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Reducing Prevalence of Pressure Ulcers in the Long Term Acute Care Setting First Author: Donna Trigilia Authors: Donna Trigilia APRN, MSN, CWCN Sandra DeLong BSN, CWCN David Rosenblum, M.D. Gaylord Hospital Wallingford, Connecticut Catherine T. Milne APRN, MSN, BC, CWOCN Tracy Houle APRN, MSN, BC, CWOCN Connecticut Clinical Nursing Associates, LLC Bristol, Connectic Background: The prevalence of pressure ulcers in the Long-Term Acute Care Hospital (LTACH) setting is largely under-reported in the literature. Data is also sparse regarding pressure ulcer prevention, management strategies and quality improvement initiatives (QII). Implementation of QII in other venues has resulted in pressure ulcer prevalence rate reductions. Our goal was to establish the prevalence of ulcers and evaluate the impact of QII in this setting. Methods: An interdisciplinary skin care team was created with the intent to reduce the facility acquired rate and overall prevalence to that of the reported national LTACH pressure ulcer rates of 7% and 27.3%1 respectively. Institutional prevalence studies were performed. Based on the collected data, a comprehensive quality improvement initiative was established. Included in this effort was the implementation of standards of care for wound prevention and management, staff education and the acquisition of appropriate research-based wound care products. Results: Prior to initiating the quality improvement process, facility acquired pressure ulcer rates varied by unit from 16-25% with an overall combined community and facility acquired rate of 33-58.3%. Since the beginning of the QII, facility acquired pressure ulcer rates have markedly decreased and remain in a range of 3.1-7.4% Conclusion: Using a multi-dimensional, interdisciplinary quality improvement approach can reduce pressure ulcer prevalence rates in the LTACH setting. Further studies in the LTACH setting are warranted. |
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