Algorithm for the Prevention and Management of Pressure Ulcers: An enabler to facilitate the implementation of the RNAO BPG on Risk Assessment and Pressure Ulcer Prevention

Background: The high prevalence of pressure ulcers is a major health issue. The management of pressure ulcers places a burden on the quality of life of patients and families as well as placing a significant strain on limited resources in health care facilities. In 2006 the Registered Nurse’s Association of Ontario (RNAO) selected our health care facility as a “Best Practice Spotlight Organization” to implement the Best Practice Guidelines (BPG) for Risk Assessment & Prevention of Pressure Ulcers and Assessment & Management of Stage I to IV Pressure Ulcers. The Wound and Ostomy Team (WOT) collaborated with the interdisciplinary Skin Integrity Task Force to develop an educational workshop program as part of the roll out process.

Objective: To provide a visual aide for nurses, allied health care professionals and support staff to facilitate adoption, implementation and long term utilization of the outlined BPG recommendations, the WOT developed an algorithm identifying possible pathways for incorporating the outlined BPG recommendations into practice.

Outcomes: With the use of the algorithm, appropriate care plans have been implemented institution wide to prevent patients from developing pressure ulcers. If pressure ulcers do develop, it provides a decision tree to guide the appropriate management, based on the “stage” of the wound, thereby promoting healing while preventing deterioration of the wound. Pressure ulcer prevalence has been successfully reduced in our facility over the last 5 years. However, further research is needed to determine the effectiveness of the algorithm in helping prevent and manage pressure ulcers. Additionally, research will help determine the impact of the educational program including the algorithm on reducing the incidence of pressure ulcers within our facility.