Evaluating pressure ulcer care by home healthcare nurses

To field test an objective evaluation tool consisting of process-oriented quality indicators for pressure ulcer care, using nursing charts of homecare nurses. These quality indicators were developed by the authors.

Most Japanese homecare nursing agencies are small and to use much of their human and economic resources to improve the care quality is not realistic. A simple and effective system for quality assurance/improvement needs to be considered.

Descriptive study design, using the chart reviews of 34 homecare nursing clients from two homecare nursing agencies.

Nursing charts were evaluated using our quality indicators for pressure ulcer care, and whether the charts pass or not in terms of the practices described in the quality indicator was rated. The pass rates by chart and nurses' self-evaluation were compared, and pass rates by charts were examined. Results.  The evaluation by chart review generally matched with self-evaluations. The pass rates by charts were higher for indicators related to wound treatment than those related to preventive care.

Home healthcare nurses could give more attention to pressure ulcer prevention. Regular self-checks of quality indicators may remind the nurses of the importance of prevention.