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Lyu Y, Cui H, Liu Y, Lin F. Current perception and knowledge of preventing medical device related pressure injury among nursing staff in intensive care units: A national descriptive cross-sectional study. Intensive Crit Care Nurs 2024; 82:103656. [PMID: 38359599 DOI: 10.1016/j.iccn.2024.103656] [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: 10/11/2023] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Sufficient knowledge is crucial for nurses in intensive care unit to prevent medical device related pressure injuries. This study was aimed to explore the Chinese intensive care nurses' perceptions and knowledge of medical device related pressure injury prevention and identify associated factors. METHODS This descriptive cross-sectional study included a convenience sample of 1286 intensive care nurses recruited from professional networks across China. Participants completed the demographic data form and the adapted 23-item Medical device related pressure injury Knowledge Assessment Questionnaire (MKAQ) questionnaire. Multiple linear regression was used to determine the associated factors. RESULTS The medical device related pressure injury knowledge assessment questionnaire scores among intensive care nurses were relatively high, with a correct rate of 78.3 %. Multiple regression analysis revealed that management position (β = 0.131, P < 0.001) was the strongest associated factor of knowledge scores, followed by academic position (β = 0.114, P = 0.009) and received training on medical device related pressure injury (β = 0.112, P < 0.001). Hospital level (β = 0.087, P = 0.004) and sex (β = 0.068, P = 0.016) were also significant associated factors. Collectively, these five variables accounted for 18.2 % of the variance in knowledge scores. CONCLUSION Sufficient knowledge is a prerequisite for safe nursing practice. Although nurses demonstrated relatively high level of knowledge, it is essential for nursing managers to implement specific measures to enhance the knowledge among junior nursing staff, especially in non-tertiary hospitals, to promote medical device related pressure injury prevention in all intensive care settings. IMPLICATIONS FOR CLINICAL PRACTICE This study highlights the importance of sociodemographic and professional characteristics in promoting satisfactory perception and knowledge of preventing medical device related pressure injury among intensive care nurses. It is necessary for nurse managers and leaders to develop strategic interventions, along with targeted training programs and quality improvement plans that correspond to the actual training needs to improve the medical device related pressure injury prevention.
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Affiliation(s)
- Yang Lyu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Honghong Cui
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yan Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
| | - Frances Lin
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Adelaide, Australia; Caring Futures Institute, Flinders University, Bedford Park, Adelaide, Australia
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Jia L, Deng Y, Xu Y, Wu X, Liu D, Li M, Huang S, Zhang Y, Du A, Liu H, Tian Y. Development and validation of a nomogram for oral mucosal membrane pressure injuries in ICU patients: A prospective cohort study. J Clin Nurs 2024. [PMID: 38797947 DOI: 10.1111/jocn.17296] [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: 01/20/2024] [Revised: 04/12/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
AIMS Establishing a nomogram to estimate the probability of oral mucosal membrane pressure injury of endotracheal tube-intubated hospitalized patients in intensive care unit. DESIGN Multicentre prospective cohort study. METHODS Using Lasso regression and COX regression, variable selection was performed on demographic, clinical and laboratory data of 1037 ICU endotracheal tube-intubated hospitalized patients from West China Hospital, to construct a nomogram. External validation was conducted on 484 ICU endotracheal tube-intubated patients from People's Hospital of Zhongjiang County. RESULTS Among 38 potential predictors, five variables emerged as independent predictors, integrated into the nomogram: administration of antibiotics, nutritional therapy duration, agitation, hypotension and albumin levels. CONCLUSIONS We established a nomogram based on the hospital characteristics of ICU endotracheal tube-intubated patients, aiding in the prediction of the occurrence of oral mucosal membrane pressure injury. REPORTING METHOD The study followed TRIPOD guidelines. RELEVANCE TO CLINICAL PRACTICE The nomogram we developed can assist clinical worker in better identifying at-risk patients and risk factors. It enables the implementation of evidence-based nursing interventions in care to prevent the development of oral mucosal membrane pressure injury. TRIAL REGISTRATION The study has been registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn) under registration number ChiCTR2200056615.
