A quality-oriented approach to pressure ulcer management in a nursing facility.

The Jewish Home and Hospital for Aged, Bronx Division, is an 816-bed nursing facility that has developed a strategy for pressure ulcer management which relies on documentation, data flow, and feedback. Our system incorporates principles of Quality Improvement, and has resulted in a remarkably low nosocomial ulcer prevalence rate of 3.1%. We discuss Quality Improvement in the nursing facility and examine the value of pressure ulcer prevalence as a quality indicator. We present details of our system, highlighting the flow of information which comprises the Quality Improvement infrastructure, and include a discussion of benefits and costs of our system.