A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.
OBJECTIVE
To enhance the learner's competence with knowledge about a framework of quality improvement (QI) interventions to implement evidence-based practices for pressure ulcer (PrU) prevention.


BACKGROUND
This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.


OBJECTIVE
After participating in this educational activity, the participant should be better able to:1. Summarize the process of creating and initiating the best-practice framework of QI for PrU prevention.2. Identify the domains and QI interventions for the best-practice framework of QI for PrU prevention. Pressure ulcer (PrU) prevention is a priority issue in US hospitals. The National Pressure Ulcer Advisory Panel endorses an evidence-based practice (EBP) protocol to help prevent PrUs. Effective implementation of EBPs requires systematic change of existing care units. Quality improvement interventions offer a mechanism of change to existing structures in order to effectively implement EBPs for PrU prevention. The best-practice framework developed by Nelson et al is a useful model of quality improvement interventions that targets process improvement in 4 domains: leadership, staff, information and information technology, and performance and improvement. At 2 academic medical centers, the best-practice framework was shown to physicians, nurses, and health services researchers. Their insight was used to modify the best-practice framework as a reference tool for quality improvement interventions in PrU prevention. The revised framework includes 25 elements across 4 domains. Many of these elements support EBPs for PrU prevention, such as updates in PrU staging and risk assessment. The best-practice framework offers a reference point to initiating a bundle of quality improvement interventions in support of EBPs. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.
William V. Padula, PhD, MS • Postdoctoral Fellow • Department of Medicine, University of Chicago • Chicago, Illinois Manish K. Mishra, MD, MPH • Fellow • Geisel School of Medicine, Dartmouth College • Hanover, New Hampshire Mary Beth F. Makic, PhD, RN • Research Nurse Scientist, Critical Care • University of Colorado Hospital • Aurora, Colorado Robert J. Valuck, PhD, RPh • Professor • Department of Clinical Pharmacy, University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences • Aurora, Colorado.
William V
WV
Padula
Manish K
MK
Mishra
Mary Beth F
MB
Makic
Robert J
RJ
Valuck
D004502:Education, Medical, Continuing; D005069:Evaluation Studies as Topic; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D003668:Pressure Ulcer / Q000517:prevention & control*; D011322:Primary Prevention / Q000458:organization & administration*; D058996:Quality Improvement; D018570:Risk Assessment; D017592:Skin Care / Q000379:methods / Q000592:standards; D014481:United States; D014945:Wound Healing / Q000502:physiology