Pressure ulcers remain a huge problem in United States nursing home facilities despite the existence of prevention guidelines. Nursing home residents who stay for long durations of time and are vulnerable to less mobility are at particularly high risk of developing pressure ulcers. Substantial literature indicates that pressure ulcer prevention strategies exist. However, there is still inadequate knowledge on how to achieve consistently successful implementation of pressure ulcer prevention strategies. According to the Institute of Medicine, the best way to prevent pressure ulcers in nursing homes is to improve “staff training and empowerment, access to resources, and implementation of quality improvement processes.”
Pressure ulcer prevention methods have often been poorly implemented in nursing home care due to a critical gap in literature of how to implement the best programs, particularly, awareness of how local conditions or circumstances affects their success or failure. A recent study published in the Advances in Skin and Wound Care journal aimed to address this gap by analyzing nursing leadership and indirect care staff members’ perceptions about the context of pressure ulcer prevention in nursing facilities with improving and decreasing pressure ulcer rates among older adults.
The study was held in six Veterans Health Administration nursing home facilities (also known as community living centers) purposively selected in order for the sample to represent a variety of pressure ulcer care performances.
23 nursing home staff members participated in one-time half-hour interviews. After the gathered data from the interviews were analyzed, six key themes differentiating the facilities with improving and decreasing pressure ulcer care performances were drawn. These themes were “structures through which the change effort is initiated; organizational prioritization, alignment, and support; improvement culture; clarity of roles and responsibilities; communication strategies; and staffing and clinical practices.” The study’s results also revealed the potential contextual facilitators of and inhibitors to successful pressure ulcer prevention.
It was found that nursing home facilities with improving pressure ulcer care performance prioritized and supported pressure ulcer prevention methods and the implementation of pressure ulcer prevention activities through standard structures. This was not seen in nursing home facilities that had declining performance. The facilities that showed improving performing often aligned frontline clinicians and leadership goals for pressure ulcer prevention.
It is crucial that nursing home care providers are well-educated and trained to identify and treat patients with pressure ulcers. Moreover, they should screen newly admitted patients to assess their vulnerability to developing pressure ulcers and implement evidence-based strategies to prevent them from occurring. If you or a loved one has suffered from pressure ulcers due to inadequate care by nursing home facility staff members, contact us today for a free consultation. All older adults in skilled nursing facilities are entitled to the best quality care. When traumatic events such as pressure ulcers occur, we believe that nursing homes that are not providing quality care should be held responsible.