title: Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.
abstract: OBJECTIVE
  To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system.
  
  
  BACKGROUND
  Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes.
  
  
  METHODS
  Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables.
  
  
  RESULTS
  Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals.
  
  
  CONCLUSIONS
  Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance.
  
  
  CONCLUSIONS
  The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation.
authors.affiliation: Cedars-Sinai Medical Center, Nursing Research and Development, Los Angeles, CA, USA.
authors.forename: Lynn M
authors.identifier: http://orcid.org/0000-0002-6803-7307
authors.initials: LM
authors.lastname: Soban
authors.affiliation: Agency for Healthcare Research and Quality (AHRQ), Los Angeles Area Health Service Research (LAAHSR) Training Program, Department of Health Policy & Management, University of California School of Public Health, Los Angeles, CA, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Kim
authors.affiliation: VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
authors.forename: Anita H
authors.initials: AH
authors.lastname: Yuan
authors.affiliation: Department of Family, Community and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Miltner
mesh_terms: D032802:Committee Membership; D003430:Cross-Sectional Studies; D006801:Humans; D009718:Nurse Administrators / Q000706:statistics & numerical data; D009937:Organizational Objectives; D003668:Pressure Ulcer / Q000517:prevention & control*; D016730:Program Development / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration / Q000706:statistics & numerical data
keywords: Institutional management teams; Pressure ulcer prevention; leadership; organizational culture; patient safety; program evaluation