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Affiliation(s)
- Lingli Jia
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuchun Deng
- Department of Critical Care Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan Province, China
| | - Yu Xu
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaoli Wu
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Dan Liu
- Department of Critical Care Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan Province, China
| | - Muying Li
- Department of Critical Care Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan Province, China
| | - Shijun Huang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yaodan Zhang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Aiping Du
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Huan Liu
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yongming Tian
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Özyürek P, Gürlek Kisacik Ö. Medical device-related pressure injuries prevention practices of intensive care unit nurses: A cross-sectional study in Turkey. J Tissue Viability 2024:S0965-206X(24)00038-X. [PMID: 38521682 DOI: 10.1016/j.jtv.2024.03.013] [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: 08/28/2023] [Revised: 01/29/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
AIM Medical device-related pressure injuries (MDRPIs) are becoming increasingly common across all healthcare services and age groups in terms of both incidence and severity. It is crucial for nurses to be aware that MDRPI is a potential complication of healthcare services. This study aimed to assess the preventive practices of intensive care unit (ICU) nurses in relation to MDRPIs. MATERIALS AND METHODS This cross-sectional and descriptive study was conducted with 96 nurses between March 10 and April 31, 2021. The "Nurse Information Form" and the "MDRPIs Prevention Practices Questionnaire" form were used for the data collection. RESULTS The overall practice scores of ICU nurses in preventing MDRPIs were 50.83 ± 12.93. Out of the participants, 57.3% (n = 55) achieved a total practice score of 51 and above out of 68 (considered an acceptable score indicating proficiency in positive practice). The items with the most negative practice levels among nurses were related to statements such as 'I apply hydrocolloid, thin foam, or a silicone-type dressing to prevent MDPRI' (2.86 ± 0.85) and 'I use the normal pressure injury staging when staging the MDRPI' (2.88 ± 0.86). No significant difference was observed between the mean scores of MDRPI prevention practices and the characteristics of ICU nurses, such as education level, years working in the unit, and years of experience in the profession (p > 0.05). Furthermore, a positive correlation was found between age and practice levels in preventing MDRPIs (p < 0.05). CONCLUSION The study results indicate that the practice levels of ICU nurses in preventing MDRPIs were insufficient. We believe that regular in-service training programs, grounded in clinical practice, are necessary to enhance nurses' awareness and management of MDRPIs.
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Affiliation(s)
- Pakize Özyürek
- Afyonkarahisar Health Science University, Faculty of Health Science, Surgical Nursing Department, 03200, Afyonkarahisar, Turkey.
| | - Öznur Gürlek Kisacik
- Afyonkarahisar Health Science University, Faculty of Health Science, Fundamentals of Nursing Department, 03200, Afyonkarahisar, Turkey
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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: 2] [Impact Index Per Article: 2.0] [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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Şimşek E, Demir AS, Semerci R, Karadağ A. The incidence and prevalence of medical device-related pressure injuries in pediatric patients: Systematic review and meta-analysis. J Pediatr Nurs 2023; 72:e130-e138. [PMID: 37344345 DOI: 10.1016/j.pedn.2023.06.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
PROBLEM To determine the pooled incidence and prevalence rate of medical device-related pressure injuries(MDRPIs) using the Braden QD scale, medical devices that frequently cause MDRPIs, and anatomical locations that are vulnerable to them. ELIGIBILITY CRITERIA Using the Braden QD scale, being published in English between 01/01/2018-and 01/03/2023. METHODS This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations and registered in the International Prospective Register of Systematic Reviews database (No: CRD42021276501). SAMPLE A total of 7 studies with 25,742 pediatric patients were included. RESULTS The pooled prevalence and cumulative incidence of hospital-acquired pressure injuries(HAPIs) were 7.8% (95% CI: 5.2-11.4%) and 3.9% (95% CI: 0.5-24.6%) respectively, and the incidence rate was 8.2/1000 person-days (95% CI: 2.4-14.2/1000 person-days). The pooled prevalence and cumulative incidence of MDRPIs were 7% (95% CI: 5.5-8.8%) and 5% (95% CI: 3.2-7.8%) respectively, and the incidence rate was 6.7/1000 person-days (95% CI, 0.11-13.4/1000 person-days). The most affected anatomical locations were the face (29.1%), ankle/foot (20.1%), and head (15.7%). Medical devices that frequently caused MDRPIs were external monitoring devices (24.5%), respiratory devices (22.8%), and supportive/securing devices (14.9%). CONCLUSIONS According to the current systematic review and meta-analyses, the incidence and prevalence of HAPIs and MDRPIs are moderate to high. IMPLICATIONS The findings suggested that healthcare providers should pay more attention to reducing HAPIs and MDRPIs and future studies should be conducted to understand their characteristics and risk factors.
