[Transfer of theory into practice in geriatric care: relation between pressure ulcer prevalence and guideline...

Clinical guidelines and best practice standards are designed to improve the quality of patient care, yet their sole existence is no guarantee that they will be transferred into practice. The aim of this study was to examine which parts of the implementation process have an effect on pressure ulcer prevalence. The setting took place in ten German nursing homes that had taken part in the annual German pressure ulcer surveys in 2005, 2006 and 2007, where staff members who are involved in implementing best practice standards for pressure ulcer prevention into practice were interviewed. The implementation process of each home was assessed with a scale and the nursing homes were then sorted by their scale scores as well as by the order of their prevalence rates. These results were compared. Nursing homes whose implementation had higher scores had low pressure ulcer prevalence rates. Homes with lower scores had higher prevalence rates. A stringent implementation plan based on a systematic and continuing analysis as well as on evidence-based interventions has the potential to lower pressure ulcer prevalence rates. We therefore recommend the use of change management strategies that improve staff communication and increase their incentive, include continuing staff education and the use of efficient evaluation instruments. These measures lead to more efficient nursing practice and improve the quality of care.