Facilitators/Barriers to Pressure Ulcer Prevention (PUP) in Nursing Home Community Living Centers (CLCs)

**Purpose: To describe nursing staff perceptions of facilitators/barriers for performing evidence-based practice (EBP) PUP care. **Background: Implementation and sustainability of formal and informal practices can be difficult due to variation in attitudes, beliefs, knowledge, values, work practices and other factors. **Method: Cross-sectional qualitative design. Purposeful convenience sample of 16 CLC nursing staff (9 NAs, 4 LVNs, 3 RNs)in 2 Veterans Administration CLCs. Data collected using 45-60 minute audio recorded individual structured interviews. Content analysis/descriptive statistics used to analyze data. **Results: Facilitators included centralized wound care program; staff's intrinsic motivation; beliefs that most PUPs are preventable and enhance Veterans' quality of life; coordination with NAs conducting early detection during residents' activities of daily living; strong personal responsibility for PUP; provision of care despite positive/negative feedback. Barriers included limited performance feedback by nurse managers; difficulty articulating components of best practices and limited use of documentation contained in clinical record, including Braden Scale score, especially by NAs. **Conclusions and Implications: Prevention is enhanced in a practice environment where personal resposibility, accountability, and a robust wound care team are present. Teamwork and communication were seemingly more important for learning and implementing EBPs versus formal understanding of components of EBPs. Formalized training/dissemination of EBP information for all staff, especially NAs needs to compliment informal understandiing and clinical experiences with PUP care to achieve/sustain optimal outcomes.