Improving outcomes by implementing a pressure ulcer prevention program (PUPP): Going beyond the basics

Amparo Cano, Debbie Anglade, Hope Stamp, Fortunata Joaquin, Jennifer A. Lopez, Lori Lupe, Steven P. Schmidt, Daniel L. Young

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


A multidisciplinary process improvement program was initiated at the University of Miami Hospital (UMH) in 2009 to identify the prevalence of hospital-acquired pressure ulcers (HAPU) at the institution and to implement interventions to reduce the incidence of HAPU. This deliberate and thoughtful committee-driven process evaluated care, monitored results, and designed evidence-based strategic initiatives to manage and reduce the rate of HAPU. As a result all inpatient beds were replaced with support surfaces, updated care delivery protocols were created, and monitored, turning schedules were addressed, and a wound, ostomy, and continence (WOC) nurse and support staff were hired. These initial interventions resulted in a decrease in the prevalence of HAPU at UMH from 11.7% of stage II to IV ulcers in the second quarter, 2009 to 2.1% the third quarter. The rate remained at or near the 2009 UMH benchmark of 3.1% until the first quarter of 2012 when the rate rose to 4.1%. At that time new skin products were introduced into practice and continuing re-education was provided. The rate of HAPU dropped to 2.76% by the second quarter of 2012 and has remained steadily low at 1%-2% for nine consecutive quarters.

Original languageEnglish (US)
Pages (from-to)574-585
Number of pages12
JournalHealthcare (Switzerland)
Issue number3
StatePublished - Sep 2015


  • Hospital-acquired pressure ulcers
  • Pressure ulcer prevention
  • Pressure ulcer prevention education
  • Skin care

ASJC Scopus subject areas

  • Health Informatics
  • Health Policy
  • Health Information Management
  • Leadership and Management


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