The Current State of the Clinical Utility of Evidence-Based Practice for Ulcer Prevention in Long-Term Care Facilities

Abstract

Background: Pressure ulcers (PUs) are localized skin injuries that mostly occur over bony prominences. PU prevalence in long-term care (LTC) facilities is currently extremely high despite the availability of evidence-based practice (EBP) guidelines at national and international levels. This narrative review aimed to investigate the current state of the clinical utility of EBP in the prevention of PUs in LTC facilities. Methods: A narrative review approach was used to synthesize studies that offer insights into the current state of clinical utility of EBP guidelines in LTC facilities. Studies were searched on PubMed, Web of Science, ScienceDirect, and Google Scholar. Findings: The findings revealed suboptimal implementation of EBP guidelines in LTC facilities in various countries. Nurses use clinically validated risk assessment tools less often to decide patients who are at risk of developing PUs for tailored interventions. Although scheduled positioning and the use of pressure relieving devices are commonly implemented, they are less documented in care plans. Nutritional assessments and interventions are the least often used. Nurses and other healthcare professionals often involve patients, family, and carers in planning and decision-making processes, but further improvements are still needed. Conclusion: There is a need to integrate into routine care clinically validated instruments for risk assessment for PU prevention in LTC facilities. Also, prioritizing nutritional assessments and interventions should be encouraged in LTC facilities, but there is a need to first understand barriers and facilitators.