Practices and outcomes: pressure ulcer management in nursing facilities

The objective of this study was to compare reported pressure ulcer prevention and treatment practices in nursing facilities with high prevalence of pressure ulcers versus nursing facilities with low prevalence of pressure ulcers.

A 26-item survey on implementation of nationally accepted standards for pressure ulcer prevention and treatment was mailed to directors of nursing in all 68 nursing facilities in an urban county.

There were no statistically significant differences on reported pressure ulcer prevention interventions based on pressure ulcer prevalence. When treating pressure ulcers, respondents of facilities with high prevalence of pressure ulcers reported more frequent pain assessments, more frequent use of low air-loss beds, and daily wound assessments.

The study failed to support the hypothesis that nursing facilities with low prevalence of pressure ulcers report using more guideline-recommended pressure ulcer prevention and treatment interventions than facilities with high prevalence of pressure ulcers. Reported adherence to recommended interventions for repositioning and pressure relief measures, moisture management, and attention to nutrition exceeded 60% in all facilities.

The disparity between reported interventions and pressure ulcer prevalence rates offers an opportunity for future collaborative quality improvement projects, research, and the need for leadership to develop systems of care to ensure the use of pressure ulcer prevention guidelines.