Nancy Sullivan, BA; Karen M. Schoelles, MD, SM
Note: The AHRQ reviewed contract deliverables to ensure adherence to contract requirements and quality, and a copyright release was obtained from the AHRQ before submission of the manuscript.
Disclaimer: All statements expressed in this work are those of the authors and should not in any way be construed as official opinions or positions of ECRI Institute, the AHRQ, or the U.S. Department of Health and Human Services.
Acknowledgment: The authors thank Allison Gross, MS, LIS, for performing the literature searches; Lydia Dharia and Katherine Donahue for preparing the manuscript for publication; and Paul G. Shekelle, MD, PhD, for his review and suggestions on earlier versions of the manuscript.
Financial Support: From the AHRQ, U.S. Department of Health and Human Services (contract HHSA-290-2007-10062I).
Potential Conflicts of Interest: Ms. Sullivan: None disclosed. Dr. Schoelles: Support for travel to meetings for the study or other purposes (money to institution): RAND Corporation; Other (money to institution): work done by several ECRI staff on Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices for the AHRQ supported by RAND. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-2655.
Requests for Single Reprints: Nancy Sullivan, BA, ECRI Institute Evidence-based Practice Center, 5200 Butler Pike, Plymouth Meeting, PA 19462-1298; e-mail, email@example.com.
Current Author Addresses: Ms. Sullivan and Dr. Schoelles: ECRI Institute Evidence-based Practice Center, 5200 Butler Pike, Plymouth Meeting, PA 19462-1298.
Author Contributions: Conception and design: N. Sullivan, K.M. Schoelles.
Analysis and interpretation of the data: N. Sullivan, K.M. Schoelles.
Drafting of the article: N. Sullivan.
Critical revision of the article for important intellectual content: N. Sullivan, K.M. Schoelles.
Final approval of the article: K.M. Schoelles.
Obtaining of funding: K.M. Schoelles.
Administrative, technical, or logistic support: N. Sullivan, K.M. Schoelles.
Collection and assembly of data: N. Sullivan, K.M. Schoelles.
Complications from hospital-acquired pressure ulcers cause 60 000 deaths and significant morbidity annually in the United States. The objective of this systematic review is to review evidence regarding multicomponent strategies for preventing pressure ulcers and to examine the importance of contextual aspects of programs that aim to reduce facility-acquired pressure ulcers. CINAHL, the Cochrane Library, EMBASE, MEDLINE, and PreMEDLINE were searched for articles published from 2000 to 2012. Studies (any design) that implemented multicomponent initiatives to prevent pressure ulcers in adults in U.S. acute and long-term care settings and that reported pressure ulcer rates at least 6 months after implementation were selected. Two reviewers extracted study data and rated quality of evidence. Findings from 26 implementation studies (moderate strength of evidence) suggested that the integration of several core components improved processes of care and reduced pressure ulcer rates. Key components included the simplification and standardization of pressure ulcer–specific interventions and documentation, involvement of multidisciplinary teams and leadership, use of designated skin champions, ongoing staff education, and sustained audit and feedback.
Appendix Table 1. Components of Pressure Ulcer Prevention Studies in U.S. Hospitals, 2000–2012
Appendix Table 2. Components of Pressure Ulcer Prevention Studies of Long-Term Care, 2000–2012
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Sullivan N, Schoelles KM. Preventing In-Facility Pressure Ulcers as a Patient Safety Strategy: A Systematic Review. Ann Intern Med. 2013;158:410–416. doi: 10.7326/0003-4819-158-5-201303051-00008
Download citation file:
Published: Ann Intern Med. 2013;158(5_Part_2):410-416.
Geriatric Medicine, Healthcare Delivery and Policy, Hospital Medicine, Prevention/Screening.
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use