AHRQ’s Safety Program for Nursing Homes: On-Time Pressure Ulcer Prevention
Implementation Materials: Menu of Implementation Strategies
Three implementation documents are used to help the nursing home change team integrate the pressure ulcer prevention reports they choose to use into day-to-day clinical decisionmaking. They are:
- Self-Assessment Worksheet for Pressure Ulcer Prevention
- Pressure Ulcer Prevention Menu of Implementation Strategies:
- Implementation Steps and Timeline.
The Pressure Ulcer Prevention Menu of Implementation Strategies is intended to be used after the self-assessment has been performed. The menu can help the change team identify ways to integrate the reports into current care planning discussions during existing team meetings/huddles or help determine if new meetings/huddles may be needed to improve care planning for pressure ulcer prevention. In addition, the menu suggests other uses for the reports that may help staff monitor residents’ well-being more generally.
For each option listed, the team can determine if an existing meeting would be enhanced if it included a discussion of any of the reports or if new meetings are needed. The team should also determine which staff to add to those meetings to encourage multidisciplinary input. The team is encouraged to add options that are not listed on the worksheet. Offering a menu of possible implementation strategies allows the change team to consider which strategies best fit their workflow and meet the unique needs of their facility, avoiding the "one size fits all" approach.
The Pressure Ulcer Prevention Menu of Implementation Strategies lists possible meetings, huddles, and other uses that may incorporate a discussion of one or more of the reports. The menu is divided by suggested options for each report. The worksheet also includes columns for identifying if a given suggested meeting already occurs or whether it is a new option that would need to be added to the workflow.
Users and Uses
Once particular meetings/huddles are identified, the expectation is that the change team and the facilitator will continue to work together to reengineer existing meetings or structure new meetings to incorporate the reports. Then they will pilot the use of the reports in these meetings, identifying staff responsibilities and roles during the meetings, designing ways to keep the discussion of the reports focused and efficient, and encouraging appropriate input to determine changes in care plans when needed. The team may pilot report use in one unit initially and then implement in all units or implement more broadly right away.