Prevalence and risk of pressure ulcers in acute care following implementation of practice guidelines: annual pressure ulcer prevalence census 1994-2008.

Hospital-acquired pressure ulcers in the United States were estimated to cost US$2.2 to US$3.6 billion per year in 1999.

Pressure ulcer monitoring: a process of evidence-based practice, quality, and research.

Background: A number of settings in eastern Ontario, Canada, have collaborated on establishing a common pressure ulcer monitoring system. This work was undertaken in a proactive effort to implement practice guideline recommendations related to pressure ulcer prevention. The monitoring system was developed at The Ottawa Hospital (Ottawa, Ontario, Canada), an acute care teaching hospital, and then shared with multiple settings, which adopted it.

Survey of current injury prevention practices by registered nurses in the emergency department.

Introduction: It has been shown that a vast majority of injured patients who seek treatment in emergency departments are seen and released. The events resulting in the individuals seeking treatment may have been preventable and some of the time spent in an emergency department could be used for injury prevention (IP) education. This study sought to determine current IP practices of registered nurses working in an emergency department, to discover whether or not they believed IP was important, and to identify perceived obstacles for incorporating IP education into clinical practice.

The symptom of pain in individuals recently hospitalized for heart failure.

Unlabelled: The symptom of pain is not typically associated with heart failure. Yet, emerging evidence suggests that pain is an important issue for this population.

Objectives: (1) To determine whether pain was reported by a cohort of individuals with heart failure at the time of discharge from hospital, at 2 and 6 weeks postdischarge; (2) To examine the profile of individuals who reported pain at discharge and to determine if there were differences from individuals who did not report pain; (3) To determine whether there was a difference in health-related quality of life between reported pain and no pain groups.

Adapting national and international leg ulcer practice guidelines for local use: the Ontario Leg Ulcer Community Care Protocol.

Background: Because of growing resources devoted to individuals requiring community care for leg ulcers, the authority responsible for home care in Ottawa, Ontario, Canada, established and evaluated a demonstration leg ulcer service. In an effort to provide current and evidence-based care, existing leg ulcer clinical practice guidelines were identified and appraised for quality and suitability to the new service.

Process: The Practice Guideline Evaluation and Adaptation Cycle guided development of a local protocol for leg ulcer care, which included: (1) systematically searching for practice guidelines, (2) appraising the quality of identified guidelines using a validated guideline appraisal instrument, (3) conducting a content analysis of guideline recommendations, (4) selecting recommendations to include in the local protocol, and (5) obtaining practitioner and external expert feedback on the proposed protocol.

Leg-ulcer care in the community, before and after implementation of an evidence-based service.

Background: Leg ulcers usually occur in older patients, a growing population for which increasing health care resources are required. Treatment is mainly provided in patients' homes; however, patients often receive poorly integrated services in multiple settings. We report the results of a prospective study of a community-based care strategy for leg ulcers.

Venous leg ulcer care: how evidence-based is nursing practice?

Objectives: The objectives of this study were to (1) determine how congruent community-provided leg ulcer care was with best practice for venous leg ulcers and (2) identify organizational and clinical factors associated with the provision of best practice for venous leg ulcers.

Design: The practice variation study group was an audit of nursing agency client records to determine the provision of care.

Setting And Subjects: The study population was a home care cohort of persons with venous leg ulcers (n = 66) who received care from one Ontario home care nursing agency between March 1999 and November 1999.

Assessing venous ulcer population characteristics and practices in a home care community.

To plan for a new community leg ulcer service in one Ontario region, venous ulcer population characteristics and current community care practices were obtained from a home care cohort of people with venous ulcers. A secondary analysis was conducted on the venous ulcer cohort using data collected during a Regional Prevalence and Profile Study. Patients were identified based on the clinical syndrome for venous disease criteria described in the Royal College of Nurses clinical practice guidelines and by the presence of an ankle-brachial pressure index 0.

Current home care expenditures for persons with leg ulcers.

Objective: The purpose of this study was to gain a better understanding of the home care expenditures incurred in providing care to the population with leg ulcers.

Design: The study was designed as a descriptive survey and was conducted over a 4-week period during March 1999.

Setting And Subjects: Persons in a large Ontario urban center with an ulcer below the knee, including the foot, who were receiving nursing services in the home, were eligible for inclusion in the study.