Baton Rouge, La. – A training program to reduce the incidence of pressure ulcers in Louisiana nursing facilities has resulted in some dramatic improvements, moving the state from 50th in the United States in 2016 to 42nd in the first quarter of 2018.
Louisiana is now within 1.6 percent of the national average when comparing this national benchmark of nursing home quality, reflected in publicly-accessible Nursing Home Compare data from the federal Centers for Medicare & Medicaid Services (CMS).
The program was implemented by the Louisiana Department of Health’s Office of Aging and Adult Services along with Louisiana State University Health Sciences Center-Shreveport. Led by Dr. Stanley McCallon, an associate professor of physical therapy at LSUHSC-Shreveport, the web-based and in-person, on-site training is targeted toward direct care providers.
“This is an outstanding accomplishment as Louisiana is among the unhealthiest states in the nation, which causes our elderly population to be at an increased risk of developing pressure ulcers,” said Dr. Rebekah Gee, secretary of the Louisiana Department of Health. “The pain and distress associated with pressure ulcers can be very disruptive to a resident’s care. This training program has both prevented the ulcers’ occurrence or has improved their healing, positively and immediately impacting the quality of life for that resident.”
The first round of on-site training was conducted from May 2017 to October 2017 at 50 nursing facilities. The training helped create an average 25 percent drop in the incidence of pressure ulcers at the facilities where training was implemented. The training entailed provider education on pressure relief strategies, nutritional support, skin monitoring and risk mitigation.
“Pressure ulcers, also known as bed sores or decubitus ulcers, are wounds caused by multiple factors including unrelieved pressure on the skin. Given certain conditions, an elderly person’s skin can sustain damage and develop into a pressure ulcer in as little as two to three hours,” McCallon said. “This is an important measure of the quality of clinical care in nursing homes.”
The ulcers typically develop over bony areas such as the elbow, heel, hip, shoulder, pelvis and back of the head. Pressure ulcers begin with persistent redness of skin and develop into a loss of partial thickness of skin like an abrasion, blister or shallow crater, further devolving into a painful, deep crater and exposure of muscle or bone if not properly managed.
“This in-person training over the past two years has provided a more comfortable experience for our nursing home residents,” Gee said. “We hope to expand this program to every nursing home in Louisiana in the near future.”
A second round of on-site training was conducted at an additional 50 facilities from May to October of 2018 and those results will be monitored in coming months. Training for another 50 facilities is planned by October 2019.