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Implementation of a new policy results in a decrease of pressure ulcer frequency

Implementation of a new policy results in a decrease of pressure ulcer frequency
Implementation of a new policy results in a decrease of pressure ulcer frequency
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.
0309-2402
107-112
De Laat, E.H.
67d3b592-0cad-4c45-915c-4953d1ff6bc8
Schoonhoven, L.
46a2705b-c657-409b-b9da-329d5b1b02de
Pickkers, P.
8fa9ec7b-278d-4fd1-9f98-1dca3d54fbf4
Verbeek, A.L.
eb89b82a-d5ab-40d6-852c-611e6939f0e3
van Achterberg, T.
1b413585-49b3-4989-a1b6-7fb4d4bac453
De Laat, E.H.
67d3b592-0cad-4c45-915c-4953d1ff6bc8
Schoonhoven, L.
46a2705b-c657-409b-b9da-329d5b1b02de
Pickkers, P.
8fa9ec7b-278d-4fd1-9f98-1dca3d54fbf4
Verbeek, A.L.
eb89b82a-d5ab-40d6-852c-611e6939f0e3
van Achterberg, T.
1b413585-49b3-4989-a1b6-7fb4d4bac453

De Laat, E.H., Schoonhoven, L., Pickkers, P., Verbeek, A.L. and van Achterberg, T. (2006) Implementation of a new policy results in a decrease of pressure ulcer frequency. Journal of Advanced Nursing, 18 (2), 107-112. (doi:10.1093/intqhc/mzi088). (PMID:16282333)

Record type: Article

Abstract

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.

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Published date: April 2006
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 339740
URI: http://eprints.soton.ac.uk/id/eprint/339740
ISSN: 0309-2402
PURE UUID: 7b2fcd57-bc1e-4ea6-829d-96a53436d331
ORCID for L. Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766

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Date deposited: 30 May 2012 10:14
Last modified: 15 Mar 2024 03:41

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Contributors

Author: E.H. De Laat
Author: L. Schoonhoven ORCID iD
Author: P. Pickkers
Author: A.L. Verbeek
Author: T. van Achterberg

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