Effective measures for pressure ulcers management at hospitals

              The objective of this study was to clarify the contents of effective measures for pressure ulcer management at acute hospitals in Japan.[Methods] A questionnaire survey was sent by postal mail to 66 wound ostomy continence nurses who are responsible for treating pressure ulcers at acute hospitals in Japan. The multiple-choice questionnaire was designed to ascertain structural, process and outcome elements for the qualitative assessment for pressure ulcer management. This study was approved by the ethics review board of the Chiba University School of Nursing. Statistic analyses were conducted using SPSS (Ver.16). The prevalence of pressure ulcers, the healing rate, the prevalence of stage I/II pressure ulcers, and the prevalence of stage III/IV pressure ulcers were assessed in order to quantify the outcomes of measures for pressure ulcers management. Data with and without treatment measures were compared using a t-test.

[Results] Measures that clearly increased the healing rate of pressure ulcers included clear documentations such as follows; "specialist referral procedures", "the acquisition and usage of products for treating pressure ulcers", "pressure ulcer exacerbation report procedures" and "pressure ulcer healing report procedures". Measures of these, "pressure ulcer prevention criteria", "nutritional assessment criteria", "identification of patients at a high-risk for developing pressure ulcers" and "case study meetings" increased the prevalence of early-stage pressure ulcers.

[Discussion] As effective measures for pressure ulcer management at acute hospitals, it is important to establish measures to collect information, such as identifying patients at a high-risk for developing pressure ulcers including those with worsening pressure ulcers and those whose ulcers have already healed. It is clear that implementing educational measures, such as case study meetings and developing pressure ulcer care standards, increase the prevalence of shallow pressure ulcers. This increase reflects the improved detection of early-stage pressure ulcers.