Nurses' knowledge of prevention and management of pressure ulcer at a Health Insurance Hospital in Alexandria

Knowledge and practice of informal caregivers on pressure injury prevention and treatment among patients receiving palliative care

BACKGROUND

Pressure injuries (PIs) are prevalent in palliative care. Lack of knowledge and skills among informal caregivers on PI prevention and management contributes significantly to the occurance or deterioration of PIs.

AIM

The aims of this study were to: (1) determine the level of knowledge and practices of informal caregivers on PI prevention and treatment; (2) explore the socio-demographic characteristics of informal caregivers that influence PI prevention and treatment among patients who need palliative care.

METHODS

The quantitative cross-sectional descriptive design was used to collect data from 146 informal caregivers, and a valid and reliable questionnaire was used.

RESULTS

A total of 146 informal caregivers of patients with PI completed the study. Most participants had a relatively low level of PI prevention, treatment knowledge and practice. Participants who were older than 28 years, working for the government and married had significantly better knowledge and practice of PI prevention and treatment than other participants.

CONCLUSION

Information for informal caregivers in different settings about PI prevention and treatment is needed. Informal caregivers need to acquire more professional practices and knowledge to improve the quality of patient care.

Barriers and facilitators to pressure injury prevention in hospitals: A mixed methods systematic review

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.

Evaluation of an educational film as a learning tool for nurses caring for seniors with pressure ulcers

Background:  Pressure ulcers last to be a severe and prevalent health condition in hospitals; they have been considered the most physically debilitating and expensive problems of the twentieth century. Advanced pressure ulcers are common in the elderly; about 70% happen in cases 65 years or older, peaking range from 70 and 80. Many pressure ulcers are considered preventable or even treatable with the proper procedures to preserve skin integrity. Objectives: This work aims to evaluate the influence of an instructional film on nurses caring for seniors with pressure ulcers in terms of attitude and knowledge. Materials and Method. The research employed a quasi-experimental design and was conducted in intensive care Units of the General Mansoura Hospital, Specialized Medical Hospital, and Emergency Hospital in Dakhalia governorate. The research surveyed 69 nurses. Two instruments were utilized in this research: the Braden Scale and a two-part structured interview schedule sheet. Results: Following the educational film, the nurse's practice and knowledge increased, plus there was an enhancement in wound healing of pressure ulcers for older adults. Conclusion: This study concluded that nurses' knowledge and attitude have improved after displaying the educational film program.

Pressure injury prevention practice and associated factors among nurses at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia: a cross-sectional study

OBJECTIVE

The prevention of pressure injury is of great importance in providing quality care to patients, as it has been reported that approximately 95% of all pressure injury are preventable. Nurses working in clinical settings play a key role in identifying patients at risk and administering preventative care. Therefore, this study examines pressure injury prevention practices among nurses.

DESIGN

Cross-sectional study design.

SETTING

Wolaita Sodo University Teaching and Referral Hospital, Ethiopia.

PARTICIPANTS

240 nurses.

MAIN OUTCOME MEASURES

Pressure injury prevention practices among nurses.

RESULT

Among nurses, 37.9% had good pressure injury prevention practices. The factors associated with pressure injury prevention practices included having a bachelor's degree or higher (adjusted odds ratio (AOR)=2.18; 95% CI 1.12 to 4.25), having more than 10 years of nursing experience (AOR=3.44; 95% CI 1.41 to 8.37), lacking subject knowledge (AOR=0.49; 95% CI 0.27 to 0.91) and being over the age of 40 (AOR=0.55; 95% CI 0.09 to 0.35).

CONCLUSION

The majority of nurses reported having a limited level of pressure injury prevention practice. Since pressure ulcer prevention practice is majorly the role of nurses. Upgrading the educational level of the nurses through continuous professional development opportunities can improve the preventive practice of pressure ulcer injury by increasing the knowledge and skill gained during the vocational training.

Effectiveness of training in increasing awareness about managing pressure injuries in emergency departments

INTRODUCTION

Emergency room conditions and the characteristics of the patients followed up pose a risk for pressure injury.

AIM

This study was conducted as a pilot study to assess the effectiveness of a training program in increasing the awareness of healthcare professionals working in an emergency department about how to manage pressure injuries.

METHODS

The study was a prospective, pre-test post-test intervention study without a control group. The study included 595 patients who were hospitalized in the emergency room for more than two hours and voluntarily agreed to participate, as well as 11 physicians and 17 nurses working in the emergency department between 15 April and 19 June 2019 2019. It was carried out in three stages. In the first stage, the 30-day pressure injury incidence rate in the emergency department was evaluated using the "Emergency Department Patients Information and Pressure Injury Assessment Form" and "The Braden Scale for Predicting Pressure Injury Risk". In the second stage, the healthcare professionals were given training about pressure injuries. The knowledge levels of healthcare professionals before and after the training were evaluated using "The Descriptive Characteristics Form for Emergency Department Personnel (doctors and nurses)" and "The Questionnaire for Identifying and Preventing Pressure Injury". In the third stage, the 30-day pressure injury incidence rate in the was re-evaluated after the training using the same two scales as before. The SPSS 25 package program was used to evaluate the data in terms of frequency, percentage, mean and standard deviation, and the Mann-Whitney U Test for independent groups, the t-test, the correlated sample t-test, the Wilcoxon Signed Rank test, Pearson Chi-square test, Yates Chi-square test and Fisher's Exact Chi-square test were also used.

RESULTS

The mean knowledge test score of the healthcare professionals working in the emergency department was determined as X¯±SD = 53.71 ± 14.70 before the training and X¯±SD = 58.57 ± 11.83 after the training. The average score on the prevention dimension of the Questionnaire for Identifying and Preventing Pressure Injury was found to be statistically significantly higher than before the training (p < 0.05). The pressure injury incidence in the emergency department was 12.5% before the training and 8.8% afterwards.

CONCLUSION

It was observed that the knowledge of healthcare professionals about pressure injury was insufficient and that training given on this topic both increased their knowledge and decreased the incidence of pressure injury. However, the difference was not statistically significant. Training about pressure injuries is important for preventing pressure injury, identifying the injury early, treating the injury appropriately and increasing the awareness of healthcare professionals.

Pressure injury knowledge of Turkish internship nursing students

AIM

This study aimed to describe the pressure injury (PI) knowledge of Turkish internship nursing students (INSs).

MATERIALS AND METHODS

This descriptive study was performed using the Turkish version of the Modified Pieper Pressure Ulcer Knowledge Test. The study population consisted of INSs in a nursing program in the West Black Sea Region, Turkey. The sample of the study was 278 (74.1% of a total of 375 volunteer INSs).

RESULTS

The mean knowledge test score was 29.03 ± 7.15 (range 11-44). The prevention/risk score was higher; only 28.4% of the students had a satisfactory test score.

CONCLUSION

The results of this study indicated that the INSs had significant knowledge gaps regarding PI. Nursing students' knowledge deficiencies regarding PIs should be identified at undergraduate level, and the necessary educational measures should be taken.

Nurses' Knowledge and Attitudes towards Prevention of Pressure Ulcers

BACKGROUND

Pressure ulcers (PU) remain a serious complication of immobile patients and a burden for healthcare professionals. The incidence and prevalence remain alarming. Knowledge and attitudes of nurses play a fundamental role in prevention. The aim of this study was to determine the knowledge and attitudes of nurses towards the prevention of PU in selected Slovak hospitals and find relationships and differences among selected variables.

METHODS

A quantitative exploratory cross-sectional design was chosen. Validated instruments were used. From the 460 randomly selected nurses, 225 (49%) participated in this research.

RESULTS

Results showed insufficient knowledge (45.5%) and attitudes (67.9%) of nurses towards PU prevention. There was a significant positive correlation found between the knowledge and attitudes (ρ = 0.300; p = 0.000). Nurses´ knowledge was significantly different within the level of education (p = 0.031) and work department (p = 0.048).

