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Song B, Wu Z, Liu M, Zhang Q, Ma X, Li X, Liu Y, Lin F. Barriers and facilitators of adherence to evidence-based pressure injury prevention clinical practice guideline among intensive care nurses: A cross-sectional survey. Intensive Crit Care Nurs 2024; 83:103665. [PMID: 38471401 DOI: 10.1016/j.iccn.2024.103665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals. RESEARCH METHODOLOGY/DESIGN This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation. SETTING Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China. RESULTS In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (β = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (β = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support. CONCLUSION ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators. IMPLICATIONS FOR CLINICAL PRACTICE Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.
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Affiliation(s)
- Bing Song
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China; School of Nursing and Midwifery, Griffith University, Queensland, Australia.
| | - Zijing Wu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China; School of Nursing and Midwifery, Griffith University, Queensland, Australia.
| | - Miao Liu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Qian Zhang
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Xiaolu Ma
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Yu Liu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Frances Lin
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; College of Nursing and Health Sciences, Flinders University, South Australia, Australia; Caring Futures Institute, Flinders University, South Australia, Australia; School of Health, University of the Sunshine Coast, Queensland, Australia; Sunshine Coast Health Institute, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
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Gül G, Özyürek P. Evaluation of final-year nursing students' attitudes towards preventing medical device-related pressure ulcers using a ABC model of affect, behavior and cognitive dimensions. J Tissue Viability 2024:S0965-206X(24)00069-X. [PMID: 38782614 DOI: 10.1016/j.jtv.2024.05.007] [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: 01/20/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Half of the hospital-acquired pressure ulcers are associated with the use of medical devices. Nursing students provide care services to patients in clinical settings and intensive care units who have or are at risk for medical device-related pressure ulcers (MDRPUs). In the prevention and care of MDRPUs, the attitudes of nursing students towards preventing of pressure ulcers are as crucial as their knowledge level and clinical skills. AIM The aim of this descriptive study is to assess the attitudes of final-year nursing undergraduate students towards preventing MDRPUs across cognitive, affective, and behavioral dimensions of ABC model. MATERIALS AND METHODS Data of the study was handed between April 1 and December 31, 2021, with 147 final-year nursing students. Data were collected using the Student Information Form and the Attitude Towards Preventing Medical Device-Related Pressure Ulcers Questionnaire (ATP-MDRPUsQ). RESULTS The mean attitude score towards preventing MDRPUs was 3.98 ± 0.45 on a 5-point Likert scale. The mean scores for the cognitive, affective, and behavioral sub-dimensions were 3.88 ± 0.57, 4.15 ± 0.51, and 4.00 ± 0.672, respectively. A moderate positive relationship was found between the cognitive sub-dimension and both the affective and behavioral sub-dimensions (r = 0.451; r = 0.302; p < 0.01, respectively). Based on cluster analysis, the mean attitude scores of students towards MDRPU prevention were grouped into two clusters. The students in Cluster-2 and female students had higher mean attitude scores (p < 0.01). The item with the lowest mean score in the questionnaire pertained to the item, "I believe that I need training on the etiology and prevention of medical device-related pressure ulcers." CONCLUSION The general attitudes of final-year nursing students towards prevention MDRPU were satisfactory. However, their cognitive attitudes were less positive compared to their affective and behavioral attitudes. It is recommended to incorporate theoretical and practical courses focusing on the prevention of these injuries into nursing curricula to enhance students' knowledge and attitudes.
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Affiliation(s)
- Gülçin Gül
- Graduate Education Institute, Afyonkarahisar Health Sciences University, 03200, Afyonkarahisar, Turkey
| | - Pakize Özyürek
- Faculty of Health Science, Surgical Nursing Department, Afyonkarahisar Health Sciences University, 03200, Afyonkarahisar, Turkey.
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Celik B, Turhan Damar H, Savsar A, Ferraiuolo F, Repustic M, Ogce Aktas F. Investigation of related factors of operating room nurses' attitudes and awareness towards surgery-related pressure injury prevention in Turkey, Croatia, and Italy. J Tissue Viability 2024:S0965-206X(24)00065-2. [PMID: 38821842 DOI: 10.1016/j.jtv.2024.05.003] [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: 02/18/2024] [Revised: 03/29/2024] [Accepted: 05/15/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVE The aim of this study is to examine related factors of operating room nurses' attitudes and awareness towards surgery-related pressure injury prevention in Turkey, Croatia, and Italy. METHODS A descriptive and cross-sectional design was used. The study was conducted between March and September 2023. Data were collected with an online questionnaire created on Google Forms, consisting of a Nurse Information Form, a Surgery-related Pressure Injury Awareness Form, and the Attitude towards Pressure Ulcer Prevention Instrument. RESULTS The sample of the study consisted of 258 operating room nurses working in Turkey, Croatia, and Italy. It was found that the majority of the participants (70.90 %) did not use a risk scale, had not received education on pressure injury prevention and treatment (58.10 %) but wanted to receive it (86 %). Mean attitude scores of operating room nurses by country were at an adequate level in Turkey (42.48 ± 4.30) but not at the desired level in Croatia (37.48 ± 3.44) and Italy (36.20 ± 4.02). While there was a significant positive relationship between the awareness and attitudes of operating room nurses in Turkey (p = 0.002) and Croatia (p < 0.001), no relationship was found between these variables of nurses in Italy (p = 0.109). A statistically significant difference was found between nurses' consideration of themselves sufficient and their attitudes and awareness in all three countries (p < 0.05). It was also determined that reading articles affected nurses' awareness in all countries. CONCLUSIONS While operating room nurses' attitudes towards preventing pressure injuries were adequate in Turkey, it was determined that those of the nurses in Croatia and Italy were not at the desired level. Nurses should receive regular training on surgical pressure injuries to increase their awareness and to support them in implementing the recommendations of pressure injury guidelines in accordance with institutional policy.
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Affiliation(s)
- Buket Celik
- Dokuz Eylul University Faculty of Nursing, Izmir, Turkey.
| | - Hale Turhan Damar
- Izmir Democracy University, Vocational School of Health Services, Elderly Care Program, Izmir, Turkey.
| | - Adile Savsar
- Izmir University of Economics, Faculty of Health Science, Department of Nursing, Izmir, Turkey.
| | | | | | - Filiz Ogce Aktas
- Izmir University of Economics, Faculty of Health Science, Department of Nursing, Izmir, Turkey.
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Fu L, Chen Y, Lin L, Xu Z, Zhuang Y. Knowledge, attitude, and practice of critical care nurses and their influence on acute skin failure patients in China: A multicenter cross-sectional study. Jpn J Nurs Sci 2024; 21:e12582. [PMID: 38217104 DOI: 10.1111/jjns.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 01/15/2024]
Abstract
AIM Acute skin failure (ASF) can happen in critically ill patients. Therefore, adequate knowledge and skills regarding ASF are essential to manage this disorder. The aim of this work was to investigate the nurses' knowledge, attitude, and practice (KAP) regarding ASF patients and to analyze its influencing factors in the intensive care unit. METHODS A multicenter cross-sectional study was performed in 10 tertiary hospitals in March 2022. Eligible nurses received a survey with a self-designed questionnaire about their KAP regarding ASF, which included three dimensions and a maximum score of 120. A higher score corresponded to better KAP. RESULTS A total of 255 nurses participated in this study. The mean KAP score was 75.6 ± 16.9. The mean scores of the knowledge, attitude, and practice dimensions were 26.2 ± 10.6, 38.2 ± 6.1, and 11.3 ± 4.3, respectively. The dimensions were ranked according to score (from low to high) as follows: knowledge (2.6 ± 1.1), practice (2.8 ± 1.1), and attitude (3.8 ± 0.6). Multivariate linear regression analysis showed that more training sessions and an advanced professional title were associated with higher KAP scores. CONCLUSIONS The overall KAP score on ASF was low in nurses. Nurses had a positive attitude towards ASF, but their knowledge and practice required significant improvement. Those who had received more training and held a more advanced professional title exhibited higher KAP scores regarding ASF. Therefore, nurse managers should establish a relevant knowledge training system, strengthen relevant training, and improve nursing practices for ASF in order to achieve a high level of KAP in nurses who treat ASF patients.
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Affiliation(s)
- Lisang Fu
- Department of Nursing, Hospital of Putian University, Putian, China
| | - Yiyuan Chen
- Department of Respiratory Intensive Care Unit, Affiliated Hospital of Putian University, Putian, China
| | - Libin Lin
- Department of Respiratory Intensive Care Unit, Affiliated Hospital of Putian University, Putian, China
| | - Zhenmei Xu
- Department of Respiratory Intensive Care Unit, Affiliated Hospital of Putian University, Putian, China
| | - Yaoning Zhuang
- Department of Respiratory Intensive Care Unit, Affiliated Hospital of Putian University, Putian, China
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Zalluhoğlu C, Akdoğan D, Karakaya D, Güzel MS, Ülgü MM, Ardalı K, Boyalı AO, Sezer EA. Region-Based Semi-Two-Stream Convolutional Neural Networks for Pressure Ulcer Recognition. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:801-813. [PMID: 38343251 PMCID: PMC11031520 DOI: 10.1007/s10278-023-00960-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 04/20/2024]
Abstract
Pressure ulcers are a common, painful, costly, and often preventable complication associated with prolonged immobility in bedridden patients. It is a significant health problem worldwide because it is frequently seen in inpatients and has high treatment costs. For the treatment to be effective and to ensure an international standardization for all patients, it is essential that the diagnosis of pressure ulcers is made in the early stages and correctly. Since invasive methods of obtaining information can be painful for patients, different methods are used to make a correct diagnosis. Image-based diagnosis method is one of them. By using images obtained from patients, it will be possible to obtain successful results by keeping patients away from such painful situations. At this stage, disposable wound rulers are used in clinical practice to measure the length, width, and depth of patients' wounds. The information obtained is then entered into tools such as the Braden Scale, the Norton Scale, and the Waterlow Scale to provide a formal assessment of risk for pressure ulcers. This paper presents a novel benchmark dataset containing pressure ulcer images and a semi-two-stream approach that uses the original images and the cropped wound areas together for diagnosing the stage of pressure ulcers. Various state-of-the-art convolutional neural network (CNN) architectures are evaluated on this dataset. Our experimental results (test accuracy of 93%, the precision of 93%, the recall of 92%, and the F1-score of 93%) show that the proposed semi-two-stream method improves recognition results compared to the base CNN architectures.
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Affiliation(s)
- Cemil Zalluhoğlu
- Department of Computer Engineering, Hacettepe University, Ankara, Turkey.
| | | | | | | | - M Mahir Ülgü
- Health Information Systems, Republic of Turkey, Ministry of Health, Ankara, Turkey
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de Almeida RMF, Tura LFR, Queiroz ABA, Ferreira MDA, da Silva RC. Beliefs and practices of the nursing team related to pressure injury preventive measures: A analysis of social representations. J Adv Nurs 2024. [PMID: 38523566 DOI: 10.1111/jan.16170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/20/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024]
Abstract
AIMS AND OBJECTIVES To analyse the process of elaborating social representations about pressure injury preventive measures by the nursing team (nurses and nurse technicians) and how this process relates to preventive practices for hospitalized patients. DESIGN Qualitative study, with the application of the theory of social representations in its procedural methodological approach. METHODS The study was carried out in an inpatient clinic of a public hospital in the state of Rondônia, Brazil. Totally, 28 nursing professionals in the medical clinic sectors who had worked directly with patient care for more than 6 months participated. The data were collected between July and September 2021 via in-depth interviews with the application of a semi-structured instrument. Analysis was carried out with the help of ALCESTE software, which performed a lexicographic analysis, and also via thematic analysis. The COREQ guided the presentation of the research report. RESULTS The social representations were developed based on the professionals' symbolic beliefs about the visibility/invisibility of the results of applying preventive care. These symbolic constructions mobilized positive and negative feelings among the nursing team, which guided the classification of prevention practices as being of greater or lesser priority among other care activities. There were favourable attitudes among professionals, which included applying prevention measures in their daily routines, and unfavourable attitudes of non-adherence to the institution's protocol for preventing pressure injuries. CONCLUSIONS The nursing team's perception of pressure injury prevention is influenced by symbolic, affective, values, and social dimensions. Non-adherence behaviours are attributed to the belief in the invisibility of prevention outcomes, resulting in a reluctance to implement preventive measures. RELEVANCE TO CLINICAL PRACTICE Understanding the subjective logic that explains the thinking and actions of the nursing team suggests the need to incorporate discussions on beliefs, values, sentiments, and attitudes of nursing professionals into educational programs on pressure injury prevention. PATIENT OR PUBLIC CONTRIBUTION No public contribution.
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Affiliation(s)
| | - Luiz Fernando Rangel Tura
- Institute of Studies and Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Rafael Celestino da Silva
- Anna Nery School of Nursing, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Tomas N, Mandume AM. Nurses' barriers to the pressure ulcer risk assessment scales implementation: A phenomenological study. Nurs Open 2024; 11:e2079. [PMID: 38268250 PMCID: PMC10782216 DOI: 10.1002/nop2.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The aim of the study was to explore nurses' barriers to the pressure ulcer risk assessment scales implementation. DESIGN A qualitative descriptive phenomenological study. METHODS The research participants comprised of 10 nurses at various medical and surgical departments in a teaching hospital northeast of Namibia. Data were collected between August and September 2022 through in-depth, semi-structured face-to-face individual interviews and analysed using Colaizzi's 7-step method. RESULTS The interviews with nurses, led to two major themes being discovered: (1) factors hindering the effective prevention of pressure ulcers; (2) suggestions for improvements in the utilization of risk assessment scales. The participants noted that they had inadequate knowledge of the formal risk assessment scales; there were inadequate resources and insufficient staff; there were no policies or guidelines regarding the management of pressure ulcers, all of which influenced their utilization of pressure risk assessment scales. Education and training, the provision of equipment, the hiring of new staff and the formulation of policies/guidelines would thus improve the nurses' utilization of the scales. CONCLUSION The findings of this study have uncovered three primary factors that have a detrimental impact on the utilization of risk assessment scales by nurses, that is their lack knowledge on pressure ulcer risk assessment scales; a shortage of staff and equipment; and an absence of policies/guidelines. The findings from this study provide valuable implications for guiding quality improvement initiatives aimed at enhancing the standard of care in Namibia and other resource-limited settings.
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Affiliation(s)
- Nestor Tomas
- Department of General Nursing Science, School of Nursing and Publish Health, Faculty of Health Sciences and Veterinary MedicineUniversity of Namibia (UNAM)RunduNamibia
| | - Annalisa M. Mandume
- Department of General Nursing Science, School of Nursing, Faculty of Health Sciences and Veterinary MedicineUniversity of Namibia (UNAM)RunduNamibia
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Alshahrani B, Middleton R, Rolls K, Sim J. Critical care nurses' knowledge and attitudes toward pressure injury prevention: A pre and post intervention study. Intensive Crit Care Nurs 2023; 79:103528. [PMID: 37603978 DOI: 10.1016/j.iccn.2023.103528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To explore nurses' knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention. DESIGN/METHOD A pre-and post-intervention study. Pre-intervention data collection involved administering an instrument, including demographic information, the Pressure Ulcer Knowledge Assessment Tool version 2, and the Attitudes towards Pressure Ulcer Prevention instruments. Following the analysis of pre-intervention data, an educational intervention was implemented. Post-intervention data were collected using the same instrument. SETTING Intensive care units at three Saudi Arabian hospitals. MAIN OUTCOME MEASURES Nurses' knowledge and attitudes towards pressure injury prevention. RESULTS The pre-intervention phase included 190 participants, and the post-intervention phase included 195 participants. Participants completed a paper-based survey at two different time points between June 2021 and March 2022. The mean pre-intervention scores for nurses' knowledge and attitudes towards pressure injury prevention were 43.22% and 74.77%, respectively. Following the educational intervention, the knowledge and attitude scores increased significantly to 51.22% and 79.02%, respectively. Higher knowledge of pressure injury prevention was positively associated with positive attitudes towards prevention practices. Age, clinical nursing experience, and experience in intensive care units were identified as factors correlated with knowledge of pressure injury prevention. A Bachelor's qualification or higher predicted better knowledge and attitudes towards pressure injury prevention. CONCLUSIONS Nurses' knowledge and attitudes towards pressure injury prevention greatly improved following tailored, evidence-based education. The educational intervention featured multiple on-site bedside discussions, case studies, small-group presentations, and the provision of printed resources. IMPLICATIONS FOR CLINICAL PRACTICE Nurses' knowledge and attitudes towards pressure injury prevention should be examined, and education provided to ensure evidence-based prevention practices are implemented. Tailored small-group education sessions delivered conveniently could be an effective approach. Efforts should focus on attracting and retaining experienced, highly qualified nurses to ensure the adoption of evidence-based prevention practices.
