AHRQ Research Findings Support Effort to Reduce Pressure Ulcers in Virginia

Prevention and Care Management
December 2015

An AHRQ-funded study on pressure ulcer prevention and treatment has been used to help frail older adults in Virginia remain at home instead of entering a nursing facility. VHQC, Medicare's Quality Innovation Network-Quality Improvement Organization for both Virginia and Maryland, used the study results to train health care providers who deliver care through the Program of All-Inclusive Care for the Elderly (PACE).

VHQC delivered pressure ulcer prevention information and training at seven PACE sites in 2013-2014. PACE provides comprehensive medical and social services across Virginia for nearly 1,300 individuals aged 55 and older who qualify for nursing home care but prefer to get assistance and remain at home.

A pressure ulcer is an area of skin that breaks down when pressure causes exposure of underlying tissue, including bone. About half of the sites participating in VHQC's multi-faceted PACE initiative received information and training on pressure ulcer prevention and treatment.

"PACE performance results greatly exceeded program goals for our pressure ulcer improvement activities," said Donald A. Glozer, M.H.A., president and CEO of VHQC. "Participating sites improved their ability to prevent pressure ulcers by 77.5 percent relative to their performance at baseline."

The AHRQ-funded study that helped guide pressure ulcer prevention was "Stage 2 pressure ulcer healing in nursing homes," which appeared in the July 2008 issue of the Journal of the American Geriatric Society.

"The AHRQ study provided simple but effective techniques to help prevent pressure ulcers and also to treat them," noted Terri B. Lindsey, B.S.N., R.N., a VHQC improvement consultant. "We worked one-on-one with the PACE staff to promote improvement techniques such as changing positions frequently, staging pressure ulcers correctly, and ensuring proper nutrition and skin care to prevent ulcers."

"The [AHRQ] study also helped the PACE health care professionals better understand what could be accomplished for pressure ulcers through appropriate monitoring and treatment, before the situation became more serious," Ms. Lindsey said. "By providing an evidence- and process-based assessment on how to care for fragile skin and avoid further damage, we made a difference."

Impact Case Study Identifier: 
AHRQ Product(s): Research
Topics(s): Prevention and Care Management, Long-Term Care, Pressure Ulcers, Chronic Care: Self-Management
Geographic Location: Virginia
Implementer: VHQC
Date: 12/16/2015

Bergstrom N, Smout R, Horn S, Spector W, Hartz A, Limcangco R. J Am Geriatr Soc 2008 Jul; 56(7):1252-8; http://www.ncbi.nlm.nih.gov/pubmed/18482291.

Page last reviewed December 2015