title: A Multisite Quality Improvement Project to Standardize the Assessment of Pressure Ulcer Healing in Veterans with Spinal Cord Injuries/Disorders.
abstract: OBJECTIVE
  The objective was to implement the evidence-based Spinal Cord Impairment Pressure Ulcer Monitoring Tool (SCI-PUMT) in 23 Spinal Cord Injury/Disorders Centers (SCI/D) in the Veterans Health Administration (VHA).
  
  
  METHODS
  A collaborative was held in Minnesota that was attended by key personnel from SCI/D Centers in the VHA.
  
  
  METHODS
  This initiative was based on a 3-year longitudinal study that established the validity and reliability of a novel pressure ulcer monitoring tool for persons with spinal cord impairment. A multifaceted evidence-based strategy was used to implement the Institute for Healthcare Improvement's framework of Plan-Do-Study-Act. The plan was executed by clinical champions who implemented the tool in their respective SCI/D Centers following a conference that used both didactic and practicum approaches.
  
  
  RESULTS
  A 15-item toolkit was developed to educate clinicians and patients regarding use of the SCI-PUMT. Toolkit elements were frequently accessed over the VA intranet (n = 3254). The 1.5-day national conference rolled out the new tool to the SCI/D Centers. Pre/post SCI-PUMT knowledge of the SCI-PUMT improved by 78% during the conference. Following the conference, periodic conference calls cemented the implementation efforts of the SCI-PUMT clinical champions and barriers were mitigated.
authors.affiliation: Susan S. Thomason, DNP, RN, ACNS-BC, CRRN, CWCN, is a Research Associate; Gail Powell-Cope, PhD, ARNP, FAAN, is Associate Director; and Matthew J. Peterson, PhD, is a Research Biomedical Engineer; all at James A. Haley Veterans' Hospital, Health Services Research & Development (HSR&D), Center of Innovation on Disability and Rehabilitation Research, Tampa, Florida. Marylou Guihan, PhD, is a Research Assistant Professor, Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and is Assistant Director, Spinal Cord Injury-Quality Enhancement Research Initiative (QUERI) Research Coordinating Center, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, Illinois. Erik S. Wallen, PhD, is Education Program Specialist, Spinal Cord Injury/Disorders System of Care, VA Central Office, Department of Veterans Affairs, Seattle, Washington. Christine M. Olney, PhD, RN, is a Research Nurse, Minneapolis VA Health Care System, Minneapolis, Minnesota. Barbara Bates-Jensen, PhD, RN, FAAN, is Consultant, VA SCI QUERI Research and Implementation for Pressure Ulcers, Chicago, Illinois; and is Professor of Nursing and Medicine, School of Nursing & David Geffen School of Medicine, University of California, Los Angeles. Dr Thomason has disclosed that her institution received funding for the educational conference held in Minneapolis, Minnesota, in 2011, and funding was provided by HSR&D-Nursing Research Initiative (original research on the Spinal Cord Impairment-Pressure Ulcer Monitoring Tool [SCI-PUMT]). Dr Powell-Cope has disclosed that she received financial support from James A. Haley Veterans' Administration Hospital for travel to the training meeting for implementing the measurement tool, and her institution has received grant funding from the VA Office of Research and Development to support ongoing research studies. Dr Peterson has disclosed that his institution received funding from HSR&D-Nursing 
authors.forename: Susan S
authors.initials: SS
authors.lastname: Thomason
authors.forename: Gail
authors.initials: G
authors.lastname: Powell-Cope
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Peterson
authors.forename: Marylou
authors.initials: M
authors.lastname: Guihan
authors.forename: Erik S
authors.initials: ES
authors.lastname: Wallen
authors.forename: Christine M
authors.initials: CM
authors.lastname: Olney
authors.forename: Barbara
authors.initials: B
authors.lastname: Bates-Jensen
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000379:methods*; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D058996:Quality Improvement; D018570:Risk Assessment; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data; D014945:Wound Healing / Q000502:physiology*