Document Detail

Adherence to pressure ulcer prevention guidelines in home care: a survey of current practice.
MedLine Citation:
PMID:  18279295     Owner:  NLM     Status:  MEDLINE    
AIMS AND OBJECTIVES: To investigate the pressure ulcer prevalence in home nursing patients and to evaluate guideline adherence of measures for the prevention of pressure ulcers and the participation of informal carers in pressure ulcer prevention. BACKGROUND: Since 2002, the Belgian Guideline for the Prevention of Pressure Ulcers was published on the Internet, but no information was available on guideline adherence in home care. METHODS: A cross-sectional survey of pressure ulcer prevalence and guideline adherence was performed in a cluster randomized sample of 2779 clients of nine regional nursing departments in Flanders, Belgium. The Belgian Guideline for the Prevention of Pressure Ulcers was the reference standard for the evaluation of the guideline adherence. RESULTS: There were 744 subjects at risk for developing pressure ulcers. The overall prevalence of pressure ulcers for the total sample population was 6.8%. The age-, sex- and risk-standardized prevalence per regional department varied between 4.9% and 9.1%. Of the 744 subjects at risk, 33 (4.4%) received preventive measures, which were in adherence to the Belgian Guideline for Prevention of Pressure Ulcers, 482 persons (64.8%) were administered measures, which did not adhere to the Belgian Guideline for Prevention of Pressure Ulcers and in 229 subjects (30.8%) at risk for developing pressure ulcers, prevention was lacking. For subjects with at least one pressure ulcer, the proportions were: 4.8% adherence, 76.6% no adherence and 18.6% no prevention. A proportion of 22.2% of the patients at risk and their informal carers were informed and motivated by the home care nurse to participate in the pressure ulcer prevention and their actual participation in the prevention was 21.4% of all risk cases. CONCLUSIONS: The adherence of nurses and clients to the guideline for pressure ulcer prevention was low. RELEVANCE TO THE CLINICAL PRACTICE: The study demonstrates a detailed evaluation of guideline adherence to pressure ulcer prevention in an individual patient situation, with special attention for materials and measures, which are not adequate and not recommended by the Belgian Guideline for the Prevention of Pressure Ulcers.
Louis Paquay; Renild Wouters; Tom Defloor; Frank Buntinx; Roseline Debaillie; Ludo Geys
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical nursing     Volume:  17     ISSN:  0962-1067     ISO Abbreviation:  J Clin Nurs     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-18     Completed Date:  2008-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207302     Medline TA:  J Clin Nurs     Country:  England    
Other Details:
Languages:  eng     Pagination:  627-36     Citation Subset:  N    
Wit-Gele Kruis van Vlaanderen, Brussels & Department of General Practice, KU Leuven, Belgium.
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MeSH Terms
Activities of Daily Living
Belgium / epidemiology
Cross-Sectional Studies
Data Collection
Home Care Services*
Practice Guidelines as Topic*
Pressure Ulcer / epidemiology,  prevention & control*
Risk Factors

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