Evaluation of the dissemination and implementation of a nutritional guideline for pressure ulcer care

Strategies to support pressure injury best practices by the inter-professional team: A systematic review

Optimal pressure injury (ulcer) management by the inter-professional team requires appropriate health care system and organisational resources, infrastructure, and policies. A systematic review was conducted on pressure injury care-related education and health care system-/organisation-level strategies. A search for relevant articles published between January 2006 and October 2014 was applied to 8 databases. Ultimately, 22 articles pertaining to education and training and 12 articles pertaining to health care system and organisation supports for pressure injury care were included in the systematic review. A lack of pressure injury assessment and management knowledge by health care professionals was an overriding theme in the education literature. Some of the methods preferred for pressure injury education among nurses and physicians included information technology (eg, e-learning) with technology support and the use of high-quality wound pictures. Although the evidence is scarce, the literature did highlight specific system- and organisation-level barriers and enablers that influence practice change, including inter-professional communication and human resource investments. In conclusion, (1) the current evidence on the education and system-level enablers, barriers, and strategies to optimise pressure injury best practices requires further investigation, and (2) multi-faceted, up-stream, evidence-based approaches for pressure injury care are essential to improve health care and patient-related outcomes.

Seating and pressure ulcers: clinical practice guideline

Pressure ulcers (bedsores) often develop following prolonged sitting especially where people are immobile or are unable to feel discomfort due to injury or disease. This guideline provides health professionals with specific recommendations intended to minimise any risk of developing pressure ulcers when their clients are seated. The guideline covers sitting when people are acutely ill in hospital and, more commonly, where people have a long-term need for prolonged sitting for example after spinal injury. Particular focus is placed upon the need to make sure the physical size and shape of the seat is appropriate for the seated individual. Guidance is provided upon areas where seated individuals require information to help them minimise pressure ulcer development. The advantages and disadvantages of different cushion materials are described.