Background Pressure ulcers (PUs) are a major health issue. As their poor management can cause serious problems related to quality of healthcare, increase in secondary costs, longer hospitalisation, infections and heavier nurses’ workload, an improvement project in quality assistance was implemented. A multidisciplinary workgroup was set up with the pharmacist as the coordinator of the team.
Purpose The objective was to develop and implement a clinical pathway for prevention and treatment of PUs.
Material and methods The workgroup was formed in 2009 including pharmacists, nurses, legal doctors, specialist nurses, epidemiologist and risk manager. The clinical pathway, identified as the internal procedure PRAO85, was published with specific modules that have since been revised. Training courses for healthcare workers have taken place and clinical and procedural audits for surveillance tools have carried out.
Results The clinical pathway provided indications for PU management in the hospital including: identification methods, prevention, diagnosis and treatment. During 2010, 6 training courses were held for all healthcare workers. To verify the procedure application, a continuous surveillance plan was implemented through clinical and procedural audits and every 3 months PU incidence rates were sent from each ward. Due to the complexity of the problem and the need to spread knowledge about prevention, training courses were organised in the ward with practical meetings. From the data obtained, an increase in the number of PUs was observed. This was probably caused by better awareness of nurses to the problem. After the increase in 2010, the number of PUs in the ward reduced by 2% between 2012 and 2013. Between 2013 and 2014, a 4% increase was observed so in 2015 the clinical pathway was revised with wound dressing management flowcharts and simplified modules. Formulary restriction was applied in order to obtain a more efficient and responsible use of wound dressings.
Conclusion Multidisciplinary team work for the development and implementation of protocols and guidelines is fundamental to improve the quality of care. Continuous collaboration between healthcare workers has allowed hospital based standardised criteria to prevent and treat PUs.
No conflict of interest
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