In addition to using the electronic record to determine whether a patient needs a boot, NCH also began a trend analysis of the prevalence of pressure ulcers every six months for the five years between January 2002 and January 2007.

The results of more frequently recorded pressure ulcers were seen almost immediately, and within the first six months, pressure ulcer prevalence dropped from 12.8% to 7.5%, McInerney says. Heel ulcers dropped from 6.7% to 3.5%.

"I was so excited and thrilled by the initial results with heel ulcers," says McInerney. "Everyone was very happy and maybe a little relieved that we seemed to be on the right track."