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

Objectives: To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks.Design: Quality improvement.Setting: SCI Rehabilitation Center.Participants: Inpatients admitted January 2012 to July 2013.Interventions: Implemen...

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Publicado en:Journal of Spinal Cord Medicine Vol. 37; no. 5; pp. 589 - 598
Autores principales: Scovil, Carol Y, Flett, Heather M, McMillan, Lan T, Delparte, Jude J, Leber, Diane J, Brown, Jacquie, Burns, Anthony S
Formato: clinical trial research Journal Article
Publicado: Taylor & Francis Ltd Sep2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2014
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      pub: Taylor & Francis Ltd
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        atl: The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program.
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          Scovil, Carol Y
          Flett, Heather M
          McMillan, Lan T
          Delparte, Jude J
          Leber, Diane J
          Brown, Jacquie
          Burns, Anthony S
      sug:
      ab: Objectives: To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks.Design: Quality improvement.Setting: SCI Rehabilitation Center.Participants: Inpatients admitted January 2012 to July 2013.Interventions: Implementation of two PU best practices were targeted: (1) completing a comprehensive PU risk assessment and individualized interprofessional PU prevention plan (PUPP); and (2) providing patient education for PU prevention; as part of the pan-Canadian SCI Knowledge Mobilization Network. At our center, the SCI Pressure Ulcer Scale replaced the Braden risk assessment scale and an interprofessional PUPP form was implemented. Comprehensive educational programing existed, so efforts focused on improving documentation. Implementation science frameworks provided structure for a systematic approach to best practice implementation (BPI): (1) site implementation team, (2) implementation drivers, (3) stages of implementation, and (4) improvement cycles. Strategies were developed to address key implementation drivers (staff competency, organizational supports, and leadership) through the four stages of implementation: exploration, installation, initial implementation, and full implementation. Improvement cycles were used to address BPI challenges.Outcome Measures: Implementation processes (e.g. staff training) and BPI outcomes (completion rates).Results: Following BPI, risk assessment completion rates improved from 29 to 82%. The PUPP completion rate was 89%. PU education was documented for 45% of patients (vs. 21% pre-implementation).Conclusion: Implementation science provided a framework and effective tools for successful pressure ulcer BPI in SCI rehabilitation. Ongoing improvement cycles will target timeliness of tool completion and documentation of patient education.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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