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Affiliation(s)
- Bassam Alshahrani
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Australia; College of Nursing, Taibah University, Saudi Arabia.
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Australia.
| | - Kaye Rolls
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Australia.
| | - Jenny Sim
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Australia; WHO Collaborating Centre for Nursing, Midwifery & Health Development, Faculty of Health, University of Technology Sydney, Australia; School of Nursing & Midwifery, University of Newcastle, Central Coast Clinical School, Australia.
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Iyer K, AlKhalifah K, Alshahrani BN, Ibrahim Alghamdi SS, Albishi S, A Alsheraihi AA, Al Sudairy N. Assessment of Knowledge, Attitude, and Practice (KAP) Among Nurses on Oral Care for Intensive Care Unit Patients in Riyadh, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e50682. [PMID: 38229773 PMCID: PMC10791100 DOI: 10.7759/cureus.50682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Oral care of intensive care unit (ICU) bound individuals is essential for overall health outcomes and to prevent complications. Nurses, who are the primary caregivers, should possess adequate knowledge, attitude, and practice (KAP) in this regard to provide optimal care to these patients. There are no standardized guidelines existing at present in this regard, making the practice of oral care more challenging. There is a diversified representation of nurses who practice in this region of the world and have not been analyzed in the past. This study would like to address this paucity of data. Hence, the aim of the present study was to evaluate the knowledge, attitude, and practice of nurses regarding oral health care in ICU patients along with analyzing any existing hospital-based policies related to oral care. MATERIALS AND METHODS A cross-sectional study was conducted among 230 nurses practicing at ICU of the National Guard Health Affairs (NGHAs) Hospital, King Abdulaziz Medical City, in Riyadh City, Saudi Arabia. Nurses responded to 22 closed-ended questionnaires, which were adopted after content validation and reliability assessment. Descriptive statistics, chi-square analysis, and multinomial logistic regression were carried out using the Statistical Package for the Social Sciences (SPSS, Version 20, 2011; IBM Corp., Armonk, USA). RESULTS A total of 230 (51.1%) nurses responded. The mean working experience of 12.6 (±7.5) years and ICU experience of 10.6 (±6.7) years were observed. Seventy-four (32.2%) nurses mentioned they received oral care training for ICU patients as part of their degree. A significant variation (p=0.03) in response was observed based on qualification concerning the knowledge of nurses if improper oral care among ICU patients could cause systemic complications. Nurses with less than five years' experience were more likely to provide oral care only once per day compared to nurses with higher experience (>10 years) (OR: 2.97, p=0.00, 95% CI: 2.40-12.2). CONCLUSION There were certain knowledge, attitude, and practice-based questions that elicited significant differences in responses based on the qualifications and experience of the nurses. Overall, the nurses did possess fair knowledge and favorable attitudes towards oral care in these patients.
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Affiliation(s)
- Kiran Iyer
- Dental Public Health, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, SAU
| | - Khalifah AlKhalifah
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, SAU
| | - Bader Nashir Alshahrani
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, SAU
| | | | - Sultan Albishi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, SAU
| | | | - Nawaf Al Sudairy
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, SAU
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Heywood-Everett S, Henderson R, Webb C, Bland AR. Psychosocial factors impacting community-based pressure ulcer prevention: A systematic review. Int J Nurs Stud 2023; 146:104561. [PMID: 37542960 DOI: 10.1016/j.ijnurstu.2023.104561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Pressure ulcers are a major health concern. They have a significant impact on the healthcare system and individuals, reducing quality of life across several domains. In community settings, self-management behaviours are central to their prevention. However, adherence with pressure ulcer prevention guidelines remains low, with little evidence guiding the relationship between patients and healthcare professionals to establish a concordant partnership. OBJECTIVE To synthesise evidence on factors contributing to community-based pressure ulcer prevention using the Theoretical Domains Framework and the Capability, Opportunity, Motivation, Behaviour (COM-B) model of behaviour. DESIGN Mixed methods systematic review and narrative synthesis. METHOD Systematic searches were conducted in the CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases on 14th December 2022. Studies were eligible if they contained data on the factors associated with adherence and concordance with pressure ulcer prevention guidelines in the community for patients, caregivers, and healthcare professionals. Methodological quality was assessed using the Hawker tool. Findings were synthesised using the Theoretical Domains Framework. The resulting themes were mapped onto the Capability, Opportunity, Motivation, Behaviour (COM-B) model. RESULTS Thirty studies were included in the review, including quantitative, qualitative, and mixed methods research. The synthesis identified 12 of the 14 Theoretical Domains Framework domains, with knowledge, social influences, beliefs about consequences, and beliefs about capabilities the most prevalent. Although knowledge appears to be an important contributor to adherence with prevention guidelines, knowledge alone does not appear sufficient to achieve concordance. A concordant relationship was facilitated by healthcare professionals' knowledge, motivation to work alongside patients and their priorities, and interpersonal skills to build rapport and trust, whilst barriers included lack of healthcare professional skills to navigate sensitive issues, paternalistic views of patient compliance and organisational processes that impact building rapport. CONCLUSIONS Several psychosocial factors may affect the ability to achieve concordance between individuals, caregivers and healthcare professionals with pressure ulcer prevention guidelines in the community. However, data regarding the efficacy of behaviour change interventions targeting these constructs is limited, with further research required to guide intervention development in this area.
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Affiliation(s)
- Suzanne Heywood-Everett
- Primary Care Wellbeing Service, Bradford District Care NHS Foundation Trust, Shipley BD18 3LD, UK.
| | - Rebecca Henderson
- Department of Psychology, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Claire Webb
- Primary Care Wellbeing Service, Bradford District Care NHS Foundation Trust, Shipley BD18 3LD, UK
| | - Amy R Bland
- Department of Psychology, Manchester Metropolitan University, Manchester M15 6BH, UK
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Avsar P, Renjith V, Chima C, Patton D, O'Connor T, Moore Z. Assessing nurses' attitudes towards pressure ulcer prevention: an updated systematic review. J Wound Care 2023; 32:544-554. [PMID: 37682786 DOI: 10.12968/jowc.2023.32.9.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE The aim of this systematic review was to critically appraise and synthesise the existing research literature pertaining to nurses' attitudes toward pressure ulcer (PU) prevention. METHOD The systematic review presented in our paper serves as an updated version of the definitive review conducted by Avsar et al. in 2019. Using systematic review methodology, we considered published quantitative studies focusing on nurses' attitudes toward PU prevention as measured using psychometric tests. The search was conducted in April 2022, using PubMed, CINAHL, Scopus, Cochrane and EMBASE databases, and returned 454 records, of which 35 met the inclusion criteria. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the evidence-based librarianship (EBL) appraisal checklist. RESULTS In most studies, distinct measurement instruments were used for measuring nurses' attitudes toward the prevention of PUs: the Moore and Price Attitude Scale and the Attitude towards Pressure Ulcer Prevention Instrument (APuP). In this first update, the mean attitude score was 69% (±14%, range: 33.6-89%). A separate analysis of the new studies alone included in this first update (n=14) indicated a mean attitude score of 62.25% (±17.9%; median: 14%), suggesting a 10.75% lower mean attitude score. In total, 46% (n=16) yielded a score ≥75%. Conversely, Avsar et al. in 2019, 86% (n=18) of studies yielded positive attitude results. Studies from the Middle East show the lowest mean attitude score (mean 55%; ±15%; median 53%; n=9), with studies from Europe displaying the highest mean attitude score (mean 79%; ±6%; median 79%; n=12). CONCLUSION The findings suggest that, overall, nurses are relatively positively disposed toward PU prevention. However, there are differences across continents. It is important to highlight also that the nurses have difficulties reflecting this positive attitude into actual preventative strategies.
