Background: Pressure ulcer prevalence, cost, associated mortality, and potential for litigation are major clinical problems in nursing homes despite guidelines for prevention and treatment.
Objective: To improve the use of pressure ulcer prevention procedures at nursing homes in Texas through implementation of process of care system changes in collaboration with a state quality improvement organization (QIO).
Design: Preintervention and postintervention measurement of performance for process of care quality indicators and of pressure ulcer incidence rates.