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Best practices for decreasing incidence of pressure ulcers

 Allina Hospitals & Clinics (MN) involved all 10 system hospitals in a pressure ulcer initiative beginning in 2008.  Components of the initiative, as described (Sendelbach, et al., 2011) include standardized surveillance and reporting, standardized education, point-of-care resources, nutritional intervention, EHR documentation, and a provider awareness campaign.  The article includes Allina’s Pressure Ulcer Prevention Algorithm.  This initiative was successful in reducing pressure ulcers — with a potential cost savings systemwide of as much as $430,000.   Another case study, featuring Buena Vista Regional Medical Center (Storm Lake, IA), has been published by the Health Research & Educational Trust (2010).  After implementing the pressure ulcer prevention bundle from the Institute for Health Improvement (2008), Buena Vista was able to cut the pressure ulcer incidence rate. 


Health Research & Educational Trust.  Decreasing pressure ulcers through skin care.  Chicago: Health Research & Educational Trust, 2010. 

Institute for Healthcare Improvement.  Getting Started Kit: Preventing Pressure Ulcers, How-To GuideCambridge, MA: IHI, 2008. 

Sendelbach, S., Zink, M., and Peterson, J.  Decreasing pressure ulcers across a healthcare systemJONA. The Journal of Nursing Administration;41(2):84-89, Feb. 2011.

Magnet status. Is it worth it?

As of March 2011, slightly fewer than seven percent of registered hospitals in the U. S. have earned the Magnet Recognition Program credential that recognizes organizations for nursing excellence. According to an article in Trustee magazine, the cost of achieving Magnet status can run from $46,000 to $251,000.

Is it worth it?

  • At Atlanticare Regional Medical Center, Atlantic City, NJ, both nurse turnover and vacancy rates dropped after the hospital achieved Magnet status, even as bed size grew by 20 percent.
  • Palomar Pomerado Health in San Diego County, CA, estimates they saved about $1.2 million a year system-wide by reducing the nurse turnover rate through the Magnet journey.
  • An article in the Journal of Nursing Administration calculates the monetary value of improved outcomes experienced by Magnet hospitals, including not only reduced turnover and vacancy rates, but also fewer needlesticks and musculoskeletal injuries and decreased falls and pressure ulcers.

The author of the Trustee article quotes Barbara Wilson, board chair at St. Luke’s Boise-Meridian Medical Center, ID, as identifying five main benefits in investing the time and money in Magnet:

  • Results in better outcomes
  • Provides a tool for recruiting nurses
  • Invests in front-line employees
  • Produces more engaged employees
  • Provides an organizational competitive advantage


Frellick, M. A path to nursing excellence. Trustee. 64(3):15-21, Mar. 2011. http://tinyurl.com/4ak72an

Drenkard, K. The business case for Magnet. Journal of Nursing Administration. 40(6):263-71, June 2010. http://tinyurl.com/4mq73jr

Growth of the program. Designations and redesignations as of March 2011. American Nurses Credentialing Center. Mar. 21, 2011. http://www.nursecredentialing.org/Magnet/ProgramOverview/GrowthoftheProgram.aspx