An evaluation of clinical practice guidelines for the prediction and prevention of pressure ulcers

Jennifer Lorna Prentice

    Research output: ThesisDoctoral Thesis

    1804 Downloads (Pure)


    [Truncated abstract] Pressure ulcers affect a substantial proportion of patients admitted to health care services worldwide imposing considerable physical, social and economic burdens on patients and communities. As largely preventable wounds their prevalence is likely to escalate as the life expectancy and incidence of people living longer with other chronic diseases increases. Clinical practice guidelines are promulgated as evidence-based tools to assist clinicians and patients to determine care strategies, reduce inequities in healthcare provision and lower the burden of illness through improved health outcomes. This prospective multi-centre study evaluated the effectiveness of the Australian Wound Management Association's Clinical Practice Guidelines for the Prediction and Prevention of Pressure Ulcers within ten selected Australian tertiary hospitals. The data, collected in 2000, examined pressure ulcer prevalence in a subset of five of these hospitals and junior doctors’ and nurses’ knowledge of pressure ulcers in all ten hospitals at two time points, before and after guideline implementation. Pressure ulcer prevalence was ascertained by two surveyors who independently examined the skin of all consenting adult patients on a designated day. ... In addition, it is recommended that all Australian health care facilities providing in-patient, residential aged or domiciliary care services be required to demonstrate compliance with the Australian Council of Health Care Standards framework for pressure ulcers in order to be an accredited healthcare provider. The use, benefits and cost utility of pressure reducing / relieving devices in the prediction and prevention of pressure ulcers in Australian contexts of care, is required to substantiate current guideline recommendations and assist service providers and clinicians in choosing devices according to patient need. A recommendation will be forwarded to the Australian Wound Management Association suggesting the Association develop a toolkit to facilitate implementation and adoption of their guidelines. It is recommended that training of doctors, nurses and allied health personnel in the prediction, prevention and management of pressure ulcers should be of a higher priority within under-and-postgraduate education programs. From a community perspective and with a view to improving the health of the community, it is proposed that pressure ulcers be the subject of ongoing health promotion campaigns aimed at raising patients’, caregivers’ and community awareness of the potential for pressure ulcers due to the secondary effects of lifestyle related chronic diseases and ensuing reduced levels of immobility.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2007


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