title: The impact of assessing the prevalence of pressure ulcers on the willingness of health care institutions to plan and implement activities to reduce the prevalence.
abstract: BACKGROUND
  In 1998, 89 health care institutions (hospitals, nursing homes, residential homes, and community care institutions) participated in the first Dutch National Pressure Ulcer Prevalence Study.
  
  
  OBJECTIVE
  Based on the innovation-decision process for individuals (Rogers 1995), the effect of their participation was investigated at different levels in the institutions [prevalence assessment coordinator, director, ward management (enrolled) nurses, and the pressure ulcer committee].
  
  
  METHODS
  A mail questionnaire was developed and filled out by 54 coordinators of the participating health care institutions.
  
  
  RESULTS
  Results showed that according to the coordinators most levels of the institutions were familiar with the results of the prevalence assessment, understood them, and were persuaded that their prevalence rate had to be changed. As a result, almost all of the coordinators of the institutions were planning activities to change pressure ulcer management, while half of the coordinators had already implemented some actions. The main activities planned or implemented were developing or updating the prevention and treatment protocol and educating the (enrolled) nurses. Some institutions were planning or had already implemented the appointment of a nurse specialist or a nurse paying special attention to pressure ulcers. Results showed that the different levels of the institutions took initiatives on different categories of activities.
  
  
  CONCLUSIONS
  It is concluded that participating in the first national prevalence study was a positive experience for the institutions, because agenda-setting took place and most started to plan or implement activities to improve the prevention and treatment of pressure ulcers.
authors.affiliation: Associate Professor, Department of Health Care Sciences, Maastricht University, POB 616, 6200 MD Maastricht, The Netherlands. r.halfens@zw.unimaas.nl
authors.forename: R J
authors.initials: RJ
authors.lastname: Halfens
authors.forename: G J
authors.initials: GJ
authors.lastname: Bours
authors.forename: C M
authors.initials: CM
authors.lastname: Bronner
mesh_terms: D003430:Cross-Sectional Studies; D003659:Decision Making, Organizational; D004059:Diffusion of Innovation; D004509:Education, Nursing, Continuing; D058016:Health Facility Administration; D006302:Health Services Research; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D009720:Nurse Clinicians; D009740:Nursing Staff / Q000193:education; D016134:Organizational Policy; D010347:Patient Care Planning / Q000458:organization & administration*; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D015995:Prevalence; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration