A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention

William V. Padula, Manish K. Mishra, Mary Beth F. Makic, Robert J. Valuck

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Pressure ulcer (PrU) prevention is a priority issue in US hospitals. The National Pressure Ulcer Advisory Panel endorses an evidence-based practice (EBP) protocol to help prevent PrUs. Effective implementation of EBPs requires systematic change of existing care units. Quality improvement interventions offer a mechanism of change to existing structures in order to effectively implement EBPs for PrU prevention. The best-practice framework developed by Nelson et al is a useful model of quality improvement interventions that targets process improvement in 4 domains: leadership, staff, information and information technology, and performance and improvement. At 2 academic medical centers, the best-practice framework was shown to physicians, nurses, and health services researchers. Their insight was used to modify the best-practice framework as a reference tool for quality improvement interventions in PrU prevention. The revised framework includes 25 elements across 4 domains. Many of these elements support EBPs for PrU prevention, such as updates in PrU staging and risk assessment. The best-practice framework offers a reference point to initiating a bundle of quality improvement interventions in support of EBPs. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.

Original languageEnglish (US)
Pages (from-to)280-284
Number of pages5
JournalAdvances in Skin and Wound Care
Issue number6
StatePublished - Jun 2014


  • Centers for Medicare & Medicaid Services policy
  • Evidence-based practices
  • Pressure ulcers
  • Quality improvement

ASJC Scopus subject areas

  • Dermatology
  • Advanced and Specialized Nursing


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