CONCLUSIONS

Results showed insufficiencies in the knowledge and attitudes of nurses towards PU prevention. Therefore, it is essential to focus on general education and continuing education and practice of nurses. Further development of educational programs and frequent measurement of these two parameters can lead to a significant improvement in the quality of care provided.

Embedding skin tone diversity into undergraduate nurse education: Through the lens of pressure injury

OBJECTIVE

To explore health disparity in on-campus undergraduate nurse education through the analysis of teaching and teaching material exploring pressure injuries.

BACKGROUND

As a discipline, nursing espouses ideologies of inclusion, equity and valuing diversity. However, little is known about how these ideologies translate into clinical care. Pressure injury prevention is a routine aspect of nursing care; yet, there is evidence of inequity in relation to clinical care and patient assessment, as people with darker skin tones have a higher prevalence of severe pressure injuries before detection of damage occurs. Despite limited literature being available surrounding the topic of pressure injuries and skin tone diversity, it remains the responsibility of nurse educators to address contemporary issues and health disparity within the nursing curriculum.

DESIGN

A multiple method collective case study. The STROBE checklist was followed in reporting this study.

METHODS

Documentary and observational data of lectures regarding pressure injuries were collected during 2017 and 2018 from five Higher Education Institutes in England delivering approved nursing undergraduate programmes.

RESULTS

Documentary analysis confirmed all Higher Education Institutes overwhelmingly directed teaching and learning activities about pressure injury towards people with Caucasian skin tones. Observation of teaching indicated all teaching sessions only contained brief, separate and superficial information on people with pressure injuries and darker skin tones. There was no discursive language or awareness of colour or colour blindness.

CONCLUSION

Radical critique of all teaching and learning activities needs to occur, to help explore, improve and meaningfully and authentically include diversity and inclusivity in nurse education, and in particular, how people across the skin tone spectrum are included and represented in teaching and learning activities.

RELEVANCE TO CLINICAL PRACTICE

Critical examination of current teaching practice is crucial to address disparity and ensure care for people with darker skin tones is optimised. Nurse educators have a responsibility to educate for the care needs of all, as the quality of nurse education has a direct impact on care delivery and health disparity. This paper highlights the importance of addressing skin tone diversity and offers the opportunity for reflective practice, not just in formal education, but in clinical settings by preceptors and senior staff.

A systematic and psychometric review of tests measuring nurses' wound care knowledge

Wound care is an important realm of nurses' clinical responsibilities, and a broad knowledge and range of skills are needed to perform efficient and safe patient care. Nurses' knowledge on this matter can be measured using knowledge tests. This study aims to identify, define, and analyse the knowledge tests developed for the measurement of nurses' wound care knowledge, and to evaluate the psychometric properties of the tests. This study was a systematic literature review. A total of 52 studies and 18 instruments were found. Of the 18 instruments, only 5 had been used more than once and were successful in a psychometric evaluation. These five instruments were analysed on the basis of their psychometric properties by using Zwakhalen et al.'s (2006) psychometric testing framework. According to the analysis, the Pressure Ulcer Knowledge Test (PUKT) and the Pressure Ulcer Knowledge Assessment Tool (PUKAT) were the most valid and reliable instruments for measuring nurses' wound care knowledge. Most of the instruments identified and analysed focused on pressure ulcers, indicating that future instruments could focus more on other types of wounds or on wound care in general in order to receive a broader understanding of nurses' wound care knowledge.

Determination of nurses' level of knowledge on the prevention of pressure ulcers: The case of Turkey

AIM OF THE STUDY

Pressure ulcers (PUs) constitute a health issue that has a high prevalence and incidence rate in acute and long-term care, requiring long-term nursing care for treatment and prevention. Therefore, nurses should have adequate knowledge of the interventions and practices used to prevent PUs.

MATERIALS AND METHODS

This study employed a descriptive and cross-sectional design to assess the level of nurses' knowledge concerning preventive interventions for PUs. Based on data found in the literature, researchers developed a 16-question Participant Information Form (including age, gender, level of education, employed ward, and training on PUs) and used this form, along with the Turkish version of the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI-T), to collect data.

