1
|
Tian J, Liang XL, Wang HY, Peng SH, Cao J, Liu S, Tao YM, Zhang XG. Nurses' and nursing students' knowledge and attitudes to pressure injury prevention: A meta-analysis based on APUP and PUKAT. NURSE EDUCATION TODAY 2023; 128:105885. [PMID: 37354659 DOI: 10.1016/j.nedt.2023.105885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Morbidity and mortality among patients due to pressure injuries continue to rise. Nurses play a critical role in preventing pressure injuries. However, published results on nurses' knowledge and attitudes for pressure injury prevention are often contradictory. OBJECTIVES To conduct a meta-analysis of nurses' and nursing students' knowledge and attitudes toward pressure injury prevention. DESIGN A meta-analysis of cross-sectional studies. DATA SOURCES Ten databases were queried for the meta-analysis. The search period was from the time of the databases' establishment to February 2023. REVIEW METHODS This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies. Statistical analysis was conducted with the Stata 15.0 software, and the quantitative data of knowledge and attitude toward preventing PI in all studies were summarized. RESULTS Thirteen studies from 9 countries were included. The meta-analysis showed that nurses and nursing students had low knowledge but positive attitudes toward pressure injury prevention. Subgroup analysis showed that the pooled proportion of both knowledge and attitudes was higher in Asia than in Europe. Nurses had higher knowledge than nursing students, however, the former had a more negative attitude than the latter. Sensitivity analyses were robust. Egger's test showed no significant publication bias. CONCLUSION The knowledge of nurses and nursing students about pressure injury prevention is not promising and there is an urgent need for continuous learning. Attitudes are more positive but there is room for improvement. The relevant departments should strengthen nurses' and nursing students' knowledge of pressure injury prevention and further improve their attitudes toward pressure injury prevention.
Collapse
Affiliation(s)
- Jing Tian
- College of Nursing, Chengdu University of Traditional Chinese Medicine, shierqiao campus, Jinniu District, Chengdu City, Sichuan province, 610075, China
| | - Xiao Li Liang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China
| | - Hong Yan Wang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China
| | - Si Han Peng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan province 610032, China
| | - Jun Cao
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China
| | - Shan Liu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, shierqiao campus, Jinniu District, Chengdu City, Sichuan province, 610075, China
| | - Yan Min Tao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, shierqiao campus, Jinniu District, Chengdu City, Sichuan province, 610075, China
| | - Xian Geng Zhang
- Sichuan Nursing Vocational College, No.173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China.
| |
Collapse
|
2
|
Tervo-Heikkinen T, Heikkilä A, Koivunen M, Kortteisto T, Peltokoski J, Salmela S, Sankelo M, Ylitörmänen T, Junttila K. Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study. BMC Nurs 2023; 22:198. [PMID: 37303039 DOI: 10.1186/s12912-023-01369-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/06/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Several nursing interventions for pressure injury prevention have been identified, including risk and skin status assessment. The aim of this study was to explore prevention of pressure injuries in Finnish acute inpatient care. The data were collected on pressure injury risk and skin status assessments, repositioning, the use of support surfaces, preventive skin care, malnutrition risk assessment, and nutritional care. METHODS This multicentre, cross-sectional study was conducted in 16 acute care hospitals, excluding psychiatric care. Adult patients from inpatient care were recruited on the annual international Stop Pressure Ulcers Day in 2018 and 2019. Enrolment covered 6,160 participants in 503 units. Descriptive statistics were used to describe pressure injuries, risk assessments, and preventive nursing interventions. Cross tabulation, Pearson's chi-square and Fisher's exact tests were also used. Reporting follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS In all, 30% of the participants had their pressure injury risk assessed during the care, and for 19% within 8 h after admission. The same time limit in risk assessment was fulfilled for 16% of the participants with a pressure injury, and 22% of the participants using a wheelchair or being bedridden. A skin status assessment within 8 h after admission was conducted for 30% of all participants, and for 29% of the participants with a pre-existing pressure injury, and for 38% of the participants using a wheelchair or being bedridden. The risk of malnutrition was screened in 20% of the participants. Preventive interventions were targeted to participants with a pressure injury instead of patients with a high-pressure injury risk. CONCLUSION This study adds evidence about pressure injury risk assessments and the implementation of preventive nursing interventions in Finnish acute care. Skin status and pressure injury risk assessments were irregularly conducted, and the outcome was not used by nurses to guide the implementation of preventive interventions. The results reveal the gaps in evidence-based nursing practice, which require further efforts to prevent pressure injuries. Improving the national focus on pressure injury prevention practice is critical for improving healthcare for our patients.