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Affiliation(s)
- Pinar Avsar
- Lecturer and Programme Director, Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
| | - Vishnu Renjith
- Lecturer and Programme Director, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
| | - Comfort Chima
- Programme Director and Nurse Tutor, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
| | - Declan Patton
- Director of Nursing and Midwifery, School of Nursing and Midwifery. The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
- Adjunct Associate Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Honorary Senior Fellow, Faculty of Science, Medicine and Health, University of Wollongong, Australia
- Honorary Professor, Lida Institute, Shanghai, China
- Visiting Professor, University of Wales, Cardiff
| | - Tom O'Connor
- Honorary Professor, Lida Institute, Shanghai, China
- Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
| | - Zena Moore
- Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Professor of Nursing, Head of School of Nursing and Midwifery, Director of the Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
- Professor, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
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Parvizi A, Haddadi S, Mollaei A, Ghorbani Vajargah P, Takasi P, Firooz M, Hosseini SJ, Farzan R, Karkhah S. A systematic review of nurses' knowledge and related factors towards the prevention of medical device-related pressure ulcers. Int Wound J 2023; 20:2843-2854. [PMID: 36792930 PMCID: PMC10410313 DOI: 10.1111/iwj.14122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
The aim of this review study is to investigate the nurses' knowledge and related factors towards the prevention of medical device-related pressure ulcers (MDRPUs). An extensive search was conducted in international electronic databases such as PubMed, Web of Science, and Scopus, and Persian databases, such as Iranmedex and the Scientific Information Database from December 1, 2022. During this search, keywords extracted from Medical Subject Headings, such as "Prevention knowledge," "Nurse," "Pressure ulcer," "Equipment and Supplies," and "Intensive Care Units" were used. The quality of the present studies in this review was evaluated based on the appraisal tool for cross-sectional studies (AXIS tool). A total of 1847 nurses participated in this review from five studies, and the majority of them (82.94%) were female. The mean age of the participants was 31.40 (SD = 5.97). The mean score of MDRPUs prevention knowledge in nurses based on PU2014 scale and researcher-made questionnaires were 16.50 (SD = 3.74) out of 31 and 65.49 (SD = 6.33) out of 100, respectively. The knowledge of nurses is influenced by factors such as age, sex, level of education, work experience, technical titles, type of hospital, level of hospital, and type of ward. Various factors had a significant positive relationship with nurses' MDRPUs prevention knowledge, which includes level of education, work experience, previous training on MDRPU, having a wound care certificate, an online search about MDRPU, and attitude and practise towards MDRPU prevention. At the same time, nurses' knowledge about the prevention of MDRPUs had a significant negative relationship with the time interval since last participating in MDRPU training or workshop. Overall, the level of MDRPUs prevention knowledge among nurses was insufficient to moderate. Therefore, it is suggested to provide facilities for nurses to receive the necessary training.
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Affiliation(s)
- Arman Parvizi
- Anesthesiology Research Center, Department of AnesthesiologyAlzahra Hospital, Guilan University of Medical SciencesRashtIran
| | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of AnesthesiologyAlzahra Hospital, Guilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | - Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
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Sun X, Chen R, Fang P, Yu R, Wang X, Liu J, Chen Y, Ling H. Model construction of factors influencing intensive care unit nurses' medical device-related pressure injury knowledge, attitude, and practice. Int Wound J 2023; 20:2582-2593. [PMID: 36891887 PMCID: PMC10410357 DOI: 10.1111/iwj.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 03/10/2023] Open
Abstract
The ability of knowledge, attitude, and practice of intensive care unit (ICU) nurses to perform medical device-related pressure injuries (MDRPIs) can affect the incidence of MDRPI in ICU patients. Therefore, in order to improve ICU nurses' understanding and nursing ability of MDRPIs, we investigated the non-linear relationship (synergistic and superimposed relationships) between the factors influencing ICU nurses' ability of knowledge, attitude, and practice. A Clinical Nurses' Knowledge, Attitude, and Practice Questionnaire for the Prevention of MDRPI in Critically Ill Patients was administered to 322 ICU nurses from tertiary hospitals in China from January 1, 2022 to June 31, 2022. After the questionnaire was distributed, the data were collected and sorted out, and the corresponding statistical analysis and modelling software was used to analyse the data. IBM SPSS 25.0 software was used to conduct Single factor analysis and Logistic regression analysis on the data, so as to screen the statistically significant influencing factors. IBM SPSS Modeler18.0 software was used to construct a decision tree model of the factors influencing MDRPI knowledge, attitude, and practice of ICU nurses, and ROC curves were plotted to analyse the accuracy of the model. The results showed that the overall passing rate of ICU nurses' knowledge, attitude, and practice score was 72%. The statistically significant predictor variables ranked in importance were education background (0.35), training (0.31), years of working (0.24), and professional title (0.10). AUC = 0.718, model prediction performance is good. There is a synergistic and superimposed relationship between high education background, attended training, high years of working and high professional title. Nurses with the above factors have strong MDRPI knowledge, attitude, and practice ability. Therefore, nursing managers can develop a reasonable and effective scheduling system and MDRPI training program based on the study results. The ultimate goal is to improve the ability of ICU nurses to know and act on MDRPI and to reduce the incidence of MDRPI in ICU patients.
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Affiliation(s)
- Xiao‐Xuan Sun
- School of NursingNanchang UniversityNanchangPeople's Republic of China
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Rui‐Bin Chen
- Information Office of the First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Ping‐Ping Fang
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Ran Yu
- School of NursingNanchang UniversityNanchangPeople's Republic of China
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Xu‐Xing Wang
- School of NursingNanchang UniversityNanchangPeople's Republic of China
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Jia‐Qiu Liu
- School of NursingNanchang UniversityNanchangPeople's Republic of China
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Ying Chen
- School of NursingNanchang UniversityNanchangPeople's Republic of China
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
| | - Hua Ling
- School of NursingNanchang UniversityNanchangPeople's Republic of China
- Nursing Departmentthe First Affiliated Hospital of Nanchang UniversityNanchangPeople's Republic of China
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14
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Korkmaz S, Sönmez M, Gürlek Kısacık Ö. The effect of knowledge levels of intensive care nurses about pressure injuries on their attitude toward preventing pressure injuries. J Tissue Viability 2023; 32:325-332. [PMID: 37149433 DOI: 10.1016/j.jtv.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/28/2023] [Accepted: 04/15/2023] [Indexed: 05/08/2023]
Abstract
AIM The aim of this study was to determine the current knowledge levels of intensive care nurses about pressure injuries and their attitudes toward preventing pressure injuries, and to reveal the relationship between these variables. MATERIALS AND METHODS This descriptive cross-sectional study was conducted with 152 nurses, working in the Adult Intensive Care Units of a Training and Research Hospital. Data were collected between 10.08.2021 and 31.11.2021 with the Patient Information Form, Modified Pieper Pressure Ulcer Knowledge Test and Attitude toward Pressure Injury Prevention Scale. Frequency analysis, descriptive statistics, multiple logistic regression analysis and the structural equation modeling technique were used in the analysis of the study data. RESULTS The mean age of the nurses was 25.82 ± 3.42 years, 86.2% of them were female and 67.1% of them had a bachelor's degree. Total mean score of the Modified Pieper Pressure Ulcer Knowledge Test of the intensive care nurses was found to be 32.58 ± 6.58. The knowledge score of 113 out of 152 nurses was ≥60% or above. The total mean score of the Attitude toward Pressure Injury Prevention Scale was 42.00 ± 5.70 and a total of 76.97% (117 participants) of them were found to score 75% or above on the scale. The results of the regression analysis showed that educational degree, and status of having training about pressure injuries did not affect the total mean score of the Knowledge Test and the Attitude Scale. However, it revealed that the frequency of encountering a patient with pressure injuries in the unit where they work has affected the total mean score of the scales significantly (p < 0.05). As per the results of the structural equation model, the Modified Pieper Pressure Ulcer Knowledge Test scores of the nurses were found to have a statistically significant effect on the scores of the Attitude toward Pressure Injury Prevention Scale (p < 0.05). CONCLUSION This study revealed that intensive care unit nurses had a positive attitude toward Pressure Injury Prevention and their knowledge was sufficient and that as the Modified Pieper Pressure Ulcer Knowledge Test scores increase, their positive attitude toward Pressure Injury Prevention also increases.
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Affiliation(s)
- Serap Korkmaz
- Gülhane Training and Research Hospital, Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara, Turkey.
| | - Münevver Sönmez
- Faculty of Health Science, Fundamentals of Nursing Department, Atılım University, 06830, Ankara, Turkey.
| | - Öznur Gürlek Kısacık
- Faculty of Health Science, Fundamentals of Nursing Department, Afyonkarahisar Health Science University, 03200, Afyonkarahisar, Turkey.
