pressure ulcers, veterans, quality improvement, wound healing, assessment tool, spinal cord impairment



  1. Thomason, Susan S. DNP, RN, ACNS-BC, CRRN, CWCN
  2. Powell-Cope, Gail PhD, ARNP, FAAN
  3. Peterson, Matthew J. PhD
  4. Guihan, Marylou PhD
  5. Wallen, Erik S. PhD
  6. Olney, Christine M. PhD, RN
  7. Bates-Jensen, Barbara PhD, RN, FAAN


OBJECTIVE: The objective was to implement the evidence-based Spinal Cord Impairment Pressure Ulcer Monitoring Tool (SCI-PUMT) in 23 Spinal Cord Injury/Disorders Centers (SCI/D) in the Veterans Health Administration (VHA).


SETTING: A collaborative was held in Minnesota that was attended by key personnel from SCI/D Centers in the VHA.


METHODS: This initiative was based on a 3-year longitudinal study that established the validity and reliability of a novel pressure ulcer monitoring tool for persons with spinal cord impairment. A multifaceted evidence-based strategy was used to implement the Institute for Healthcare Improvement's framework of Plan-Do-Study-Act. The plan was executed by clinical champions who implemented the tool in their respective SCI/D Centers following a conference that used both didactic and practicum approaches.


OUTCOMES: A 15-item toolkit was developed to educate clinicians and patients regarding use of the SCI-PUMT. Toolkit elements were frequently accessed over the VA intranet (n = 3254). The 1.5-day national conference rolled out the new tool to the SCI/D Centers. Pre/post SCI-PUMT knowledge of the SCI-PUMT improved by 78% during the conference. Following the conference, periodic conference calls cemented the implementation efforts of the SCI-PUMT clinical champions and barriers were mitigated.