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Affiliation(s)
- Enes Şimşek
- Koç University, School of Nursing, Department of Child Health and Disease Nursing, Istanbul, Turkey.
| | - Ayşe Sılanur Demir
- Koç University, School of Nursing, Department of Fundamentals of Nursing, Istanbul, Turkey
| | - Remziye Semerci
- Koç University, School of Nursing, Department of Child Health and Disease Nursing, Istanbul, Turkey
| | - Ayişe Karadağ
- Koç University, School of Nursing, Department of Fundamentals of Nursing, Istanbul, Turkey
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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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Luo Z, Liu S, Yang L, Zhong S, Bai L. Ambulance referral of more than 2 hours could result in a high prevalence of medical-device-related pressure injuries (MDRPIs) with characteristics different from some inpatient settings: a descriptive observational study. BMC Emerg Med 2023; 23:44. [PMID: 37098503 PMCID: PMC10127406 DOI: 10.1186/s12873-023-00815-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/19/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer. METHOD A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers. RESULTS One hundred one referrals were eventually included. The mean age of participants was (58.3 ± 11.69) years, predominantly male (67.32%, n = 68), with a mean BMI of 22.48 ± 2.2. The mean referral time among participants was 2.26 ± 0.26 h, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n = 54) of participants were conscious, 73.26% (n = 74) were in the supine position, 23.76% (n = 24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n = 6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n = 4), followed by the heel (30%, n = 3) and nose bridge (20%, n = 2) caused by the respiratory devices and spinal board. CONCLUSION MDRPIs are more prevalent during long ambulance referrals than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.
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Affiliation(s)
- Zhenyu Luo
- Guanyuan Central Hospital, Guanyuan, Sichuan, China.
| | - Sihui Liu
- The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Linhe Yang
- Guanyuan Central Hospital, Guanyuan, Sichuan, China
| | - Shuyan Zhong
- Guanyuan Central Hospital, Guanyuan, Sichuan, China
| | - Lihua Bai
- Guanyuan Central Hospital, Guanyuan, Sichuan, China
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Li Z, Marshall AP, Lin F, Ding Y, Chaboyer W. Registered nurses' approach to pressure injury prevention: A descriptive qualitative study. J Adv Nurs 2022; 78:2575-2585. [PMID: 35307866 PMCID: PMC9545357 DOI: 10.1111/jan.15218] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/20/2022] [Accepted: 02/13/2022] [Indexed: 02/02/2023]
Abstract
AIMS To explore Registered Nurses' approaches to pressure injury prevention, including how they perceive their roles, how they prioritize pressure injury prevention and factors influencing prevention in the Chinese context. DESIGN A qualitative descriptive study. METHODS Audio-recorded, face-to-face, semi-structured individual interviews were conducted with Registered Nurses in a large tertiary hospital in China from August to December 2020. Using the System Engineering Initiative for Patient Safety Model, the interview guide was developed to describe the work system, processes and outcomes (three domains) associated with nurses' pressure injury prevention practices. Deductive and inductive content analyses were used. FINDINGS Twenty-seven nurses participated in the interviews. Four themes related to two domains of the model emerged: Work system: (i) Nurses lead and coordinate pressure injury prevention; Work processes: (ii) Individualized pressure injury prevention is founded on comprehensive patient assessment; (iii) Collaborating ensures patients receive appropriate pressure injury prevention; and (iv) Competing factors influence the delivery of appropriate pressure injury prevention. One category emerged about work outcome: Nurses strive to do their best in pressure injury prevention but hold major concerns when pressure injuries occur. CONCLUSIONS Nurses play a leading role in pressure injury prevention delivery but require appropriate resources and assistance and support from other healthcare personnel, patients and carers. Understaffing, lack of resources, complex reporting and poor patient compliance challenge nurses in their delivery of pressure injury prevention. IMPACT Pressure injury prevention is primarily a nursing responsibility therefore nurses' approaches to prevention were explored. Nurses rely on collaboration with others and access to various resources to provide pressure injury prevention. They recognize the patients' and carers' roles and acknowledge the importance of accessing guidance and support from nursing leaders and wound experts. Acknowledging nurses leading role in prevention and ensuring they have adequate resources are important for quality care.