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15
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Wu Z, Song B, Liu Y, Zhai Y, Chen S, Lin F. Barriers and facilitators to pressure injury prevention in hospitals: A mixed methods systematic review. J Tissue Viability 2023:S0965-206X(23)00055-4. [PMID: 37150650 DOI: 10.1016/j.jtv.2023.04.009] [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: 02/10/2023] [Revised: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To systematically synthesize research evidence on barriers and facilitators to pressure injury prevention in hospital settings. METHODS A systematic literature review of quantitative, qualitative, and mixed methods research was undertaken using PubMed, MEDLINE, Embase, CINAHL, and Cochrane Library. Studies that reported barriers or/and facilitators to pressure injury prevention in the acute care settings and published in English from 2008 to 2022 were included. Studies were excluded if they were conducted in residential care facilities and nursing homes, or other long-term community care settings. Two authors independently screened articles against the inclusion and exclusion criteria. Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. Reported results were mapped to the Theoretical Domains Framework to identify the barriers and facilitators to pressure injury prevention. RESULTS A total of 78 studies were included. There were 65 quantitative studies, 11 qualitative studies, and two mix-methods studies. The most salient Theoretical Domains Framework domains identified in this review were "Knowledge", "Skills", "Environmental Context and Resources", "Optimism", "Social/Professional Role and Identity", and "Social influences". CONCLUSION The barriers and facilitators to pressure injury prevention in hospital settings identified in this systematic review were diverse, and included issues at both individual and organizational level. Healthcare organizations can address the barriers and facilitators from the influential Theoretical Domains Framework domains. Future research is required to investigate the effectiveness of behaviour change interventions that specifically target these barriers and facilitators to pressure injury prevention.
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Affiliation(s)
- Zijing Wu
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Bing Song
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Yu Liu
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Yongzhen Zhai
- Department of Infectious Disease, Shengjing Hospital of China Medical University, No.39 Huaxiang Road, Tiexi District, Shenyang, Liaoning Province, China.
| | - Si Chen
- Department of Neurology, The Fourth Affiliated Hospital of China Medical University, No.4 Chongshan East Road, Huanggu District, Shenyang, Liaoning Province, China.
| | - Frances Lin
- School of Health, University of the Sunshine Coast, Queensland, Australia.
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16
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Mpasa F, van Rooyen DRM, Jordan PJ, Venter D, ten Ham-Baloyi W. Malawian critical care nurses' views on the implementation of an educational intervention to enhance sustained use of an evidence-based endotracheal tube cuff pressure management guideline: A survey study. SOUTHERN AFRICAN JOURNAL OF CRITICAL CARE 2023; 39:10.7196/SAJCC.2023.v39i1.550. [PMID: 37521961 PMCID: PMC10378196 DOI: 10.7196/sajcc.2023.v39i1.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 02/09/2023] [Indexed: 08/01/2023] Open
Abstract
Background Evidence-based guidelines can assist critical care nurses in promoting best practices, including those related to endotracheal tube cuff pressure management. However, these guidelines require tailored strategies to enhance their implementation, uptake, and sustained use in practice. Objectives To evaluate Malawian critical care nurses' views on the implementation of an endotracheal tube cuff pressure management guideline to enhance sustained guideline use. Methods An explorative-descriptive survey design was employed, using a questionnaire with closed- and open-ended questions that was distributed after implementation of an educational intervention based on an endotracheal tube cuff pressure management guideline. The questionnaire had a Cronbach's alpha score of 0.85. Results A total of 47 nurses working in four public and two private hospital intensive care units in Malawi participated. Quantitative findings showed that the majority of the participants (92%) indicated that the strategies used for the group that received the full intervention including both active (monitoring visits) and passive (a half-day educational session using a PowerPoint presentation, and a printed guideline and algorithm) strategies (intervention 1 group) were useful, clear and applicable and enhanced implementation of the guideline. These results were statistically significant (mean (standard deviation) 1.86 (0.84); t=6.07; p<0.0005). Qualitative data revealed three major themes related to recommendations for uptake and sustained use of the guideline in nursing practice: the guideline needs to be translated, updated, and made available to ICU staff; implementation strategies (continuous supervision and follow-up); and facilitating factors for successful implementation (education and training on guideline content, resources, and commitment to best practices). Conclusion The study highlighted that although the implementation strategies used were positively received by participants, they need to be further tailored to their context to enhance guideline uptake and sustained use in practice. Further study is required to ensure that tailored implementation strategies facilitate guideline uptake and sustained use, specifically in resource-constrained contexts. Contributions of the study The study findings can be used by nurses and academics when developing educational interventions for critical care units to enhance implementation of guidelines in this context.
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Affiliation(s)
- F Mpasa
- Lecturer, Department of Nursing and Midwifery Science, Faculty of Health Sciences, Mzuzu University, Luwinga, Malawi; Former PhD candidate,
Department of Nursing Science, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - Dalena R M van Rooyen
- Deputy Dean, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - P J Jordan
- Associate Professor and Head, Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town,
South Africa
| | - D Venter
- Consultant Statistician, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - W ten Ham-Baloyi
- Research Associate, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
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17
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Acosta-Hernández C, Fernández-Castillo RJ, Montes-Vázquez M, González-Caro MD. Is caring for pressure ulcers in the intensive care unit in Spain still a challenge? A qualitative study on nurses' perceptions. J Tissue Viability 2023; 32:114-119. [PMID: 36529583 DOI: 10.1016/j.jtv.2022.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/08/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The incidence of pressure ulcers is an indicator of quality in intensive care units. Due to their frequency and severity, they are identified as a problem of great importance, where the well-being of patients and relatives is compromised, also generating a high healthcare cost. Nurses are primarily responsible for the care of pressure ulcers, however, the existing literature exposes a clear lack of knowledge regarding its prevention and treatment. OBJECTIVES To explore the attitudes, knowledge and perceived barriers by intensive care nurses regarding pressure ulcers treatment and prevention in a critical care setting. DESIGN A descriptive qualitative study has been carried out through semi-structured interviews with 22 intensive care nurses from two tertiary university hospitals in Spain. The consolidated criteria for reporting qualitative research (COREQ) guidelines were used to reinforce the methodological approach of the study. FINDINGS From the collected data, 4 main themes emerged: "lack of specific knowledge about pressure ulcers in intensive care", "continuity of care: the main problem to solve", "teamwork and pressure ulcers: gasping for improvement" and "Skin care as another vital sign". CONCLUSION Most intensive care nurses consider that they do not have sufficient knowledge regarding pressure ulcers. The nurses' attitudes are positive, however, an ineffective transmission of information and registration regarding ulcers is perceived. Regarding the treatment of pressure ulcers, the lack of continuity of care and updated knowledge/training have been the main barriers. In terms of prevention, the most mentioned barriers have been the clinical condition of the patient and the lack of personnel, despite the level of knowledge.
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Affiliation(s)
- Claudia Acosta-Hernández
- Emergency Department, San Juan de Dios Hospital, Avda. San Juan de Dios, s/n, 18001, Bormujos, Seville, Spain
| | - Rafael-Jesús Fernández-Castillo
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Avenzoar St., 6, 41009, Seville, Spain; Intensive Care Clinical Unit, University Hospital Virgen Macarena, Dr. Fedriani St., 3, 41009, Seville, Spain. https://twitter.com/RJFernandez92
| | - Manuel Montes-Vázquez
- Intensive Care Department, University Hospital Virgen de Valme, Crta, de Cádiz, km 548, 41014, Seville, Spain
| | - María-Dolores González-Caro
- Intensive Care Clinical Unit, University Hospital Virgen Macarena, Dr. Fedriani St., 3, 41009, Seville, Spain
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18
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Guerrero JG, Mohammed H, Pingue-Raguini M, Cordero RP, Aljarrah I. A Multicenter Assessment of Nurses' Knowledge Regarding Pressure Ulcer Prevention in Intensive Care Units Utilizing the PUKAT 2.0. SAGE Open Nurs 2023; 9:23779608231177790. [PMID: 37273548 PMCID: PMC10233595 DOI: 10.1177/23779608231177790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Pressure ulcer (PU) care is pivotal in the practice of nurses working in intensive care units (ICUs). Therefore, nurses must possess adequate knowledge about the potential risks leading to the development of PUs, as well as managing complications that worsen patient conditions. Objective To evaluate the level of knowledge of ICU nurses concerning PU prevention in tertiary hospitals in Saudi Arabia. Methods In this cross-sectional study, the researchers recruited 320 ICU nurses from four tertiary hospitals using convenience sampling. Nurses' knowledge regarding PU prevention was assessed using the revised and updated version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) 2.0. Data were collected between May and June 2022. The CROSS checklist was observed for reporting. Results The mean scores of nurses' level of knowledge regarding PU prevention according to the themes of the revised and updated version of the PUKAT 2.0 were as follows-etiology: 62.81 ± 23.77; classification and observation: 50.86 ± 23.28; risk assessment: 31.19 ± 24.26; nutritious diet: 46.04 ± 25.96; prevention: 22.36 ± 12.41; and specific patient groups: 14.84 ± 22.88. Furthermore, the score for nurses' overall level of knowledge of PU prevention was 39.55 ± 8.84 out of 100, interpreted as low based on the 60% cutoff; the minimum knowledge score was 0. Notably, knowledge of PU etiology, classification, observation, and specific patient groups differed based on the hospital of affiliation. Interestingly, gender was the only demographic characteristic based on which nurses' knowledge regarding specific patient groups differed. Conclusion This study identified insufficient knowledge among ICU nurses regarding PU prevention, which can lead to complications among patients. Simulation scenarios related to PU prevention and management will be an effective way to help nurses gain appropriate knowledge that can be applied in clinical practice.
