Back on October 12, 2013, we wrote the Agency for Healthcare Research and Quality (AHRQ) of the US Dept of Health and Human Services to comment on their publication, Preventing Pressure Ulcers in Hospitals - A Toolkit for Improving Quality of Care. The AHRQ Toolkit included a wide variety of activities, including turning, repositioning, nutrituional aupplements, pads and dressings, lotions and cleansers, etc.
We wrote that their toolkit was unnecessarily complicated and detailed, and urged the adoption instead of the NDF Prevention Protocol:
1. Assess the pressure ulcer risk for every patient at admission using the Braden Scale.
2. Immediately place each at-risk patient on a pressure-relieving surface proven to have been effective in pressure ulcer production.
In reply the AHRQ wrote that "The hospital is given the option to customize its prevention strategy based on the tools provided". (This has been the case forever with no discernable improvement - ed.)
But this month (May 2013) the AHRQ has published its 400+ page comprehensive Comparative Effectiveness Review number 87, Pressure Ulcer Risk Assessment and Prevention: Comparitive Effectiveness. In this exhaustive report the AHRQ was able to make only three definitive statements:
1." ...commonly used risk assessment instruments (such as the Braden, Norton, and Waterlow Scales) can help identify patients at increased risk for ulcers.."
2." ....randomized trials consistently found that more advanced static support surfaces were associated with lower risk of pressure ulcers compared with standard mattresses in higher risk patients with no clear differences among different advanced static support surfaces."
3. "Evidence on effectivenes of other preventive interventions (nutritional supplementation; repositioning; pads and dressings; lotions, creams, and clensers; ...) compared with stand care was sparse and insufficient to reach reliable conclusions."
Evidently the AHRQ has convinced itself that the NDF Prevention Protocol is the only thing that makes sense.