Evidence-based treatment for pressure ulcers by stage

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.: Evidence-based treatment for pressure ulcers by stage
Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.): yes
If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:: dressings plus/minus a cytolytic agent, dressing plus or minus antibiotics; the role of wet to dry versus occlusive versus moist dressings
What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.): Hospitalized patients who are immobilized for long periods
Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)
Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.): Benefits in terms of time to heal or prevention or progession to a worse stage
Describe any health-related risks, side effects, or harms that you are concerned about.: Sepsis, osteomyelitis

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

AHRQ Priority Populations

Low income groups
Minority groups
Women
Children
Elderly
Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

Describe why this topic is important.: Highly prevalent, responsible for many healthcare dollars in cost, fraught with anecdotal evidence, there is strong evidence in otehr literatures (rehab, nursing) that physicians might not routinely have access to
What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.): Clinical need. I looked at your website and there is an old manuscript/book chapter on the topic but no clear, concise, up-to-date materials for clinicians and quality improvement leaders
Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.): yes
If yes, please explain:: This is one of the 'never events' for CMS, yet there is no succint clinician guide or other summary of evidence-based interventions and their relative risks and benefits

How will an answer to your research question be used or help inform decisions for you or your group?: Inform quality improvement initiatives, influence daily inpatient clinical practice, influence training of residents
Describe the timeframe in which an answer to your question is needed.: As soon as possible
Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.: I am not specifically aware of any but I would not be surprised if vulnrable groups were less likely to receive evidence-based care or have their pressure ulcers progress during hospitalizations. There is, from what I've seen, a great amount of clinical inertia on this topic in large part because of lack of training and expertise

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate): Inform quality improvement initiatives, influence daily inpatient clinical practice, influence training of residents

Are you making a suggestion as an individual or on behalf of an organization?: Individual

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Effective Health Care Program