International Journal for Quality in Health Care Advance Access originally published online on November 10, 2005
International Journal for Quality in Health Care 2006 18(2):107-112; doi:10.1093/intqhc/mzi088
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Review Article
Implementation of a new policy results in a decrease of pressure ulcer frequency
1 Nursing Science Section, Centre for Quality of Care Research, 2 Department of Intensive Care, and 3 Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Objective. To determine the effects of a new policy on the efficiency of pressure ulcer care.
Design. Series of 1-day pressure ulcer surveys before and after the implementation.
Setting. A 900-bed University Medical Centre in The Netherlands.
Participants. On the days of the surveys, 657 patients were included before the implementation, 735 patients at 4 months after the implementation, and 755 patients at 11 months after the implementation.
Intervention. Implementation of a hospital guideline for pressure ulcer care combined with the introduction of viscoelastic foam mattresses on the efficiency of the prevention and treatment of pressure ulcers.
Main outcome measures. Comparisons before versus after the implementation were made regarding the care behaviour of nurses and the frequency of patients with pressure ulcer.
Results. Inadequate prevention decreased from 19 to 4% after 4 months and to 6% after 11 months (P < 0.001), and inadequate treatment decreased from 60 to 31% (P = 0.005). Excluding the use of mattresses as a positive indicator for care behaviour, we found no significant increase in adequate care to prevent pressure ulcers. Also, in adequate treatment activities, we found no significant difference. Overall, we found a significant decrease in hospital-acquired pressure ulcer frequency from 18 to 13% (P = 0.003) after 4 months and 11% (P < 0.001) after 11 months.
Conclusion. The number of pressure ulcer patients in hospital can successfully be reduced. General measures such as the introduction of adequate mattresses and guidelines for prevention and treatment are promising tools in this respect.
Keywords: decubitus ulcer, epidemiology, guidelines adherence, guidelines implementation, support surfaces, survey
Address reprint requests to Erik H. De Laat, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. E-mail: e.delaat{at}zorg.umcn.nl
Accepted for publication October 4, 2005.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M Lugtenberg, J S Burgers, and G P Westert Effects of evidence-based clinical practice guidelines on quality of care: a systematic review Qual. Saf. Health Care, October 1, 2009; 18(5): 385 - 392. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Gunningberg and N. A. Stotts Tracking quality over time: what do pressure ulcer data show? Int. J. Qual. Health Care, August 1, 2008; 20(4): 246 - 253. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Labarere, J.-L. Bosson, M.-A. Sevestre, E. Sellier, C. Richaud, and A. Legagneux Intervention targeted at nurses to improve venous thromboprophylaxis Int. J. Qual. Health Care, October 1, 2007; 19(5): 301 - 308. [Abstract] [Full Text] [PDF]
|
|