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Affiliation(s)
- Zhaoyu Li
- School of Nursing and Midwifery, Menzies Health Institute QueenslandGriffith UniversityGriffithQueenslandAustralia
| | - Andrea P. Marshall
- School of Nursing and Midwifery, Menzies Health Institute QueenslandGriffith UniversityGriffithQueenslandAustralia,Nursing and Midwifery Education and Research Unit, Gold Coast HealthGold Coast University HospitalGold CoastQueenslandAustralia
| | - Frances Lin
- School of Nursing and Midwifery, Menzies Health Institute QueenslandGriffith UniversityGriffithQueenslandAustralia,School of Nursing, Midwifery and ParamedicineUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Yanming Ding
- Nursing DepartmentPeking University First HospitalBeijingChina
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute QueenslandGriffith UniversityGriffithQueenslandAustralia
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Crunden EA, Worsley PR, Coleman SB, Schoonhoven L. Barriers and facilitators to reporting medical device-related pressure ulcers: A qualitative exploration of international practice. Int J Nurs Stud 2022; 135:104326. [DOI: 10.1016/j.ijnurstu.2022.104326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/13/2022] [Accepted: 07/11/2022] [Indexed: 10/31/2022]
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Ünver S, Yildirim M, Cansu Yeni̇ğün S. Personal protective equipment related skin changes among nurses working in pandemic intensive care unit: A qualitative study. J Tissue Viability 2022; 31:221-230. [PMID: 35094886 PMCID: PMC8785367 DOI: 10.1016/j.jtv.2022.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/25/2021] [Accepted: 01/20/2022] [Indexed: 01/17/2023]
Abstract
AIM The respiratory tract is the main transmission way of the SARS-CoV-2 virus and nurses who care for COVID-19 patients in intensive care units (ICUs) are required to constantly use personal protective equipment (PPE) during their daily work. This study aimed to examine the PPE-related skin changes experienced by the nurses working in pandemic ICU during the COVID-19 pandemic. METHODS Using a descriptive phenomenological approach, semi-structured interviews were conducted between November 1st and December 25th, 2020, in the pandemic ICU of a training and research hospital in Usak, Turkey. The nurses who worked in the pandemic ICU for at least one week and experienced skin changes due to PPE use were included. Individual interviews were carried out online through video conferencing. Colaizzi's method was used in data analysis by using the ATLAS.ti 8.0. RESULTS The main themes were main causes of PPE-related skin changes, its location along with secondary adverse effects, symptomatology, prevention, and therapeutic interventions used for curing PPE-related skin changes. Nurses mostly reported PPE-related skin changes behind their ears, over their nose, cheeks and jaw due to wearing N95 masks and on the forehead due to wearing face shields. Wearing PPE at least 2 h, the type/quality of PPE, and being dehydrated were identified as the common causes. CONCLUSION This study provides a deeper understanding into the PPE-related skin change experiences of pandemic ICU nurses and the importance of the quality of the PPE used. It is recommended to enable shortened working shifts and ergonomic PPE materials for ICU nurses.
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Affiliation(s)
- Seher Ünver
- Trakya University, Faculty of Health Sciences, Department of Surgical Nursing, Edirne, Turkey,Corresponding author. Trakya University, Balkan Campus, Faculty of Health Sciences, Department of Surgical Nursing, 22020, Edirne, Turkey
| | - Meltem Yildirim
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Science and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Seda Cansu Yeni̇ğün
- Akdeniz University, Kumluca Faculty of Health Sciences, Department of Surgical Nursing, Antalya, Turkey
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Sönmez M, Bahar A. Medical device-related pressure injuries: Knowledge levels of nurses and factors affecting these. J Tissue Viability 2022; 31:231-238. [DOI: 10.1016/j.jtv.2022.01.006] [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: 01/16/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
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Cao S, Gu M, Feng M, Jia Y, Zhao Y, Chen S, Zhu L, Bo S, Zhao Q. Implementation of evidence in preventing medical device-related pressure injury in ICU patients using the i-PARIHS framework. J Nurs Manag 2022; 30:318-327. [PMID: 34448285 DOI: 10.1111/jonm.13458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 02/03/2023]
Abstract
AIM To examine the effectiveness of implementing the evidence in preventing medical device-related pressure injury (MDRPI) in intensive care patients. BACKGROUND MDRPI is a common problem that significantly complicates patients' medical condition. However, evidence in preventing MDRPI is not properly implemented in clinical practice. METHODS A pre- and post-implementation study was conducted using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. A baseline survey was implemented; barriers and enablers of evidence implementation were analysed to inform facilitation support strategies, such as training nursing staff and developing resources and tools. Changes in nurses, patients and the system were assessed after evidence implementation. RESULTS Nurses' knowledge scores and evidence compliance significantly improved. The incidence of MDRPI in patients decreased from 24.39% to 4.26%. Standardized care and workflows to prevent MDRPI were established. CONCLUSION The i-PARIHS framework supported effective implementation of the evidence in preventing MDRPI, narrowing the gap between evidence and clinical practice. IMPLICATIONS FOR NURSING MANAGEMENT We provide an effective case of transforming evidence into practice based on the i-PARIHS framework. It can be used as a reference for colleagues in intensive care unit (ICU) or other settings to implement MDRPI prevention.
