Transforming Long-term Care
As part of a larger effort to transform long-term care (LTC), Ottawa’s Perley Health has begun to share the lessons it learned from a project to reduce the impact of pressure injuries, commonly known as bedsores.
Pressure injuries can significantly reduce quality of life and often take many months to heal. For LTC homes, the effective treatment of pressure injuries represents a complex challenge.
To help meet this challenge, Perley Health launched a multi-faceted initiative a few years ago. The project continues to be an overwhelming success: the number of worsening pressure injuries among Perley Health’s 450 residents has declined by 52 per cent, while the number of infections in all types of wounds is down by 56 per cent.
The driving force behind the success of the pressure-injury project is Samantha Boulerice, a Registered Nurse and certified Wound Ostomy and Continence Care Specialist.
“I’ve always had a passion to care for the elderly,” says Boulerice. “I know that pressure injuries can have devastating impacts on residents. Many can’t find a comfortable position, so they choose to stay in their rooms and avoid activities, which can make matters worse.”
Boulerice is quick to share credit for the initiative’s success with Perley Health staff, donors and partners. The initiative began with a comprehensive analysis of how Perley Health staff identify, treat and track pressure injuries, along with a review of relevant clinical guidance, including clinical best practices published by the Registered Nurses Association of Ontario (RNAO). Perley Health has long participated in RNAO’S Best Practices Spotlight Organization program.
Perley Health established a quality-improvement team with representatives from across the organization—not only nurses, personal support workers and occupational therapists, but also those responsible for staff training, and ordering and stocking supply cupboards.
Together, the team identified a series of effective operational actions and an overarching strategy to foster adherence. The actions focus on operations — measures that ensure staff can consistently apply clinically proven prevention and treatment protocols.
Perley Health recognizes that sharing lessons learned from the project can help other LTC homes. To support this work, it established the Centre of Excellence in Frailty-informed Care™ (COE) in 2019. The COE conducts and partners in research studies, and develops and shares the evidence-based best practices needed to transform LTC.
The latest example is the tip sheet Six Key Elements of an Effective Wound-care Program, along with a booklet of guidelines and a website that share lessons learned. This spring, COE Knowledge Translation Specialist Heather Macleod and team are distributing and promoting these resources at a series of events, such as the annual conference
I’ve always had a passion to care for the elderly. I know that pressure injuries can have devastating impacts on residents.
– SAMANTHA BOULERICE
of Advantage Ontario, the association of non-profit LTC homes. The materials are also posted to the COE website.
“Staff of LTC homes are determined to improve the quality of care they provide and resources such as these are designed to help them,” says Heather Macleod.
“It makes me happy to know that what we learn and apply at Perley Health can benefit residents of other homes,” says Boulerice.