RESULTS

A group of 471 nurses working in two foundation hospitals in 2018 participated in the study by completing a questionnaire. Among the participants, 44.2% worked in surgery, 21.2% in internal medicine, and 34.6% in other wards (such as intensive care, pediatrics, and the operating theater). Most of the nurses(73.5%) held a bachelor's degree, and their average work experience was 7.27 ± 7.00 years. It was determined that 69.4% of the nurses had not received in-service training relating to PUs, 55.6% did not attend lectures/conferences or read articles on the prevention of PUs, and 59.7% rated themselves as "adequate" in interventions used to prevent PUs. Based on the use of PUPKAI-T, 17 individuals (3.6%) scored equal to or more than the 60% cut-off value, and 454 individuals (96.4%) scored less than 60%. The mean level of knowledge on PUs was calculated as 11.1 ± 2.659 (range: 1-18) out of 26 questions.

CONCLUSIONS

Results of the study showed that the general level of knowledge of nurses in preventing PUs are extremely insufficient. Therefore, various strategies should be developed to increase nurses' level of knowledge on the etiology and development, classification and observation, and risk assessment of PUs, as well as on nutrition plans and preventive interventions.

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The abstract book contains the abstracts of keynote lectures, global gelebration, focus sessions, symposia, regional view, workshops, sponsored symposia, oral presentations, posters and the index.

Practice on pressure ulcer prevention among nurses in selected public hospitals, Tigray, Ethiopia

Objectives

Pressure ulcers are localized cellular damages to the skin and underlying tissues caused by pressure, shearing and frictional force. The aim of this study is to assess practices towards pressure ulcer prevention among nurses in the Central Zone of Tigray, Ethiopia, from September 10, 2017 to June 15, 2018. This study has also identified the major barriers that hamper nurses from preventing pressure ulcers. These barriers were heavy workload, inadequate training, and lack of universal guideline and shortage of resource. 17.2% of the participants had a good practice and 82.2% of the respondents had a poor practice of pressure ulcer prevention.

Result

Finding of this study showed that respondents have inadequate knowledge which may have led to their poor practice towards pressure ulcer prevention. Immediate intervention should be done on public hospitals of central Tigray to improve nurses’ practice towards pressure ulcer prevention.

Factors related to knowledge, attitude, and practice of nurses in intensive care unit in the area of pressure ulcer prevention: A multicenter study

INTRODUCTION

As one of the main members of the health team, nurses have an important role in pressure ulcer prevention in health care centers. The aim of this study was to investigate knowledge, attitude, and practice of nurses on the prevention of pressure ulcers and their related factors.

METHODS

This cross-sectional study was carried out in 2018. The total number of ICU nurses employed in educational-health centers affiliated to Iran University of Medical Sciences were examined. Among a total of 328 nurses, 308 questionnaires were completed by the participants. Pressure Ulcer Knowledge Questionnaire, Attitude Toward Pressure Ulcer, and Practice of Pressure Ulcer Prevention questionnaires were used to collect data. SPSS software version 16 and independent t-test, Chi-square, Fisher exact, one-way Analysis of variance, and multiple linear regressions tests were used for data analysis.

FINDINGS

Based on the mean score of knowledge, attitude, and practice of the nurses about the pressure ulcer prevention were 63.47 ± 10.31, 39.10 ± 40.22, and 32.03 ± 6.17, respectively. There was a positive and significant relationship between these three variables. Findings revealed that knowledge was increased by 0.051 units, with a one-year increase in work experience of nurses in the ICU. Moreover, women's knowledge and their attitude were higher than those of men as 3.132 and 1.65 units, respectively. Based on the findings, attitude of nurses increased by 0.43 units for an hour of extra work per week. Nurses' attitude score in the General ICU and their practice were higher than scores of other nurses as 2.144 and 2.574 units, respectively. Moreover, practice of nurses increased by 0.162 unit with one-year increase of their age.

CONCLUSION

Given the undesirable level of knowledge and attitude and relatively desirable practice of nurses in the field of pressure ulcer prevention and the importance of improving the safety of patients admitted to the ICU, it is suggested that appropriate educational planning be developed to raise the level of knowledge, attitude, and practice of health care providers, especially nurses, in the area of pressure ulcer prevention.

