Efficacy of a comprehensive pressure ulcer prevention program in an extended care facility.

The effects of a comprehensive pressure ulcer prevention program on the incidence of nosocomial skin breakdown and cost effectiveness were evaluated in this 8-month prospective study and follow-up after an 11-month interval. Baseline data were collected on all residents of a 125-bed nursing home who were present at the study start or were subsequently admitted during the initial 8-month interval. Reassessments were conducted on all residents at 2-month intervals during the initial 8-month study period. New admissions were similarly assessed. The program, which was modeled in accordance with the AHCPR's guideline on pressure ulcers, was implemented after staff education and a 2-month evaluation of residents. A total of 241 residents were entered in the study, the majority of whom were female, incontinent, and at high risk for pressure ulcers. After program implementation, the incidence of pressure ulcers decreased significantly (p < .001) at each of the four initial post-program measurement periods and the 11-month follow-up. The cost analysis for the 8-month study period revealed savings that totalled more than $230,000 for the prevention program versus treatment costs. Findings support the implementation of comprehensive pressure ulcer prevention programs in extended care facilities to decrease the dollar cost of care and the cost of human suffering with a pressure ulcer.