OBJECTIVES: To measure pressure ulcer quality indicator (QI) scores and to describe the self-reported skin integrity assessment, pressure ulcer risk assessment, and pressure ulcer prevention and treatment practices in long-term care facilities (LTCFs).
DESIGN: Retrospective analysis of a large data set and comparative survey.
SETTING: LTCFs in Missouri.
PARTICIPANTS: Three hundred sixty-two LTCFs participated in the survey. Three hundred twenty-one facilities had pressure ulcer QI scores between April 1 and September 30,
MEASUREMENTS: Pressure ulcer QI scores, Pressure Ulcer Prevention & Treatment Practices Survey. RESULTS: The mean ± standard deviation pressure ulcer QI score was 10.9 ± 6.2%, with a risk-adjusted score of 15.7 ± 8.9% for high-risk residents and 3.1 ± 3.6% for low-risk residents. Minimizing head-of-bed elevation to less than 301 was used by fewer than 20% of facilities. More than 40% of facilities used a risk assessment tool that was not evidence based. Fewer than 13% of facilities used the Agency for Health Care Policy and Research pressure ulcer prevention and treatment guidelines. No relationship was found between the number of prevention strategies (P=.892) or the number of treatment strategies (P=.921) and the pressure ulcer QI scores.
CONCLUSION: Valid and reliable pressure ulcer risk assessment tools are seriously underused. Evidence-based pressure ulcer prevention and treatment guidelines appear
to be rarely implemented. This study provides a basis for developing educational and quality improvement programs and future research related to pressure ulcer prevention and treatment in LTCFs.
Wipke-Tevis, D.D., Williams, D.A., Rantz, M.J., Popejoy, L.L., Madsen, R.W., Petroski, G.F., & Vogelsmeier, A.A. (2004). Nursing home quality and pressure ulcer prevention and management practices. Journal of the American Geriatrics Society, 52(4), 583-588.View the PDF