Evaluating the Effects of a Pressure Injury Prevention Algorithm

OBJECTIVE

To evaluate the effect of a pressure injury prevention algorithm on pressure injury prevention.

DESIGN, SETTING, AND PARTICIPANTS

This intervention study was conducted in the anesthesiology and reanimation ICU (ARICU) of a university hospital. The study included two sample groups (nurses and patients). All patients older than 18 years (prealgorithm, n = 80; postalgorithm, n = 74) in the ARICU who verbally consented were included in the study. All 15 nurses who worked in the ARICU during the postalgorithm period agreed to participate in the study.

INTERVENTIONS

The study was performed in four phases. In the first phase, pressure injury incidence was evaluated in the ARICU (prealgorithm period; April 1 to September 30, 2016). At the same time, a pressure injury prevention algorithm was developed. In the second phase, ARICU nurses were provided education on how to prevent pressure injury and use the pressure injury prevention algorithm. In the third phase, the nurses provided care based on the pressure injury prevention algorithm (postalgorithm period; November 1, 2016, to April 30, 2017). In the fourth phase, the incidence of pressure injury in the pre- and postalgorithm periods was compared, and the effectiveness of the algorithm was evaluated.

MAIN RESULTS

The pressure injury incidence was 46.10 per 1,000 patient-days in the prealgorithm period and 9.21 per 1,000 patient-days in the postalgorithm period. The decline was statistically significant (z = 9.590, P < .001).

CONCLUSIONS

Nursing education and the evidence-based pressure injury prevention algorithm reduced pressure injury rates. Further study of this algorithm in other ICUs and among various care populations is recommended to fully establish its efficacy.

Iranian nurses' knowledge, attitude and behaviour on skin care, prevention and management of pressure injury: A descriptive cross-sectional study

AIM

Pressure injuries as an indicator measuring the quality of nursing care and patient safety is a major health care problem worldwide. The aim of this study was to assess the knowledge, attitude and behaviour of nurses in preventing pressure injuries.

DESIGN

Descriptive cross-sectional study.

METHODS

This descriptive cross-sectional study enrolled 214 registered nurses in Iran. Patient satisfaction was assessed using pieker pressure ulcer knowledge test, attitude towards pressure ulcer tool and behaviour of pressure ulcer questionnaire. Data analysed by SPSSv.24 applying descriptive and inferential statistics.

RESULTS

The mean scores of knowledge, attitude and behaviour of nurses on the prevention of pressure injury were 27.24 (SD 5.23), 38.55 (SD 6.43) and 51.24 (SD 7.54), respectively. There was a correlation between knowledge, attitude and behaviour with the history of pressure injury training. Also, there was a significant relationship between knowledge with educational level and attitude with work experience. Knowledge, attitude and behaviour of nurses were in moderate level. Necessary measures to overcome problems such as the availability of pressure reducing equipments, motivating the nurses, eliminating the shortage of nurses and empowering nurses by holding practical workshops are important in providing patients safety.

Nursing Education Program for Hospital-Acquired Pressure Injury Prevention in Adult Acute Care Setting: A Quality Improvement Project

The purpose of this Quality Improvement project was to develop a multimedia hospital-acquired pressure injury (HAPI) prevention education program. The project setting was 3 adult critical care units plus a step-down unit located in the Mid-Atlantic region of the United States. A multimedia educational intervention was developed, which comprised 4 modules designed to improve nursing knowledge and competency in HAPI prevention. A posteducation program staff survey was also administered to evaluate nurse satisfaction with the program. Nurse knowledge of HAPI prevention was measured before and following implementation of the educational intervention. One hundred twenty-nine participants completed the education program, and 117 completed the satisfaction survey. Analysis revealed a statistically significant increase in knowledge after the education course (P < .05). Findings also indicated participants were satisfied that the program met stated aims.

