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Pressure ulcer: Prevention protocols and prevalence.

Doris Wilborn1, Ruud Halfens, Theo Dassen

  • 1Department of Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany. doris.wilborn@charite.de

Journal of Evaluation in Clinical Practice
|November 15, 2006
PubMed
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Developing pressure ulcer prevention protocols increases nurse awareness and improves patient outcomes. However, inconsistent adherence to guidelines like the DNQP standard hinders evidence-based practice, necessitating better implementation strategies.

Area of Science:

  • Nursing Quality Improvement
  • Healthcare Management
  • Patient Safety

Background:

  • Pressure ulcers are a significant concern in healthcare settings, impacting patient well-being and healthcare costs.
  • Standardized protocols are crucial for effective pressure ulcer prevention.
  • Adherence to national and international guidelines is essential for evidence-based practice.

Purpose of the Study:

  • To analyze German hospital and nursing home pressure ulcer prevention protocols for content and adherence to DNQP, EPUAP, and RCN guidelines.
  • To determine the relationship between protocol existence/content and pressure ulcer prevalence.
  • To identify barriers to implementing evidence-based pressure ulcer prevention.

Main Methods:

  • Prevalence survey conducted by trained nursing staff on a fixed date.

Related Experiment Videos

  • Pressure ulcer identification via physical examination post-Braden Scale risk assessment.
  • In-house protocols analyzed for content and compared against expert standards and guidelines.

    • Main Results:

    • Only 2 of 21 in-house protocols fully aligned with expert standards.
    • EPUAP and RCN guidelines emphasize training, a gap in in-house protocols and DNQP standard.
    • No correlation found between protocol availability/content and pressure ulcer prevalence; institutions developing protocols had lower prevalence.

    Conclusions:

    • Protocol development enhances nurse awareness and attentiveness, improving outcomes.
    • The DNQP expert standard is not widely known or utilized, limiting evidence-based practice.
    • Outdated nursing knowledge and lack of systematic implementation strategies impede guideline application.