identified implementation challenges.