Collapse
Affiliation(s)
- Tarja Tervo-Heikkinen
- Wellbeing Services County of North Savo, Kuopio University Hospital, PO Box 1711, Kuopio, FI70211, Finland.
| | - Anniina Heikkilä
- Helsinki University Hospital and University of Helsinki. Group Administration, FI00029 HUS. Helsinki, PO Box 705, Helsinki, Finland
| | - Marita Koivunen
- Wellbeing Services County of Satakunta, Department of Nursing Science, Pori, Finland, and University of Turku, Sairaalantie 3, Turku, FI28500, Finland
| | - Tiina Kortteisto
- Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Elämänaukio 2, PO Box 2000, Tampere, FI33521, Finland
| | - Jaana Peltokoski
- Wellbeing Services County of Central Finland, Hoitajantie 3, Jyväskylä, FI40620, Finland
| | - Susanne Salmela
- Wellbeing Services County of Ostrobothnia, Korsholmanpuistikko 44, Vaasa, FI65100, Finland
| | - Merja Sankelo
- Wellbeing Services County of South Ostrobothnia, Hanneksenrinne 7, Seinäjoki, FI60220, Finland
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Tuija Ylitörmänen
- Finnish Institute for Health and Welfare, PO Box 30, Helsinki, FI00271, Finland
| | - Kristiina Junttila
- Helsinki University Hospital and University of Helsinki, HUS Nursing Research Center, PO Box 442, Helsinki, FI00029 HUS, Finland
| |
Collapse
|
3
|
Luo Z, Liu S, Yang L, Zhong S, Bai L. Ambulance referral of more than 2 hours could result in a high prevalence of medical-device-related pressure injuries (MDRPIs) with characteristics different from some inpatient settings: a descriptive observational study. BMC Emerg Med 2023; 23:44. [PMID: 37098503 PMCID: PMC10127406 DOI: 10.1186/s12873-023-00815-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/19/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer. METHOD A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers. RESULTS One hundred one referrals were eventually included. The mean age of participants was (58.3 ± 11.69) years, predominantly male (67.32%, n = 68), with a mean BMI of 22.48 ± 2.2. The mean referral time among participants was 2.26 ± 0.26 h, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n = 54) of participants were conscious, 73.26% (n = 74) were in the supine position, 23.76% (n = 24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n = 6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n = 4), followed by the heel (30%, n = 3) and nose bridge (20%, n = 2) caused by the respiratory devices and spinal board. CONCLUSION MDRPIs are more prevalent during long ambulance referrals than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.
Collapse
Affiliation(s)
- Zhenyu Luo
- Guanyuan Central Hospital, Guanyuan, Sichuan, China.
| | - Sihui Liu
- The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Linhe Yang
- Guanyuan Central Hospital, Guanyuan, Sichuan, China
| | - Shuyan Zhong
- Guanyuan Central Hospital, Guanyuan, Sichuan, China
| | - Lihua Bai
- Guanyuan Central Hospital, Guanyuan, Sichuan, China
| |
Collapse
|
4
|
Ding L, Ding S, He C, Zhang Q, An J. The efficacy of continuing nursing interventions on intraoperative pressure ulcer-related complications in breast cancer patients: systematic review and meta-analysis. Gland Surg 2022; 11:1078-1085. [PMID: 35800736 PMCID: PMC9253194 DOI: 10.21037/gs-22-258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/27/2022] [Indexed: 06/19/2024]
Abstract
BACKGROUND This study systematically reviewed the effects of continuous nursing intervention on intraoperative pressure ulcers (PUs) and related complications in breast cancer patients. The effectiveness of continuous nursing intervention for intraoperative pressure ulcers related complications in breast cancer patients is highly controversial. Therefore, it is necessary to systematically review and address this issue by means of meta-analysis. METHODS By searching the Cochrane Library, PubMed, Web of Science, Embase, and Chinese Biomedical Literature Database (CBM) were screened. Quality evaluation and data extraction were performed for the included studies, and meta-analysis was performed for the included RCTs using Review Manager 5.2 software. Literature was included in strict compliance with the PICOS principle, and bias risk was analyzed by t-test and funnel plot. RESULTS A total of 1,431 patients were enrolled in 9 studies, and meta-analysis showed that there was a significant statistical difference between the experimental group and the control group in the incidence of PUs [odds ratio (OR) =0.18, 95% confidence interval (95% CI): 0.13-0.24, P<0.00001], the Braden pressure ulcer risk score after nursing [mean difference (MD) =2.64, 95% CI: 1.47-3.81, P<0.0001], and the quality of life after nursing (MD =9.76, 95% CI: 6.82-12.69, P<0.00001). DISCUSSION Continuous care can reduce the incidence of PUs in patients with advanced breast cancer, reduce the severity of wounds in the healing process of PUs, and improve the knowledge of PUs in patients with advanced breast cancer risk.
