Consistent practice for pressure ulcer prevention in long-term older people care: A quasi-experimental intervention study

Background: Consistent practice, an agreed clinical practice based on evidence, has been considered as a base for effective provision of quality and safety of care. As a result, patients have an equal quality of care regardless of the organisation or worker. However, despite the international guidelines, pressure ulcer prevention practices vary in long-term older people care. Aim: To develop, implement and evaluate the impact of renewed, consistent practice for pressure ulcer prevention, in long-term older people care. Design: A quasi-experimental intervention study. Methods: Two long-term older people care facilities chosen with convenience sampling were randomly allocated to intervention or comparison group. Registered and practical nurses, in total 141/112, participated in the study. The renewed consistent practice based on international guidelines for pressure ulcer prevention was developed and implemented using the Operational Model for Evidence-Based Practices (OMEBP). Frequencies and agreement of PU prevention practices in line with international guidelines in the care facilities were measured using the PUPreP instrument. Results: In the intervention facility, improvement in line with international guidelines was seen in the frequency of PU prevention practices in risk assessment, nutrition, pressure-relieving devices and documentation. Furthermore, improvement was seen in the intervention facility in all six areas of agreement on practices. Conclusions: The results of this study support the implementation of PU prevention guidelines in long-term older people care (LOPC) and more widely in healthcare settings for older people to promote consistent practice, and safety and equal quality of care.