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Affiliation(s)
- Jefferson Garcia Guerrero
- Fakeeh College for Medical
Sciences, Abdul Wahab Naib Al Haram, Al-Hamra'a, Jeddah, Saudi
Arabia
- King Khalid University, College of
Nursing, Abha, Saudi Arabia
| | - Heba Mohammed
- Fakeeh College for Medical
Sciences, Abdul Wahab Naib Al Haram, Al-Hamra'a, Jeddah, Saudi
Arabia
- King Abdulaziz Hospital, Nursing
Department, Mecca, Saudi Arabia
| | - Minerva Pingue-Raguini
- Fakeeh College for Medical
Sciences, Abdul Wahab Naib Al Haram, Al-Hamra'a, Jeddah, Saudi
Arabia
| | | | - Imad Aljarrah
- Jadara University, College of Nursing,
Irbid, Jordan
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19
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Ghorbani Vajargah P, Mollaei A, Falakdami A, Takasi P, Moosazadeh Z, Esmaeili S, Emami Zeydi A, Karkhah S. A systematic review of nurses' practice and related factors toward pressure ulcer prevention. Int Wound J 2022. [DOI: 10.1111/iwj.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Pooyan Ghorbani Vajargah
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Amirabbas Mollaei
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Atefeh Falakdami
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Poorya Takasi
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Zahra Moosazadeh
- Student Research Committee, School of Medicine, Sari Branch Islamic Azad University Sari Iran
| | - Shaqayeq Esmaeili
- Imam Khomeini Hospital Mazandaran University of Medical Sciences Sari Iran
| | - Amir Emami Zeydi
- Department of Medical‐Surgical Nursing, Nasibeh School of Nursing and Midwifery Mazandaran University of Medical Sciences Sari Iran
| | - Samad Karkhah
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
- Burn and Regenerative Medicine Research Center Guilan University of Medical Sciences Rasht Iran
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20
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Almeida RMFD, Tura LFR, Silva RCD. Preventive Measures For pressure injuries: structure of social representations of nursing teams. Rev Esc Enferm USP 2022; 56:e20220012. [PMID: 36279565 PMCID: PMC10081604 DOI: 10.1590/1980-220x-reeusp-2022-0012en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/26/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To analyze the structure of social representations on the preventive measures to pressure injury of nursing teams. METHOD Qualitative research, based on the structural approach of Social Representations. It was conducted with 103 nursing professionals from a specialized hospital, using the Word Association Test. Data were submitted to prototypical analysis, using two analysis techniques of centrality, similarity and double negation. RESULTS The evocations "care" and "decubitus" made up the central core of the representation, which was structured based on the imagery dimension of changing position, from which a hierarchy of preventive measures occurs. The term "care" referred to the normative dimension of representation as a responsibility of nursing, and to the practical dimension, as preventive actions with the use of technologies. CONCLUSION The image, normative and practice dimensions are part of the representation structure and guide compliance with preventive measures.
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Affiliation(s)
| | - Luiz Fernando Rangel Tura
- Universidade Federal do Rio de Janeiro, Instituto de Estudos e Saúde Coletiva, Rio de Janeiro, RJ, Brazil
| | - Rafael Celestino da Silva
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna Nery, Departamento de Enfermagem Fundamental, Rio de Janeiro, RJ, Brazil
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21
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Li J, Zhu C, Liu Y, Li Z, Sun X, Bai Y, Song B, Jin J, Liu Y, Wen X, Cheng S, Wu X. Critical care nurses' knowledge, attitudes, and practices of pressure injury prevention in China: A multicentric cross-sectional survey. Int Wound J 2022; 20:381-390. [PMID: 35906851 PMCID: PMC9885482 DOI: 10.1111/iwj.13886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/25/2022] [Indexed: 02/03/2023] Open
Abstract
Pressure injury is a serious and preventable problem in intensive care units. Translating guidelines into clinical practice can reduce the incidence of pressure injury. Identifying clinical status, barriers and facilitators contribute to guideline implementation. To identify the knowledge, attitudes, and practices of pressure injury prevention in Chinese critical care nurses. Secondary data were extracted from a multicentric clinical trial. Knowledge and attitudes toward pressure injury prevention were assessed by a fourteen-item questionnaire. The observed practices were recorded using a case report form. The report complies with the STROBE statement. A total of 950 critical care nurses in 15 hospitals from six provinces of China were investigated. A total of 53.1% of nurses received a median score of 6 points or less. Knowledge regarding the repositioning procedure, risk assessment, and heel pressure injury prevention was insufficient. Over 99% of nurses strongly or somewhat agreed that pressure injury prevention was very important and that they were willing to take measures to prevent pressure injury. A total of 27 781 patient days of pressure injury prevention practice were recorded. Repositioning was the most commonly used prevention measure, followed by support surfaces and prophylactic dressings. A combination of repositioning, support surface, and prophylactic dressing was lacking. Chinese critical nurses showed a low level of knowledge and a positive attitude toward pressure injury prevention. Practices of pressure injury prevention were unsatisfactory. There is a clear gap between the guidelines and clinical practices. The barrier (low-level knowledge) and facilitator (positive attitude) were identified in this study. According to these findings, strategies need to be developed to promote guideline implementation.
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Affiliation(s)
- Jiamin Li
- Department of Nursing, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Chen Zhu
- Department of Nursing, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Ying Liu
- Department of Nursing, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Zhaoyu Li
- School of Nursing and MidwiferyGriffith UniversityGold CoastQueenslandAustralia
| | - Xiangyu Sun
- Department of Nursing, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yunfeng Bai
- Department of Nursing, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Baoyun Song
- Department of NursingHenan Provincial People's HospitalZhengzhouChina
| | - Jingfen Jin
- Department of NursingZhejiang University School of Medicine Second Affiliated HospitalHangzhouChina
| | - Yilan Liu
- Department of NursingWuhan Union HospitalWuhanChina
| | - Xianxiu Wen
- Department of NursingSichuan Academy of Medical Sciences and Sichuan People's HospitalChengduChina
| | - Shouzhen Cheng
- Department of NursingSun Yat‐sen University First Affiliated HospitalGuangzhouChina
| | - Xinjuan Wu
- Department of Nursing, Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
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Carreiro GSP, Soares MJOG, Oliveira SHS, Mendonça AEO. Nursing team knowledge assessment instruments about pressure injury: integrative review. REVISTA CIÊNCIAS EM SAÚDE 2022. [DOI: 10.21876/rcshci.v12i2.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives: to identify in the scientific literature how the assessment of knowledge of the nursing team about pressure injuries is conducted, which instruments are used, and their psychometric properties. Methods: integrative review conducted with 44 scientific articles. The search was conducted between October and December 2021 in the following data sources: BDENF, Cinahl, Lilacs, MEDLINE, Scopus, Google Scholar, and Web of Science, using the strategy in Portuguese: ("lesão por pressão" OR "úlcera por pressão" OR "úlcera de decúbito" OR "escara de decúbito") AND enfermagem AND conhecimento, and, in English, ("pressure ulcer" OR "bed sore" OR "bed sores" OR bedsore OR bedsores) AND nursing AND knowledge. Articles published between 2012 and November 2021 were included, with text available in full, in open access, in English, Portuguese, or Spanish, resulting from original research related to care in the hospital area. Results: The most used knowledge assessment instrument was the P-PUKT and its versions, used in 50% of the studies, followed by the PUKAT and its versions. Three studies also used instruments constructed and validated by the authors, five qualitative studies, and four studies used non-validated instruments. Conclusion: Valid instruments to assess knowledge are essential to identify possible failures in patient care. Heterogeneity in the samples and in the classification criteria of the participants' level of knowledge made it impossible to compare the results obtained in the studies, constituting a limitation.