Knowledge and attitudes of nurses in a major public hospital in Cyprus towards pressure ulcer prevention

STUDY AIM

The main aim of the study was to identify the knowledge and attitudes of nurses towards pressure ulcer prevention in a major public hospital in Cyprus.

MATERIAL AND METHODS

A descriptive and cross-sectional study design was used to collect the data between December 2014 and February 2015, the sample consisted of n = 102 nurses employed in a major public hospital in Cyprus. Customised and standardised Pressure Ulcer Knowledge Test and an attitudes Likert questionnaire was used to investigate both parameters. Descriptive and inferential statistics, parametric (t-test), non-parametric tests (Mann-Whitney U) and Pearson test was applied. Statistical significance was set at p = 0.05.

RESULTS

The majority of the participants (44.1%) n = 45 were employed in the intensive care unit, were female (61.8%) n = 63, registered nurses (93.1%) n = 95, had more than 5 years of experience (59.4%) n = 32 and 10.8% (n = 11) had a postgraduate title. The mean value regarding the knowledge questionnaire was 16.16, IQR: 17(15-18) correct answers 77%. In the attitudes questionnaire the median value was 41.82, IQR: 43 (40-46). Knowledge and attitudes correlated positively and statistically significantly (Pearson's R = 0,223, p = 0,019).

CONCLUSION

The result suggests that nurses had relatively inadequate knowledge levels and positive attitudes, attitudes and knowledges correlated statistically significantly and positively. It is proposed that through the development of educational programs and the frequent measurement of the two parameters further improvement can be achieved.

Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: a cross-sectional study

BACKGROUND

Pressure ulcers are common conditions among hospitalized patients and impose substantial burden on patients and their caregivers. To assess the knowledge and attitudes of health professionals towards PUs prevention.

METHODS

A cross-sectional study was performed in the rehabilitation hospital at King Fahad Medical City, Riyadh, Saudi Arabia in 2014. The study population consisted of nurses, physical therapists, occupational therapists, and physical medicine rehabilitation physicians who have a minimum of at least one year of clinical practice. The survey that was created for use in this study consisted of demographic characteristics, Pressure Ulcers Knowledge Test and Staff Attitude Scale.

RESULTS

The survey was completed by 105 participants of the 120 total eligible staff. The mean knowledge score of correct answers from all participants was 34.1 ± 4.8 (71.5 %). Only 77(73.3 %) participants had a mean knowledge score of ≥ 70 %. The mean attitude score was 30.5 (56.5 %). The study revealed that age and profession factors had a significant relationship with participants' mean knowledge of PUs prevention (P < 0.001), (P < 0.001) respectively. Moreover, 101 (98.1 %) participants are concerned about PUs prevention in their practices. While, 11 (10.7 %) of participants believe that PUs prevention is a time consuming procedure.

CONCLUSIONS

The present study assessed the current knowledge and attitudes of health professionals regarding PUs prevention in an acute rehabilitation hospital. The majority of participants had an average level of knowledge and exhibited unsatisfactory attitudes towards PUs prevention. Increased health professionals awareness may improve their attitudes towards PUs prevention.

Nurses' attitudes towards pressure ulcer prevention in Turkey

BACKGROUND

Pressure ulcers remain a major problem in healthcare system. Pressure ulcer incidence is widely accepted as an indicator for the quality of care. Positive attitudes towards pressure ulcer prevention have positive impacts on preventive care.

AIMS AND OBJECTIVES

The aim of this study was to identify nurses' attitude towards pressure ulcer prevention.

DESIGN

The study design was descriptive.

SETTING AND SAMPLE

The study was carried out in a university hospital in Izmir, Turkey. The study population consisted of 660 nurses who work in medical and surgical clinics and intensive care units. The study sample consisted of 426 nurses who agreed to participate.

METHOD

Attitude towards Pressure Ulcer Prevention Instrument was used in order to evaluate nurses' attitudes. Written permissions for ethical considerations and Attitude towards Pressure Ulcer Prevention Instrument permission were obtained. Data were collected between June and July 2014. The statistics program SPSS 18 packaged software was used in the analyses of data.

