Milne CT, Trigilia D, Houle TL, Delong S, Rosenblum D, et al.
Ostomy/wound management. Date of publication 2009 Apr 1;volume 55(4):50-9.
1. Ostomy Wound Manage. 2009 Apr;55(4):50-9.
Reducing pressure ulcer prevalence rates in the long-term acute care setting.
Milne CT(1), Trigilia D, Houle TL, Delong S, Rosenblum D.
Author information:
(1)Connecticut Clinical Nursing Associates, LLC, Bristol, Connecticut, USA.
ccna2@juno.com
Information about pressure ulcer prevalence, prevention, and optimal management
strategies in the long-term acute care hospital (LTACH) setting is sparse.
Although care processes in other patient care settings have been reported to
affect pressure ulcer prevalence rates, the effect of such programs in the LTACH
is unknown. To reduce perceived above-average pressure ulcer prevalence rates and
improve care processes, a 108-bed LTACH used a failure mode and effects analysis
to identify and address high-priority areas for improvement. Areas in need of
improvement included a lack of 1) wound care professionals, 2) methods to
consistently document prevention and wound data, and 3) an interdisciplinary
wound care team approach, as well as a faulty electronic medical record. While
prevalence data were collected, policies and procedures based on several
published guidelines were developed and incorporated into the pressure ulcer plan
of care by the newly established wound care team. Improved assessment and
documentation methods, enhanced staff education, revised electronic records,
wound care product reviews, and a facility-wide commitment to improved care
resulted in a reduction of facility-acquired pressure ulcer prevalence from 41%
at baseline to an average of 4.2% during the following 12 months as well as fewer
missing electronic record data (<1% of charts had missing data). These study
results suggest that staff education, better documentation, and a dedicated wound
care team improves care practices and reduces pressure ulcer prevalence in the
LTACH. Studies to increase knowledge about the LTACH patient population and their
unique needs and risk profiles are needed.
PMID: 19387096 [Indexed for MEDLINE]