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Caregivers' Knowledge, Attitude, and Practice towards Pressure Injuries in Spinal Cord Injury at Rehabilitation Center in Bangladesh. Adv Orthop 2022; 2022:8642900. [PMID: 35747167 PMCID: PMC9213162 DOI: 10.1155/2022/8642900] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/26/2022] [Accepted: 05/27/2022] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to determine caregivers' knowledge, attitude, and practice (KAP) on the prevention and care of pressure injuries (PIs) in individuals with spinal cord injury. A quantitative cross-sectional study with descriptive correlation design was used to implement a modified semistructured questionnaire using a convenient sampling method. McDonald's standard of learning outcome measurement criteria was used to categorize caregivers' KAP. A Pearson product-moment correlation coefficient (r) was utilized to assess the relationships between caregivers' KAP, with a p value of 0.05 or less considered statistically significant. The study findings indicate that caregivers had a moderate level of knowledge (M = 73.68%, SD = 6.43), a neutral attitude (M = 70.32%, SD = 6.89), and a moderate level of practice (M = 74.77%, SD = 9.08). A positive correlation existed between caregivers' knowledge and attitude (r = 0.30, p < 0.01), as well as between knowledge and practice (r = 0.37, p < 0.01). Nevertheless, there was no correlation between attitude and practice (r = 0.12, p > 0.05). The study findings suggest that caregivers need to develop a positive attitude and expand their knowledge in order to improve their practice. The KAP factors that require higher priority were positioning and turning the patient, preventing skin breakdown, assessing weight changes over time, interest in patient care, additional care for PIs, frequently changing the individual's position, priority to PI care, interest in other types of care other than PIs, using special cushions, consulting doctors on a regular basis, being aware of clothing and fabrics, proper transfer technique, pressure relief, and skin inspection, among others.
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Emami Zeydi A, Ghazanfari MJ, Esmaeili S, Mobayen M, Soltani Y, Emami Sigaroudi A, Fast O, Karkhah S. Knowledge, attitude, and practice of Iranian nurses towards pressure ulcer prevention: A systematic review. J Tissue Viability 2022; 31:444-452. [PMID: 35718594 DOI: 10.1016/j.jtv.2022.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/04/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Pressure ulcer (PU), as a long-term disabling condition, is an important indicator for patient safety and quality of nursing care in hospitals. This systematic review aimed to evaluate the knowledge, attitude, and practice of Iranian nurses towards PU prevention. METHODS A systematic search was conducted on PubMed, Web of Science, Scopus databases, Google Scholar Search Engine, as well as Magiran, Iranmedex, and Scientific Information Database (SID) Persian databases using the relevant keywords, from the earliest date available to August 21, 2020. Studies were appraised using the appraisal tool for cross-sectional studies (AXIS tool). FINDINGS Among a total of 1,543 Iranian nurses included in the 9 studies, 80.53% were female with a mean age of 31.14 (SD = 5.52) years. The mean work experience of the participants was 7.94 years (SD = 5.44). The knowledge and practice of Iranian nurses toward PU prevention were insufficient and relatively desirable, respectively. Also, the present study showed that nurses' attitudes toward PU prevention were contradictory. Age, gender, level of education, work experience, and participation in previous educational workshops were possible factors related to nurses' knowledge about PU prevention. Women with higher work experience had a more positive attitude. CONCLUSION This review found inappropriate knowledge, attitude, and practice of Iranian nurses toward PU prevention and highlights the importance of regular upgrading of nurses' knowledge and practice related to PU prevention.
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Affiliation(s)
- Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
| | - Shaqayeq Esmaeili
- Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Yasaman Soltani
- Medical Education Research Center, Educational Development Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Abdolhossien Emami Sigaroudi
- Cardiovascular Diseases Research Center, Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran.
| | - Olive Fast
- Mount Royal University, Calgary, Alberta, Canada.
| | - Samad Karkhah
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran; Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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25
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Cukljek S, Rezic S, Ficko SL, Hosnjak AM, Smrekar M, Ljubas A. Croatian nurses' and nursing students' knowledge about pressure injury prevention. J Tissue Viability 2022; 31:453-458. [DOI: 10.1016/j.jtv.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/30/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
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26
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Designing devices to communicate effectively with intensive care nurses to prevent pressure injuries: A qualitative study. Intensive Crit Care Nurs 2022; 71:103244. [DOI: 10.1016/j.iccn.2022.103244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 11/23/2022]
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27
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Huang X, Zan T, Tang J, Zhang D, Zu W, Wang T, Wang L, Nie W. Psychometric properties of the Chinese version of the attitude towards pressure ulcer prevention instrument: A cross‐sectional survey. Int Wound J 2022; 19:2019-2030. [PMID: 35307948 DOI: 10.1111/iwj.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Tao Zan
- Department of Intensive Care Unit Bethune First Hospital of Jilin University Changchun China
| | - Jing Tang
- Department of Intensive Care Unit Bethune First Hospital of Jilin University Changchun China
| | - Dan Zhang
- School of Life and Health Yenching Institute of Technology Langfang China
| | - Wanting Zu
- School of Nursing Jilin University Changchun China
| | - Taiwei Wang
- Department of Intensive Care Unit Bethune First Hospital of Jilin University Changchun China
| | - Lisheng Wang
- School of Nursing Jilin University Changchun China
| | - Wenbo Nie
- School of Nursing Jilin University Changchun China
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28
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Furtado K, Lopes T, Afonso A, Infante P, Voorham J, Lopes M. Content Validity and Reliability of the Pressure Ulcer Knowledge Test and the Knowledge Level of Portuguese Nurses at Long-Term Care Units: A Cross-Sectional Survey. J Clin Med 2022; 11:jcm11030583. [PMID: 35160035 PMCID: PMC8836429 DOI: 10.3390/jcm11030583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Improvement in pressure ulcer care depends both on the dissemination of knowledge and its implementation. This study aims to translate the Pressure Ulcer Knowledge Test into Portuguese from Portugal and evaluate the internal consistency of the questionnaire. The second aim is to assess nurses’ pressure ulcer knowledge level. (2) Methods: The Pressure Ulcer Knowledge Test was translated into Portuguese, and the translated test’s internal consistency and content validity were assessed. Further, the authors conducted a cross-sectional survey using the test among 221 nurses working in long-term care units. (3) Results: The Cronbach’s alpha internal coefficient of reliability recorded for the 47 items was 0.738, which is higher than the minimum acceptable level of 0.7. The Cronbach’s alpha for the subscales was 0.709 for prevention/risk and less than 0.5 for staging and wound description. Only two of the 221 nurses achieved a score of 90% correct answers or more. The nurses scored lower in questions related to prevention/risk (Me = 67.4%, IQR = 60.6–75.8% vs. staging: ME = 85.7%, IQR = 71.4–85.7%, description: ME = 85.7%, IQR = 71.4–85.7%, p < 0.001). (4) Conclusion: The internal consistency of the instrument was acceptable. The instrument can accurately measure Portuguese nurses’ knowledge of pressure ulcers, and its information can help improve education and implementation of best practices.
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Affiliation(s)
- Katia Furtado
- Out patient Department, Hospital of Portalegre, Unidade Local de Saúde do Norte Alentejano, 7300-312 Portalegre, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, Portugal;
- Correspondence:
| | - Teresa Lopes
- Emergency Department, University Hospitalar Center Cova da Beira, 6200-000 Covilhã, Portugal;
- Department of Nursing, Health School, Polyctechnic Institute of Guarda, 6300-000 Guarda, Portugal
| | - Anabela Afonso
- CIMA, IIFA, Universidade de Évora, 7000-671 Évora, Portugal; (A.A.); (P.I.)
- Departamento de Matemática, ECT, Universidade de Évora, 7000-671 Évora, Portugal
| | - Paulo Infante
- CIMA, IIFA, Universidade de Évora, 7000-671 Évora, Portugal; (A.A.); (P.I.)