RESULTS

The average age of the nurses who took part in the study was 31.86 ± 7.09 years and the average work experience was 8.88 ± 7.41 years; 36.9% (n: 157) were working in intensive care units. The nurses' average score on the Attitude towards Pressure Ulcer Prevention Instrument was 43.74 ± 4.29 (84.12%).

CONCLUSION

It was seen that the attitudes of the nurses towards the prevention of pressure ulcers was positive. To read guidelines and training time about pressure ulcer prevention affect positively attitudes towards the prevention of pressure ulcers.

Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia

Background

Pressure ulcers are the common conditions among patients hospitalized in acute and chronic care facilities and impose significant burden on patients, their relatives and caregivers. Pressure ulcers have been described as one of the most costly and physically debilitating complications since the 20^th century. The pain and discomfort due to pressure ulcer prolongs illness, rehabilitation, time of discharge and even contribute to disability and death. This study was aimed to assess knowledge, practice and factors associated with pressure ulcer prevention among nurses in Gondar University Hospital, North-west Ethiopia.

Method

An institution-based cross-sectional survey was conducted from March 15 - April 10, 2014 among 248 nurses in Gondar University hospital. A pretested and structured self-administered questionnaire was used for data collection. Data were entered using EPI info version 3.5.3 statistical software and analyzed using SPSS version 20 statistical package. Descriptive statistics was used to describe the study population in relation to relevant variables. Bivariate and multivariate logistic regression was also carried out to see the effect of each independent variable on the dependent variable.

Result

Nearly half (54.4 %) of the nurses had good knowledge; similarly 48.4 % of them had good practice on prevention of pressure ulcer. Educational status [Adjusted Odds Ratio (AOR) = 2.4, 95 % CI (1.39-4.15)], work experience [AOR = 4.8, 95 % CI (1.31-10.62)] and having formal training [AOR = 4.1, 95 % CI (1.29-9.92)] were significantly associated with knowledge on prevention of pressure ulcer. While, satisfaction with nursing leadership [AOR = 1.9, 95 % CI (1.04-3.82)], staff shortage [AOR = 0.07, 95 % CI (0.03-0.13)] and inadequate facilities and equipment [AOR = 0.4, 95 % CI (0.19-0.83)] were found to be significantly associated with the practice on prevention of pressure ulcer.

Conclusion

Knowledge and practice of the nurses regarding prevention of pressure ulcer was found to be inadequate. Having higher educational status, attending formal training and being experienced were positively associated with knowledge; while shortage of facilities and equipments, dissatisfaction with nursing leadership and inadequate staff number showed negative association with practice of nurse’s pressure ulcer prevention. In-service training and upgrading courses are some of the important steps to improve nurses’ knowledge and practice on prevention of ulcer pressure.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-015-0076-8) contains supplementary material, which is available to authorized users.

Plan de Atención Integral de Enfermería para el Cuidado de Personas con Úlceras por Presión

<p class="normal"><strong>Antecedentes. </strong>Las Úlceras por Presión son un problema de salud pública que afecta al paciente, su familia y el sistema de salud; provocan sufrimiento afectando su calidad de vida. El tratamiento genera altos costos para la institución y aumenta la carga de trabajo en el equipo de salud. Las intervenciones de enfermería para planear el cuidado eficaz, oportuno e individualizado en personas con úlceras por presión, se basan en valoración integral de la persona, actividades de prevención, diagnóstico, tratamiento y rehabilitación con el uso de taxonomías NANDA-NIC-NOC, las cuales permiten responder cuestionamientos sobre la seguridad, eficiencia y costo-efectividad del cuidado de enfermería.</p><p class="normal"><strong>Objetivo.</strong> Proponer un plan de atención de enfermería integral para las personas con Úlceras por Presión.</p><p class="normal"><strong>Materiales y métodos.</strong> Revisión sistemática de literatura científica de los últimos 5 años en las bases de datos MEDLINE, CINAHL, LILACS, FECYT, EMBASE y SCIELO.</p><p class="normal"><strong>Resultados.</strong> Construcción de un plan de atención de enfermería flexible basado en evidencia científica, resultado de los hallazgos de la revisión sistemática, que oriente la toma de decisiones en el cuidado integral de las personas con Úlceras por Presión y contribuya a la calidad de los servicios de salud mejorando la Calidad de Vida relacionada con la Salud.</p><p class="normal"><strong>Conclusiones. </strong>Es preciso brindar un cuidado integral basado en evidencia científica conducente a establecer medidas preventivas que guíe la intervención de enfermería eficaz e individualizada garante de la limitación del daño y la rehabilitación oportuna de las personas con Úlceras por Presión, aportando al desarrollo y visibilidad disciplinar.</p><strong>Palabras Clave. </strong>Atención de Enfermería, Úlcera por Presión, Prevención y Control, Diagnóstico, Tratamiento (DeCS).

