Evaluating the implementation and outcomes of the Saskatchewan Pressure Ulcer Guidelines in long-term care facilities.

The Health Quality Council and the Saskatchewan Association of Health Organizations convened a committee to develop evidence-based best practice guidelines for pressure ulcer prevention and management in the province of Saskatchewan, Canada. The Health Quality Council designed a pilot project to 1) implement these guidelines in long-term care facilities using an evidence-based strategy and 2) evaluate the impact of the guidelines on the incidence and prevalence of residents with pressure ulcers. Seven long-term care facilities in Saskatchewan participated in the project, which ran from November 2004 to September 2005. Data from 753 patients were collected and analyzed. Following guideline implementation, the incidence of residents with pressure ulcers decreased from 6.0% to 0.2% and the prevalence rate decreased from 8.8% to 3.7%. The greater decline in incidence compared to prevalence suggests that process improvements occurred primarily in the prevention of new pressure ulcers. These results suggest that organizational commitment to improving skin and wound care followed by the facilitated implementation of evidence-based guidelines can result in improved clinical outcomes for long-term care residents.