- Departamento de Matemática, ECT, Universidade de Évora, 7000-671 Évora, Portugal
| | - Jaco Voorham
- DTIRS—Data to Insights Research Solutions, 1750-307 Lisboa, Portugal;
| | - Manuel Lopes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, Portugal;
- São João de Deus School of Nursing, Universidade de Évora, 7000-671 Évora, Portugal
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29
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Ghazanfari MJ, Karkhah S, Maroufizadeh S, Fast O, Jafaraghaee F, Gholampour MH, Zeydi AE. Knowledge, attitude, and practice of Iranian critical care nurses related to prevention of pressure ulcers: A multicenter cross-sectional study. J Tissue Viability 2022; 31:326-331. [DOI: 10.1016/j.jtv.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
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30
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Almeida RMFD, Tura LFR, Silva RCD. Medidas preventivas à lesão por pressão: estrutura das representações sociais da equipe de enfermagem. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0012pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
RESUMO Objetivo: Analisar a estrutura das representações sociais sobre as medidas preventivas à lesão por pressão da equipe de enfermagem. Método: Pesquisa qualitativa, pautada na abordagem estrutural das Representações Sociais. Foi realizada com 103 profissionais de enfermagem de um hospital especializado utilizando-se a Técnica de Associação Livre de Palavras. Os dados foram submetidos à análise prototípica, e empregou-se duas técnicas de análise da centralidade, de similitude e da dupla negação. Resultados: As evocações “cuidado” e “decúbito” compuseram o núcleo central da representação, que se estruturou com base na dimensão imagética da mudança do decúbito, a partir da qual ocorre uma hierarquização das medidas preventivas. O termo “cuidado” remeteu à dimensão normativa da representação como uma responsabilidade da enfermagem, e à dimensão prática, pelas ações preventivas com o emprego de tecnologias. Conclusão As dimensões da imagem, normativa e da prática integram a estrutura da representação e orientam a adesão às medidas preventivas.
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Hu L, Sae-Sia W, Kitrungrote L. Intensive Care Nurses' Knowledge, Attitude, and Practice of Pressure Injury Prevention in China: A Cross-Sectional Study. Risk Manag Healthc Policy 2021; 14:4257-4267. [PMID: 34703338 PMCID: PMC8524251 DOI: 10.2147/rmhp.s323839] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background Pressure injury (PI) remains a critical health issue worldwide. The global incidence of hospital-acquired PI is 8.4%, and among intensive-care unit (ICU) patients, it is even higher, ranging from 6.60% to 36.80%. It is important to investigate ICU nurses’ PI prevention knowledge, attitudes, and practices (KAP). Aim The aim of this study was to describe the level of Chinese ICU nurses’ knowledge, attitudes, and self-reported practices of PI prevention. Materials and Methods From March 31 to April 30, 2019, we recruited a total of 510 ICU nurses into the current study using convenience sampling. The Modified Pressure Ulcer Knowledge Assessment Tool version 2.0, Attitudes toward Pressure Ulcer Prevention instrument, and Questionnaire to evaluate nurses’ Adherence to Recommendations for Preventing Pressure Ulcers were used for data collection. We used one-way analysis of variance, Student’s t-test, and the Mann–Whitney U-test to assess differences in knowledge, attitudes, and self-reported practices of PI prevention among ICU nurses, whom we categorized by their demographic characteristics. Results Mean scores of participants’ knowledge, attitude, and their self-report practice were 65.82 ± 9.29, 76.65 ± 8.62, and 83.35 ± 13.55, respectively. Participants with bachelor’s degrees or higher, who worked in tertiary hospitals, and who had received training on PI prevention over the last year had higher scored on PI prevention knowledge (all P < 0.05). Participants who had received training on PI prevention over the last year scored higher on attitude than those who had not received such training over the last year (P = 0.001). Conclusion ICU nurses surveyed in this study did not demonstrate an acceptable level of knowledge about PI prevention, while their attitudes and self-reported practices were acceptable. Continuing education or in-service training should be provided to enhance ICU nurses’ knowledge of PI prevention.
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Affiliation(s)
- Li Hu
- Breast Surgery Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, People's Republic of China.,Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Wipa Sae-Sia
- Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Luppana Kitrungrote
- Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
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32
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Parisod H, Holopainen A, Kielo-Viljamaa E, Puukka P, Beeckman D, Haavisto E. Attitudes of nursing staff towards pressure ulcer prevention in primary and specialised health care: A correlational cross-sectional study. Int Wound J 2021; 19:399-410. [PMID: 34121328 PMCID: PMC8762573 DOI: 10.1111/iwj.13641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/03/2023] Open
Abstract
The aim of this correlational, cross‐sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P = .047). Working as a wound care nurse (P = .0005), working experience after graduation (P = .0017), self‐reported pressure ulcer prevention and early detection skills (P < .0001), pressure ulcer prevention knowledge (P = .0002), and views about the realisation of their unit's pressure ulcer prevention practices (P < .0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence‐based pressure ulcer prevention practices should be promoted.
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Affiliation(s)
- Heidi Parisod
- Nursing Research Foundation, Helsinki, Finland.,WHO Collaborating Center for Nursing, Helsinki, Finland.,Department of Nursing Science, University of Turku, Turku, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland.,WHO Collaborating Center for Nursing, Helsinki, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Emilia Kielo-Viljamaa
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
| | - Pauli Puukka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden.,Department of Clinical Research, Faculty of Health Sciences, Research Unit of Plastic Surgery, Odense, Denmark
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
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Zhang YB, He L, Gou L, Pei JH, Nan RL, Chen HX, Wang XL, Du YH, Yan H, Dou XM. Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device-related pressure injury: A cross-sectional study in western China. Int Wound J 2021; 18:777-786. [PMID: 33960668 PMCID: PMC8613385 DOI: 10.1111/iwj.13581] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022] Open
Abstract
The knowledge, attitude, and practice of nurses in intensive care units (ICUs) are determinants for the efficacy of preventing the medical device-related pressure injury (MDRPI). The aim of this study was to determine the level and factors of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI in western China. An annual cross-sectional study was conducted in hospitals of western China from May 2020 to September 2020. Nurses' knowledge and attitudes were assessed using Clinical Nurses Prevention MDRPI of Critically Ill Patients for the Knowledge, Attitude, Practice Assessment Scale. SPSS software version 25.0 and independent t-test, Chi-square, Fisher exact, one-way analysis of variance, and multiple linear regression tests were used for data analysis. A total of 1002 nurses in ICUs from 37 hospitals in Gansu Province, China, participated in this study. The scores of overall KAP, knowledge, attitudes, and practice were 149.17 ± 24.62, 53.83 ± 12.23, 37.24 ± 6.35 and 58.10 ± 9.83, respectively. There was a positive and significant relationship between three variables. Findings revealed that nurses' knowledge score in the Tertiary hospital was higher than scores of other hospitals as 3.840 units. Moreover, the knowledge score and practice score of nurses with bachelor's degree or above were higher than other nurses and are 0.978 and 1.106 units, respectively. Based on the findings, practice of nurses increased by 0.992 units, with a 1-year increase in work experience of nurses in the ICU. The levels of knowledge, attitude, and practice of nurse in ICUs on preventing MDRPI were acceptable. The findings of the study highlight that a comprehensive approach should be conducted for raising the level of knowledge, attitude, and practice of nurses' ICUs on preventing medical MDRPI, as well as improving the quality of care for critically ill patients.
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Affiliation(s)
- Ya-Bin Zhang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Li He
- Department of Emergency, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China
| | - Ling Gou
- Department of EICU, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China
| | - Ju-Hong Pei
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Rui-Ling Nan
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China.,Department of EICU, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China
| | - Hai-Xia Chen
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Xing-Lei Wang
- Department of Liver Diseases Branch, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China
| | - Ye-Hui Du
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Hui Yan
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Xin-Man Dou
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People's Republic of China.,Department of Nursing, Lanzhou University Second Hospital, Lanzhou, Gansu, People's Republic of China
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Kielo‐Viljamaa E, Suhonen R, Ahtiala M, Kolari T, Katajisto J, Salminen L, Stolt M. The development and testing of the C/WoundComp instrument for assessing chronic wound-care competence in student nurses and podiatrists. Int Wound J 2021; 18:62-78. [PMID: 33236837 PMCID: PMC7949283 DOI: 10.1111/iwj.13495] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study was to describe the level of chronic wound-care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.
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Affiliation(s)
- Emilia Kielo‐Viljamaa
- Department of Nursing ScienceUniversity of TurkuFinland
- Department of HealthcareArcada University of Applied SciencesFinland
| | - Riitta Suhonen
- Department of Nursing ScienceUniversity of TurkuFinland
- Turku University HospitalFinland
- Welfare DivisionCity of TurkuFinland
| | | | - Terhi Kolari
- Department of BiostatisticsUniversity of TurkuFinland
| | - Jouko Katajisto
- Department of Mathematics and StatisticsUniversity of TurkuFinland
| | | | - Minna Stolt
- Department of Nursing ScienceUniversity of TurkuFinland
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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.
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