Pressure ulcer prevention knowledge among Jordanian nurses: a cross- sectional study

Background

Pressure ulcer remains a significant problem in the healthcare system. In addition to the suffering it causes patients, it bears a growing financial burden. Although pressure ulcer prevention and care have improved in recent years, pressure ulcer still exists and occurs in both hospital and community settings. In Jordan, there are a handful of studies on pressure ulcer. This study aims to explore levels of knowledge and knowledge sources about pressure ulcer prevention, as well as barriers to implementing pressure ulcer prevention guidelines among Jordanian nurses.

Methods

Using a cross-sectional study design and a self-administered questionnaire, data was collected from 194 baccalaureate and master’s level staff nurses working in eight Jordanian hospitals. From September to October of 2011, their knowledge levels about pressure ulcer prevention and the sources of this knowledge were assessed, along with the barriers which reduce successful pressure ulcer care and prevention.

ANOVA and t-test analysis were used to test the differences in nurses’ knowledge according to participants’ characteristics. Means, standard deviation, and frequencies were used to describe nurses’ knowledge levels, knowledge sources, and barriers to pressure ulcer prevention.

Results

The majority (73%, n = 141) of nurses had inadequate knowledge about pressure ulcer prevention. The mean scores of the test for all participants was 10.84 out of 26 (SD = 2.3, range = 5–17), with the lowest score in themes related to PU etiology, preventive measures to reduce amount of pressure/shear, and risk assessment. In-service training was the second source of education on pressure ulcer, coming after university training. Shortage of staff and lack of time were the most frequently cited barriers to carrying out pressure ulcer risk assessment, documentation, and prevention.

Conclusions

This study highlights concerns about Jordanian nurses’ knowledge of pressure ulcer prevention. The results of the current study showed inadequate knowledge among Jordanian nurses about pressure ulcer prevention based on National Pressure Ulcer Advisory Panel guidelines. Also, the low level of nurses’ pressure ulcer knowledge suggests poor dissemination of pressure ulcer knowledge in Jordan, a suggestion supported by the lack of relationship between years of experience and pressure ulcer knowledge.

Nurses' attitudes and perceived barriers to pressure ulcer prevention in Jordan

OBJECTIVE

To explore Jordanian nurses' attitudes toward pressure ulcer prevention and to identify their perceived barriers to care in pressure ulcer prevention.

METHOD

A cross-sectional multi-centre study was undertaken in four hospitals in Jordan. The registered nurses and nurse assistants working at these sites were requested to complete a self-administered questionnaire.

RESULTS

In total, 428 completed questionnaires were returned. The participant nurses hold positive attitudes regarding pressure ulcers prevention (mean=3.91). The only factor that seems to have an effect on the positive attitude was the experience of the participants (χ²[2, n=227]=6.38; [=0.041). The positive attitude was enhanced with increased number of years of experience. Several barriers to good practice were reported by the participants, including: lack of staff (86.2%), time (83.6%), and patient conditions (68.6%).

CONCLUSION

Findings of this study suggest that positive attitudes are not enough to change practice. Several barriers need to be resolved first if effective prevention is to be provided. This should form a reference dataset that needs to be addressed in the tissue viability field in Jordan, which is still in its infancy.

DECLARATION OF INTEREST

There were no external sources of funding for this study. The authors have no conflicts of interest to declare with regard to the article or its content.