Implementing an evidence-based best practice system for pressure ulcer prevention and management can reduce the potential for pressure ulcer development in nursing home residents and promote healing of existing pressure ulcers.
Each resident should be assessed for pressure ulcer risk on admission and receive an in-depth assessment of any existing pressure ulcers. The assessment process drives the development of individualized interventions and goals to prevent or heal pressure ulcers. The care plan should include the specific steps necessary to meet those goals and the guidelines for reassessment to evaluate the effectiveness of the care provided and to prompt changes in treatment as needed. The use of any particular intervention should be based on the strength of the evidence provided by existing clinical trials or literature reviews. Outcomes monitoring is a vital component of any program for managing pressure ulcer risk and treating existing pressure ulcers. An effective system includes reassessment, with more frequent assessments for residents with pressure ulcers, those who are at high risk for developing pressure ulcers, or those who have experienced a significant change of condition.
The toolkit below includes evidence-based resources that will assist facility staff in developing effective systems for pressure ulcer prevention and management.
Resources Created by DADS
- Evidence-based Best Practice for Pressure Ulcer Prevention and Management summarizes the key elements of an effective pressure ulcer prevention and management program.
- Best Practice System Summary (PDF) describes key elements of an effective system for preventing and managing pressure ulcers. It also contains a resources, clinical practice guidelines and handouts referenced on this web site. This summary can be used by facility staff to assess progress with implementing best practice for pressure ulcer prevention and management.
- Pressure Ulcer Assessment and Management Guide (PDF) identifies key elements of assessing and managing pressure ulcer risk, as well as an in-depth evaluation and monitoring of existing pressure ulcers.
- Pressure Ulcer Assessment and Reassessment Guidelines (PDF) provides the key elements of assessing and reassessing pressure ulcer risk. The tool also describes the key elements to evaluate an existing pressure ulcer.
- Pressure Ulcer Prevention and Management Care Plan Process (PDF) identifies the key components of a resident-centered care plan for preventing and managing pressure ulcers.
- Pressure Ulcer Care Plan Teaching Tool (PDF) can assist facility staff in developing individualized care plans for preventing and managing pressure ulcers.
Resources from Other Organizations
- Prevention Plus provides services and products related to the Braden Scale for Predicting Pressure Ulcer Risk and evidence-based programs for pressure ulcer prevention.
- The Bates-Jensen Wound Assessment Tool (BWAT) is a validated and reliable tool for conducting in-depth evaluations of wound status. The BWAT is available on this website, along with concise instructions for using the tool.
- The National Pressure Ulcer Advisory Panel (NPUAP) is a professional organization dedicated to the preventing and managing pressure ulcers.
- The PUSH Tool 3.0 is a validated and reliable tool that is used to collect data and monitor the healing of pressure ulcers.
- Pressure Ulcers with Exposed Cartilage Are Stage IV Pressure Ulcers (PDF) is an NPUAP position statement on pressure ulcers.
- Taking the Pressure Off – Preventing Pressure Ulcers (PDF) is a nursing best practice guideline from the Registered Nurses Association of Ontario.
- Advancing Excellence in America’s Nursing Homes is a national coalition, focusing on specific target areas, including pressure ulcers, working to improve the quality of care and quality of life of nursing home residents.
- Resources for Reducing High-Risk Pressure Ulcers can assist nursing facilities with quality improvement activities, including pressure ulcer prevention. Note: You must complete a registration to access the resources on this website.
- Indiana State Department of Health:Pressure Ulcer Resource Center offers information, tools, educational modules and other resources for pressure ulcer prevention and management.
- Medline Plus: Pressure Ulcers includes multimedia presentations, photographs and patient handouts addressing pressure ulcer prevention and management. The information also is available in Spanish.
- Registered Nurses’ Association of Ontario (2004): Assessment and Management of Venous Leg Ulcers provides recommendations for assessment and management of venous leg ulcers, using evidence gathered through systematic literature review and analysis.
- Registered Nurses’ Association of Ontario (2013): Assessment and Management of Foot Ulcers for People with Diabetes, 2nd Edition provides recommendations for assessment and management of foot ulcers in people with diabetes, using evidence gathered through systematic literature review and analysis.