Document Detail

Treatment of pressure ulcers: results of a study comparing evidence and practice.
MedLine Citation:
PMID:  16896239     Owner:  NLM     Status:  MEDLINE    
Pressure ulcers remain prevalent in hospitals and nursing homes despite the availability of evidence-based guidelines for prevention and care. To evaluate the level of evidence-based literature and its application in pressure ulcer treatment, a search was conducted of relevant English and German articles published between 1994 and 2002 using the key terms decubitus ulcer and its synonyms in different combinations with therapy, wound management, and specific wound treatment terms. Results were compared to wound dressing use data obtained from two pressure ulcer prevalence surveys conducted in 51 hospitals and 15 nursing homes in Germany in 2001 and 2002 (N = 11,584). Dressing usage evidence levels were reviewed and reported usage was classified as consistent or not consistent with existing guidelines or as evidence base unknown. Pressure ulcer prevalence rates ranged from 10.6% to 13.2% and the majority of pressure ulcers (60%) were Grade 1. In nursing homes, dressing selection was consistent with current evidence in 6.8% of Grade 1 and 27.8% of Grade 2 ulcers. In acute care facilities, dressing selection in 2001 and 2002 was consistent with current evidence in 21.6% and 38.5%, respectively, of Grade 1 ulcers and in 40.2% and 51.5%, respectively, of Grade 2 ulcers. Although strong evidence exists to support the use of dressings that facilitate moist wound healing, barely half of the grade 3 and grade 4 ulcers in all care settings received this treatment. While dressing classification limitations restricted the ability to analyze all treatment methods used, findings suggest that clinician knowledge deficits regarding evidence-based treatments remain. The literature review results also indicate the level of evidence for many practice recommendations remains low. Studies to increase evidence levels of pressure ulcer prevention and treatment as well as programs to improve awareness and implementation of current evidence-based guidelines are needed.
Dorothea Helberg; Elke Mertens; Ruud Jg Halfens; Theo Dassen
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Ostomy/wound management     Volume:  52     ISSN:  0889-5899     ISO Abbreviation:  Ostomy Wound Manage     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-09     Completed Date:  2006-10-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8912029     Medline TA:  Ostomy Wound Manage     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-72     Citation Subset:  N    
Centre for the Humanities and Health Science, Charité - Universitätsmedizin Berlin, Schumannstr. 20/21, Berlin 10098, Germany.
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MeSH Terms
Clinical Nursing Research
Diffusion of Innovation
Evidence-Based Medicine / methods*
Guideline Adherence* / standards
Multicenter Studies as Topic
Nursing Evaluation Research
Practice Guidelines as Topic*
Pressure Ulcer / therapy*
Severity of Illness Index
Skin Care / methods*,  nursing,  standards
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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