title: Adapting pressure ulcer prevention for use in home health care.
abstract: OBJECTIVE
  Clinical practice guidelines on pressure ulcer (PU)prevention have been written primarily for inpatient settings,but we currently lack data as to how these guidelines have been adapted for use in home health care. The purpose of this study was to delineate interventions and activities used to prevent PU in home health care.
  
  
  METHODS
  Focus group study using text analysis.
  
  
  METHODS
  A focus group was conducted with 9 certified wound care nurses who practiced in home health care at least 50% of the time. Most of the participants had 10 or more years of home health experience and 5 or more years of wound care experience.
  
  
  METHODS
  The single 75-minute focus group was convened by teleconference and audiotaped. A semistructured moderator's guide was used to lead the discussion. Transcribed data were analyzed using standard text analysis. Preliminary results were distributed to focus group participants for review, comment, or clarification, and refined as needed.
  
  
  RESULTS
  Certified wound care nurse participants used an array of interventions, including those recommended by clinical practice guidelines, to prevent PU in home health patients.However, specific activities differed from those performed in hospitals and nursing homes. Interventions unique to homehealth care included (1) assessment of patients' economic and insured status to determine implementation options, (2) assessment of caregiving resources and caregivers' ability to manage PU prevention, and (3) collaboration with community resources and health care vendors to obtain needed prevention materials and supplies.
  
  
  CONCLUSIONS
  Findings provide insight into guideline adaptation in home health care and suggest that PU prevention in the homehealth care setting is more complex than that in hospitals and nursing homes and requires significant skills in communication and collaboration.
authors.affiliation: School of Nursing, The University of Kansas, Kansas City, KS 66160, USA. sbergquistberinger@kumc.edu
authors.forename: Sandra
authors.initials: S
authors.lastname: Bergquist-Beringer
authors.forename: Christine Makosky
authors.initials: CM
authors.lastname: Daley
mesh_terms: D005260:Female; D017144:Focus Groups; D019983:Guideline Adherence; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D024802:Nurse's Role; D017410:Practice Guidelines as Topic; D003668:Pressure Ulcer / Q000451:nursing* / Q000517:prevention & control*; D011361:Professional Competence; D019984:Quality Indicators, Health Care; D017592:Skin Care / Q000451:nursing; D014481:United States