Comparative Analysis of the Implementation of Improved Pressure Ulcer Prevention Programs Inhealth Care Organizations in Canada and Australia

Purpose: To compare findings from similar programs implemented in health care organizations in two different national health systems.  Methods: The two programs rely on a common methodology that emphasizes the role of nursing – including nursing leadership, the empowerment of nurses, and the development of nursing skills and capacities – within the context of a multi-disciplinary clinical care strategy. The primary focus is on nursing fundamentals, including established cornerstones of patient care such as head-to-toe assessments, proper nutrition and regular documentation.  Results: Implementation of Improved Pressure Ulcer Prevention Programs in the two organizations proved to be highly effective, showing significant, measurable results within one year.  The data confirm significant reductions in pressure ulcer prevalence rates and major changes in wound management practices.  One of the most important changes was a shift away from dry gauze dressings to advanced wound dressings that require far less frequent changes.  A significant reduction in daily dressing changes, enabling a much more efficient and effective utilization of nursing resources, was achieved in both organizations. In addition, infection rates were reduced to zero and all serious pressure ulcers were effectively eliminated in both cases, resulting in fewer hospital admissions.  Discussion: Nursing practice offers an effective starting point for pressure ulcer prevention and management.  Implementation of a successful and sustainable pressure ulcer prevalence reduction program requires organizational change.  If implemented in a disciplined and rigorous manner, these programs offer the potential to deliver both improved clinical outcomes and more efficient utilization of limited clinical resources.