Implementing Pressure Ulcer Prevention and Treatment Programs: Using AMDA Clinical Practice Guidelines

Abstract

The American Medical Directors Association (AMDA) Clinical Practice Guidelines (CPG) project was undertaken to develop tools that long-term care (LTC) practitioners can use to improve the delivery of quality care. Each guideline was developed by an interdisciplinary work group of LTC professionals using a process that combined evidence-based and consensus-based thinking. The CPG is a tool to guide the care delivery in a specific area and can help the care team in developing programs and care processes. A CPG detailing the implementation of other CPGs was developed as well. The Pressure Ulcers CPG was one of the initial CPGs developed by AMDA in 1996, and it was followed by a Pressure Ulcer Therapy Companion CPG in 1999. In developing both Pressure Ulcers CPGs, the workgroups were assisted by the previously developed Agency for Health Care Policy and Research (AHCPR) CPGs on the prevention and treatment of pressure ulcers. The workgroup attempted to apply the AHCPR recommendations to the specific practice environment in LTC facilities. This article reviews key points of AMDA’s Pressure Ulcer Therapy Companion CPG supplemented by information from the AHCPR. To assist facilities in implementation, important points in the AMDA Guideline Implementation CPG are discussed as they relate to implementation of the Pressure Ulcer CPG. The goal of this review is to assist medical directors, physicians and all other members of the care team in LTC facilities to understand, develop and implement pressure ulcer prevention and treatment programs.