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Indicators & Change Ideas

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Explore the quality indicators being tracked by health care organizations in Ontario through Quality Improvement Plans (QIPs) and change ideas to help improve them. Connect with others to share your experiences and ideas of your own.

INDICATORS & CHANGE IDEAS

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Percentage of long-term care residents whose stage 2, 3, or 4 pressure ulcer worsened

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Pressure ulcers, also known as pressure injuries, are a serious and often preventable condition that can affect residents in long-term care. Pressure injuries in stages 2, 3, or 4 involve damage that extends beyond the skin surface, ranging from partial-thickness skin loss to deep tissue injury involving muscle or bone. When these injuries worsen, residents may experience significant pain, increased risk of infection, and reduced quality of life. For older adults with limited mobility or chronic health conditions, a worsening pressure injury can signal a decline in overall health and function, often requiring more intensive care and treatment. Preventing progression through early detection, regular skin assessments, and evidence-based interventions is critical to maintaining residents’ comfort, dignity, and overall well-being.

Key Resources

Change Ideas

Deliver staff education and training on early detection and prevention

  • Provide ongoing training on pressure injury prevention, assessment, and staging, using current best practice guidelines
  • Use case studies and visual tools to improve staff recognition of early-stage skin changes
  • Educate all staff, including non-clinical team members, on the importance of repositioning and skin checks

Conduct comprehensive risk screening and assessment for every resident

  • Screen all new residents for pressure injury risk using validated tools (e.g., Braden Scale) within 24 hours of admission
  • Repeat risk assessments regularly and after significant changes in a resident’s health status
  • Document risk scores and tailor prevention plans accordingly

Implement the evidence-based SSKIN prevention bundle

  • Adopt and maintain the SSKIN bundle (surface, skin inspection, keep moving, incontinence, nutrition) for all at-risk residents
  • Ensure repositioning schedules are documented and followed
  • Provide high-specification foam mattresses or pressure redistribution surfaces for residents at high risk

Engage residents and families in prevention

  • Review prevention strategies and care plans with residents and families during care conferences
  • Provide education on early signs of skin breakdown and how to report them promptly
  • Involve residents in setting mobility, nutrition, and hydration goals to support skin health

Facilitate interprofessional collaboration for wound care planning

  • Involve wound care specialists, nurses, physiotherapists, dietitians, and occupational therapists in prevention and treatment plans
  • Have physiotherapists design mobility programs to reduce prolonged pressure
  • Have dietitians assess nutritional needs and recommend supplements to promote skin healing

Percentage of long-term care residents whose stage 2, 3, or 4 pressure ulcer worsened

0 Comments

Pressure ulcers, also known as pressure injuries, are a serious and often preventable condition that can affect residents in long-term care. Pressure injuries in stages 2, 3, or 4 involve damage that extends beyond the skin surface, ranging from partial-thickness skin loss to deep tissue injury involving muscle or bone. When these injuries worsen, residents may experience significant pain, increased risk of infection, and reduced quality of life. For older adults with limited mobility or chronic health conditions, a worsening pressure injury can signal a decline in overall health and function, often requiring more intensive care and treatment. Preventing progression through early detection, regular skin assessments, and evidence-based interventions is critical to maintaining residents’ comfort, dignity, and overall well-being.

Key Resources

Change Ideas

Deliver staff education and training on early detection and prevention

  • Provide ongoing training on pressure injury prevention, assessment, and staging, using current best practice guidelines
  • Use case studies and visual tools to improve staff recognition of early-stage skin changes
  • Educate all staff, including non-clinical team members, on the importance of repositioning and skin checks

Conduct comprehensive risk screening and assessment for every resident

  • Screen all new residents for pressure injury risk using validated tools (e.g., Braden Scale) within 24 hours of admission
  • Repeat risk assessments regularly and after significant changes in a resident’s health status
  • Document risk scores and tailor prevention plans accordingly

Implement the evidence-based SSKIN prevention bundle

  • Adopt and maintain the SSKIN bundle (surface, skin inspection, keep moving, incontinence, nutrition) for all at-risk residents
  • Ensure repositioning schedules are documented and followed
  • Provide high-specification foam mattresses or pressure redistribution surfaces for residents at high risk

Engage residents and families in prevention

  • Review prevention strategies and care plans with residents and families during care conferences
  • Provide education on early signs of skin breakdown and how to report them promptly
  • Involve residents in setting mobility, nutrition, and hydration goals to support skin health

Facilitate interprofessional collaboration for wound care planning

  • Involve wound care specialists, nurses, physiotherapists, dietitians, and occupational therapists in prevention and treatment plans
  • Have physiotherapists design mobility programs to reduce prolonged pressure
  • Have dietitians assess nutritional needs and recommend supplements to promote skin healing
Aaron Miller True