title: Integrated care pathway: the prevention and management of pressure ulcers.
abstract: The introduction of this pathway for the prevention and management of pressure ulcers was influenced by the development of the pathway for the management of a patient with a fractured neck of femur. Systematic documentation of preventative measures for patients with a fractured neck of femur helped reduce the incidence of pressure ulcers in this high-risk group. The original draft was informed by evidence-based clinical practice guidelines. This draft of the pathway was piloted, reviewed and changed in line with current evidence and comments from users. It was invaluable to pilot the pathway and review as necessary in order to make this a true workable document that would enable continuity of care, help prevent hospital-acquired pressure ulcers and be an effective teaching aid. A trust-wide retrospective audit of documentation for the prevention and management of pressure ulcers has been conducted, which found that the pathway facilitated a more concise approach to inform care than standard documentation. A further audit has been undertaken in the care of the elderly directorate which has demonstrated various ways in which the pathway had been completed. Challenges remain for the effective use of this documentation. Further education needs to be completed in order to promote multiprofessional use of the pathway. The pathway is now being integrated into others, which will increase awareness and involvement of other professional groups in this important aspect of patient care. Ongoing audit will take place to assess the impact upon patient outcomes.
authors.affiliation: Royal Liverpool and Broadgreen University Hospitals NHS Trust.
authors.forename: Mary
authors.initials: M
authors.lastname: Newton
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D019091:Critical Pathways / Q000592:standards*; D004282:Documentation / Q000592:standards; D019317:Evidence-Based Medicine; D005265:Femoral Neck Fractures / Q000150:complications*; D006801:Humans; D015994:Incidence; D017770:Lifting; D020380:Needs Assessment; D009730:Nursing Assessment; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D009737:Nursing Records / Q000592:standards; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D011187:Posture; D017410:Practice Guidelines as Topic; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017592:Skin Care / Q000379:methods / Q000451:nursing