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Muhammad D, Darain K, Farhan M, Khan MA, Ahmad H, Khan MM, Ullah Z, Ullah S, Salam A, Ullah S, Khan J, Zarin M. Prevalence and Risk Factors of Pressure Ulcers in Bedbound Diabetic vs. Non-diabetic Patients in a Lower-Middle-Income Country. Cureus 2024; 16:e61861. [PMID: 38975559 PMCID: PMC11227621 DOI: 10.7759/cureus.61861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Pressure ulcers, also known as bedsores, are a significant concern for bedridden individuals, presenting both physical and socioeconomic challenges. Factors such as prolonged immobility, chronic medical conditions, and poor nutrition contribute to their development. Despite extensive research in some regions, studies comparing diabetic and non-diabetic populations remain limited, particularly in low-income settings. This study aimed to investigate the risk factors and frequency of pressure ulcers among bedridden patients, addressing this gap in understanding and guiding targeted interventions. Materials and methods A cross-sectional study was conducted across four government hospitals in Peshawar, Pakistan. A total of 388 bedridden patients with pressure ulcers were included, and data were collected through a questionnaire. The questionnaire covered demographics, comorbidities, duration of bedbound status, BMI, and caregivers' awareness of pressure ulcer care. Data analysis was performed using SPSS version 22.0 (Armonk, NY: IBM Corp.), with qualitative data presented as frequencies and percentages and quantitative data as mean and standard deviation. Chi-square tests were utilized for significance, with p<0.05 considered significant. Results Of the 388 patients analyzed, 230 (59.3%) were diabetic, highlighting the prevalence of diabetes among pressure ulcer cases. The majority of diabetic patients with ulcers were over 41 years old, and 293 (75.5%) had comorbidities. Surgical intervention was the primary cause of ulcers in 213 (54.8%) cases, followed by stroke in 77 (19.8%) cases. Notably, 252 (65%) of caregivers exhibited inadequate knowledge regarding ulcer care. Stage II ulcers were prevalent in both diabetic and non-diabetic cohorts. Conclusions Pressure ulcers are poorly controlled complications observed in bedridden individuals, highlighting a critical need for comprehensive preventive measures and caregiver education to alleviate the burden of pressure ulcers, especially in diabetic patients. Factors such as prolonged immobility, surgical interventions, and insufficient caregiver knowledge contribute to the development of pressure ulcers. Understanding these complexities is essential for implementing effective care approaches and mitigating the impact of pressure ulcers.
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Affiliation(s)
- Diyan Muhammad
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
| | - Khola Darain
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
| | | | | | - Hussain Ahmad
- Oncology, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | | | - Zia Ullah
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
| | - Sibghat Ullah
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
| | - Abdus Salam
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
| | - Shakir Ullah
- General Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Junaid Khan
- Orthopedics, Khyber Teaching Hospital, Peshawar, PAK
| | - Muhammad Zarin
- General Surgery, Khyber Teaching Hospital, Peshawar, PAK
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Qian L, Yan S, Ting ST, Han ZM, Qi T. Complications and psychological impact of pressure ulcers on patients and caregivers. Int Wound J 2024; 21:e14836. [PMID: 38531386 DOI: 10.1111/iwj.14836] [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: 02/04/2024] [Revised: 02/18/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Pressure ulcers are persistent skin lesions that have substantial detrimental effects on the physical well-being of patients. Moreover, their psychological ramifications for both patients and their caregivers are becoming more widely acknowledged. This research was conducted to examine the psychological ramifications of pressure ulcers and ascertain efficacious approaches to mitigate these effects and improve overall well-being. A cross-sectional study was conducted from March 2022 to December 2023 across tertiary care centres located in Beijing. The cohort consisted of 431 participants, which included primary caregivers and patients who were diagnosed with pressure ulcers. The data were gathered through the utilization of structured questionnaires and semi-structured interviews. These methods encompassed demographic details, clinical characteristics and validated scales that assessed psychological parameters, including quality of life, anxiety, stress and depression. The research exposed substantial psychological toll on both individuals receiving care and those providing care, with caregivers enduring diminished quality of life and elevated levels of anxiety, depression and stress (p < 0.05). A significant positive correlation was identified between the degree of psychological distress and severity of pressure ulcers (p < 0.05). Both location of the ulcer and duration of care were substantial contributors to the psychological burden (p < 0.05). In spite of the apparent necessity, a significant proportion of the participants refrained from obtaining psychological counselling. The results underscored the significant psychological ramifications of pressure ulcers for both individuals receiving care and the caregivers. As a result, comprehensive care strategies that incorporate psychological assistance into the prescribed treatment plan are imperative. This research highlighted the criticality of implementing all-encompassing, interdisciplinary approaches to tackle the complex issues presented by pressure ulcers in an effort to enhance the general welfare of those influences.
