The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program

The Journal of Spinal Cord Medicine, 2014 · DOI: 10.1179/2045772314Y.0000000247 · Published: January 1, 2014

Spinal Cord Injury Healthcare Dermatology

Simple Explanation

Pressure ulcers are a common and serious complication after spinal cord injury. This study aimed to use implementation science to improve the use of best practices for preventing pressure ulcers in a rehabilitation center. The study focused on two main practices: doing a thorough risk assessment for pressure ulcers and creating a prevention plan, and providing education to patients about how to prevent pressure ulcers. By using implementation science frameworks, the rehabilitation center was able to significantly increase the rate at which these best practices were followed, leading to better care for patients with spinal cord injuries.

Study Duration

18 Months

Participants

287 Inpatients admitted January 2012 to July 2013

Evidence Level

Not specified

Key Findings

1
Risk assessment completion rates improved from 29% to 82% following the implementation of best practices.
2
The completion rate for the interprofessional pressure ulcer prevention plan (PUPP) was 89%.
3
Documentation of pressure ulcer education for patients increased from 21% to 45% after implementation.

Research Summary

This study used implementation science frameworks to improve the adoption of pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program. The implementation focused on comprehensive risk assessment and individualized prevention plans, as well as patient education. Results showed significant improvements in risk assessment completion rates, prevention plan completion, and documentation of patient education, demonstrating the effectiveness of implementation science in improving clinical practice.

Practical Implications

Improved Clinical Practice

Implementation science provides a structured approach to integrating best practices, enhancing patient care and outcomes in SCI rehabilitation.

Framework for Other BPI

The expertise gained in implementation frameworks can be applied to other best practice implementations within the SCI KMN and the broader SCI rehabilitation community.

Focus on Timeliness and Documentation

Ongoing efforts should concentrate on improving the timeliness of tool completion and enhancing the documentation of patient education to ensure comprehensive care.

Study Limitations

1
The study focused on implementation processes and completion rates, with patient outcomes (PU incidence) to be reported in future publications.
2
Completion of forms within targeted timeframes remained a challenge, indicating a need for continued adaptation of practices.
3
Documentation of patient education remained low despite staff training, suggesting an underestimation of actual patient education efforts.

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