Collapse
Affiliation(s)
- Lin Ding
- Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Shuang Ding
- Department of Nuclear Medicine, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Chunmei He
- Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Qifa Zhang
- Comprehensive Neurological Ward, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Jingjing An
- Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
5
|
Yazıcı G, Aktaş D, Bulut H, Muslubaş N, Güler Demir S, Göçmen Baykara Z, Demircan A. Effectiveness of training in increasing awareness about managing pressure injuries in emergency departments. Int Emerg Nurs 2022; 60:101111. [PMID: 34952483 DOI: 10.1016/j.ienj.2021.101111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/16/2021] [Accepted: 10/27/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Emergency room conditions and the characteristics of the patients followed up pose a risk for pressure injury. AIM This study was conducted as a pilot study to assess the effectiveness of a training program in increasing the awareness of healthcare professionals working in an emergency department about how to manage pressure injuries. METHODS The study was a prospective, pre-test post-test intervention study without a control group. The study included 595 patients who were hospitalized in the emergency room for more than two hours and voluntarily agreed to participate, as well as 11 physicians and 17 nurses working in the emergency department between 15 April and 19 June 2019 2019. It was carried out in three stages. In the first stage, the 30-day pressure injury incidence rate in the emergency department was evaluated using the "Emergency Department Patients Information and Pressure Injury Assessment Form" and "The Braden Scale for Predicting Pressure Injury Risk". In the second stage, the healthcare professionals were given training about pressure injuries. The knowledge levels of healthcare professionals before and after the training were evaluated using "The Descriptive Characteristics Form for Emergency Department Personnel (doctors and nurses)" and "The Questionnaire for Identifying and Preventing Pressure Injury". In the third stage, the 30-day pressure injury incidence rate in the was re-evaluated after the training using the same two scales as before. The SPSS 25 package program was used to evaluate the data in terms of frequency, percentage, mean and standard deviation, and the Mann-Whitney U Test for independent groups, the t-test, the correlated sample t-test, the Wilcoxon Signed Rank test, Pearson Chi-square test, Yates Chi-square test and Fisher's Exact Chi-square test were also used. RESULTS The mean knowledge test score of the healthcare professionals working in the emergency department was determined as X¯±SD = 53.71 ± 14.70 before the training and X¯±SD = 58.57 ± 11.83 after the training. The average score on the prevention dimension of the Questionnaire for Identifying and Preventing Pressure Injury was found to be statistically significantly higher than before the training (p < 0.05). The pressure injury incidence in the emergency department was 12.5% before the training and 8.8% afterwards. CONCLUSION It was observed that the knowledge of healthcare professionals about pressure injury was insufficient and that training given on this topic both increased their knowledge and decreased the incidence of pressure injury. However, the difference was not statistically significant. Training about pressure injuries is important for preventing pressure injury, identifying the injury early, treating the injury appropriately and increasing the awareness of healthcare professionals.
Collapse
Affiliation(s)
- Gülay Yazıcı
- Ankara Yıldırım Beyazıt University Health Sciences, Faculity Nursing Department, Ankara, Turkey.
| | - Dilek Aktaş
- Ankara Yıldırım Beyazıt University Health Sciences, Faculity Nursing Department, Ankara, Turkey
| | - Hülya Bulut
- Gazi University, Health Sciences Faculty, Nursing Department, Ankara, Turkey
| | | | - Sevil Güler Demir
- Gazi University, Health Sciences Faculty, Nursing Department, Ankara, Turkey
| | | | - Ahmet Demircan
- Gazi University Hospital, Emergengy Service, Ankara, Turkey
| |
Collapse
|
6
|
Attitudes of Spanish Nurses towards Pressure Injury Prevention and Psychometric Characteristics of the Spanish Version of the APuP Instrument. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228543. [PMID: 33217957 PMCID: PMC7698736 DOI: 10.3390/ijerph17228543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 02/08/2023]
Abstract
The prevention of pressure injuries in hospitalised patients is a critical point of care related to patient safety. Nurses play a key role in pressure injury (PI) prevention, making it important to assess not only their knowledge but also their attitude towards prevention. The main purpose of this study was to translate into Spanish and evaluate the psychometric properties of the Attitude towards Pressure ulcer Prevention instrument (APuP); a secondary aim was to explore the associations of attitude with other factors. A Spanish version was developed through a translation and back-translation procedure. The validation study was conducted on a sample of 438 nursing professionals from four public hospitals in Spain. The analysis includes internal consistency, confirmatory factorial analysis, and construct validity in known groups. The 12-item Spanish version of the APuP fit well in the 5-factor model, with a Cronbach's alpha of 0.7. The mean APuP score was 39.98, which means a positive attitude. Registered nurses have a slightly better attitude than Assistant nurses. A moderate correlation (R = 0.32) between knowledge and attitude for the prevention of PI was found. As concluded, the Spanish version of the APuP questionnaire is a valid, reliable and useful tool to measure the attitude toward PI prevention in Spanish-speaking contexts. This version has 12 items grouped into 5 factors, and its psychometric properties are similar to those of the original instrument.
Collapse
|