Implementation of a risk factor-based pressure injury prevention protocol in a long-term care facility: a quality improvement project

BACKGROUND: Annually 11-20 % of older adults residing in long term care facilities (LTCF) develop a pressure injury (PI), resulting in $3.8 billion in treatment costs. Clinical trials support risk factor-based prevention strategies in hospital settings. METHODS: A pre-post cohort design project was implemented at a suburban LTCF. Recent Braden Scale risk assessments were reviewed, and an evidenced based algorithm was used to determine prevention strategies based on a unique risk profile. After a three-month implementation period, survey data was collected from direct care staff and management to measure buy-in, sustainability, and effect on cost. RESULTS: Among the 71 participants (mean age 85.07) there was an 80 % reduction in PI incidence. Surveys indicated that nursing staff found the protocol effective without increasing the workload. An intervention fidelity of 92 % was observed. CONCLUSIONS: This protocol, accepted by facility management, benefits facilities by streamlining decision making, allowing nursing staff to make informed decisions and reducing waste.