AHRQ Leads Efforts to Prevent Nursing Home Pressure Ulcers

By William Spector, Ph.D., Senior Social Scientist, and Linda Bergofsky, M.S.W., M.B.A., Staff Fellow
AHRQ Center for Delivery, Organization, and Markets

Pressure ulcers are a frequent problem among nursing home residents. They’re painful, expensive to treat, and increase risks for infection and hospitalization. They’re also challenging to prevent. Even with access to electronic medical records (EMRs), nursing home staff members often don’t have the clinical information they need to identify residents at risk and intervene before pressure ulcers emerge.

 AHRQ's Safety Program for Nursing Homes: On-Time Prevention, however, has shown impressive potential to reduce pressure ulcers. The On-Time program supports prevention efforts by delivering timely, needed information to nursing home staff via specialized clinical reports that are pre-programmed into EMRs.

An initial evaluation of the program in 12 New York nursing homes showed a 59 percent reduction in the incidence of pressure ulcers after 6 months when On-Time reports were used to identify—and intervene early—with residents at increased risk. Results from that effort were published in the March 2014 Medical Care article, “Evaluation of AHRQ’s On-Time Pressure Ulcer Prevention Program: A Facilitator-assisted Clinical Decision Support Intervention for Nursing Homes.”

To ensure that this evidence is spread further, AHRQ funded a contract in 2015 to disseminate the On Time program to 50 nursing homes across the country. The project is providing ongoing technical assistance and practice facilitation to participating nursing homes, where staff members are working with coaches to use the reports, integrating review of the information into facilities’ weekly work flow.

As nursing home leaders and staff across the country celebrate National Nursing Home Week this week, they should know that the On Time program is a tool with strong potential to support efforts to reduce pressure ulcers and protect many of the nation’s most vulnerable patients. But it’s just one example of AHRQ’s broad commitment to developing and disseminating evidence-based resources to improve care—whether supporting efforts to reduce hospital readmissions, avoid patient safety events, or provide clinicians and their patients with reliable information about their treatment choices.

We’ll keep you posted in coming months about the progress of our On Time program. In the meantime, keep an eye out for the release of another AHRQ resource aimed at improving nursing home care, the Agency’s soon-to-be-released technical brief, Resident Safety Practices in Nursing Home Settings, which will be posted on the AHRQ Web site later this month.