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Affiliation(s)
- Songmei Cao
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China.,School of Nursing, Chongqing Medical University, Chongqing, China
| | - Mengqian Gu
- Medical College, Jiangsu University, Zhenjiang, China.,Department of Intensive Care Unit, Changshu NO.1 People's Hospital, Jiangsu, China
| | - Man Feng
- Medical College, Jiangsu University, Zhenjiang, China
| | - Yingying Jia
- Medical College, Jiangsu University, Zhenjiang, China
| | - Yanyan Zhao
- Department of ICU, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Shengzhi Chen
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Liqun Zhu
- Department of Nursing, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Suping Bo
- Wound Care Center, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Sianes-Gallén M, Pujol-García AM, Rus García M, Partera Luque C, López Postigo M, Call Mañosa S, Camposo Montesino MC, Ibáñez Touriño B, Ribas Obon E, Segura Rodríguez T, Cores Fuentes P, Tamame Sanantonio M, Jornet-Gibert M. Pressure injuries during the SARS-CoV-2 pandemic: A retrospective, case-control study. J Tissue Viability 2021; 30:478-483. [PMID: 34389188 PMCID: PMC8328527 DOI: 10.1016/j.jtv.2021.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/22/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023]
Abstract
AIM OF STUDY The main objective of this study was to ascertain whether severe alterations in hypoxemic, inflammatory, and nutritional parameters in patients diagnosed with SARS-CoV-2 infection were associated with the occurrence and severity of developed dependency-related injuries. The secondary objective was to determine whether there were prognostic factors associated with the occurrence and severity of developed dependency-related injuries during the SARS-CoV-2 pandemic. MATERIAL AND METHODS A retrospective, single-centre, case-control study was conducted to compare SARS-CoV-2 patients who developed dependency-related injuries after the first 48 h after admission with a control group made up of SARS-CoV-2 patients without dependency-related injuries. The cases of the 1987 patients diagnosed with SARS-CoV-2 infection during the study period were reviewed. Data from 94 patients who developed dependency-related injuries and from 190 patients who did not develop them during hospital admission were analysed. RESULTS High baseline dependency levels, prolonged hospital stays, and low oxygen saturation levels on arrival in emergency department triage were associated with the occurrence of dependency-related injuries among patients diagnosed with SARS-CoV-2 infection. CONCLUSIONS SARS-CoV-2 infection can lead to complications such as dependency-related injuries. Although there are several non-modifiable variables associated with the occurrence of dependency-related injuries in these patients, it is essential to conduct further research and introduce consensus guidelines to reduce their incidence and prevalence.
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Affiliation(s)
- Mònica Sianes-Gallén
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Anna María Pujol-García
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montserrat Rus García
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Carmen Partera Luque
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montserrat López Postigo
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Silvia Call Mañosa
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - María Carmen Camposo Montesino
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Belén Ibáñez Touriño
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Eulalia Ribas Obon
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Tania Segura Rodríguez
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Pilar Cores Fuentes
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Marta Tamame Sanantonio
- Nurses Unit, Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Montsant Jornet-Gibert
- Parc Taulí Hospital Universitari, Institut D'Investigació I Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
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14
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Galetto SGDS, Nascimento ERPD, Hermida PMV, Busanello J, Malfussi LBHD, Lazzari DD. Medical device-related pressure injury prevention in critically ill patients: nursing care. Rev Bras Enferm 2021; 74:e20200062. [PMID: 33950113 DOI: 10.1590/0034-7167-2020-0062] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 10/03/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients. METHODS this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used. RESULTS six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible. FINAL CONSIDERATIONS nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.
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