Pressure ulcer prevention and treatment practices in inpatient rehabilitation facilities.

Although many strategies have been developed to prevent pressure ulcers, they remain a significant healthcare problem, particularly for chronically ill patients in rehabilitation facilities. This study describes self-reported pressure ulcer prevention and treatment practices in rehabilitation facilities. Surveys were sent to all 52 licensed inpatient rehabilitation facilities in Missouri; the response rate was 76.9%. Less than 30% of the facilities used inexpensive nursing interventions such as keeping the head of a patient's bed at or below a level of 30 degrees. Informally established protocols were used more frequently than the evidence-based pressure ulcer prevention and treatment guidelines issued by the Agency for Health Care Policy and Research. Furthermore, only 50% of the respondent facilities used established, valid, and reliable risk assessment tools. There was little difference in the interventions used when a client either developed a pressure ulcer or was assessed as being at risk for an ulcer. These findings reveal a significant gap between research and practice and suggest a need to educate rehabilitation nurses about the most appropriate, evidence-based nursing interventions for preventing and treating pressure ulcers.