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Affiliation(s)
- Li Qian
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Song Yan
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Shen Ting Ting
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Zhang Meng Han
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Tian Qi
- Nursing, Chinese PLA General Hospital, Beijing, China
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Digesa LE, Baru A, Shanko A, Kassa M, Aschalew Z, Moga F, Beyene B, Mulatu T. Incidence and Predictors of Pressure Ulcers among Adult Patients in Intensive Care Units at Arba Minch and Jinka Hospitals, Southern Ethiopia. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9361075. [PMID: 37096223 PMCID: PMC10122574 DOI: 10.1155/2023/9361075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/26/2023]
Abstract
Introduction The incidence of a pressure ulcer in intensive care units (ICU) is significantly higher than in noncritical care settings. The patients in the ICU are the most vulnerable group to disruption of the skin's integrity. Prior studies in Ethiopia failed to evaluate pressure ulcers in intensive care units and were limited to general wards. The purpose of this study was to identify the incidence and predictors of pressure ulcers in adult patients admitted to intensive care units in Southern Ethiopia. Methods A single-arm prospective open cohort of 216 patients was used to determine the presence of a pressure ulcer in the intensive care units from June 2021 to April 2022. A consecutive sampling was used until the sample size was reached. The data were collected using a structured questionnaire and analyzed using Stata 14. A cumulative incidence of a pressure ulcer was computed. The life table was used to estimate the cumulative survival. A multivariable Cox proportional hazard regression was used to identify independent predictors of a pressure ulcer. An adjusted hazard ratio with a 95% CI was used to measure the degree of association; a P value ≤ 0.05 was considered significant. Results Twenty-five patients developed a pressure ulcer (PU), making a cumulative incidence of 11.57%. Out of 25 incident cases of pressure ulcers, four-fifths (80%) of the study patients developed PU within 6 days of their admission to the ICUs. The incidence rate was 32.98 PU per 1000 person-days of ICU stay. Pressure ulcers were most commonly found on the sacrum, followed by the shoulder. Among the incident cases, 52% were stage 2 ulcers. The presence of friction or shearing forces, as well as being 40 years of age or older, was independently associated with pressure ulcers. Conclusion The overall cumulative incidence of the pressure ulcer was lower than that in other studies but occurred at a faster rate. Age (40 years of age or older) and the presence of friction or shearing forces were the main predictors of pressure ulcers in the intensive care units. Therefore, nurses working in ICUs should continually anticipate the risk of a pressure ulcer. Moreover, special attention should be given to patients of advanced ages. Furthermore, monitoring the installation of a mattress, keeping bed linens unwrinkled, and keeping patients in a proper position on a bed to prevent or reduce friction or shearing forces are very crucial in the prevention of pressure ulcers.
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Affiliation(s)
- Lankamo Ena Digesa
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Ararso Baru
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Alemayehu Shanko
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Mekidim Kassa
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Zeleke Aschalew
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Fikre Moga
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Bereket Beyene
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
| | - Tegegn Mulatu
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Ethiopia
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Monaco D, Zaghini F, Fiorini J, Venturini G, Iovino P, Vellone E, Alvaro R, Sili A. Effect of a wound healing protocol on patients with stage III and IV pressure ulcers: a preliminary observational study. J Wound Care 2022; 31:322-328. [DOI: 10.12968/jowc.2022.31.4.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To evaluate the influence of a wound healing protocol for stage III and IV pressure ulcers (PUs), and to determine the predictive power of specific sociodemographic and clinical characteristics on wound healing and infection. Method: This longitudinal study included participants with stage III and IV PUs who were recruited from 10 acute care settings of an Italian university hospital, and who were managed with a protocol inspired by the TIMECare model. Data were collected between October 2018 and March 2019. The National Pressure Ulcer Advisory Panel Staging System was used to stage the PUs. Wound healing was assessed with the Pressure Ulcer Scale for Healing (PUSH). Nutritional status was assessed with the Mini Nutritional Assessment Index. Data collection took place at admission and every seven days thereafter—a total of six times before discharge. The outcome and predictors of wound healing were assessed with Student's paired t-tests and multiple linear regressions, respectively. Results: Patients (n=126) were almost equally split between male and female, with a mean age of 78.17 years and who were all retired. Stage III and IV PUs were most prevalent at the sacrum (65.5% and 73.2%, respectively). PUSH wound healing scores improved significantly after six weeks in both stage III and IV PUs (p<0.001). Nutritional status was predictive of wound healing (R2=0.12). Conclusion: Our results showed that a good nutritional status and a protocol inspired by the TIMECare model were associated with wound healing improvements in stage III and IV PUs. We recommend this protocol in older patients with stage III and IV PUs.
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Affiliation(s)
- Dario Monaco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Jacopo Fiorini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Australian Catholic University, Melbourne, Australia
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Sili
- Nursing Department, Tor Vergata University Hospital, Rome, Italy
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Awoke N, Tekalign T, Arba A, Lenjebo TL. Pressure injury prevention practice and associated factors among nurses at Wolaita Sodo University Teaching and Referral Hospital, South Ethiopia: a cross-sectional study. BMJ Open 2022; 12:e047687. [PMID: 35288379 PMCID: PMC8921857 DOI: 10.1136/bmjopen-2020-047687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
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.
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Affiliation(s)
- Nefsu Awoke
- School of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Aseb Arba
- School of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Monaco D, Iovino P, Lommi M, Marano G, Zaghini F, Vellone E, Alvaro R, Sili A. Outcomes of wound care nurses' practice in patients with pressure ulcers: An integrative review. J Clin Nurs 2020; 30:372-384. [PMID: 33270322 DOI: 10.1111/jocn.15583] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Wound care nurses are recognised as a key element for improving health outcomes. However, there is still fragmented knowledge of the outcomes associated with their practice in individuals with pressure ulcers. AIMS AND OBJECTIVES To identify, summarise and map all available evidence related to the outcomes of wound care nurses' practice in individuals with pressure ulcers. DESIGN Integrative literature review. REVIEW METHOD To report the review, we followed the modified version of Cooper's five-step methodology, and the PRISMA guidelines. METHODS The search was carried out on CINAHL, PubMed, the Cochrane Library and Scopus, with a time frame ranging from each database inception to December 21, 2019. We included observational or experimental studies of adult individuals affected by (or at risk of) developing pressure ulcers who were also cared for by wound care nurses. RESULTS Of the 439 peer-reviewed publications, 13 studies met the inclusion criteria. The most frequent outcomes were pressure ulcer incidence, healing rate and time taken for complete healing. Less frequent outcomes were changes in pressure ulcers' stage, number of completely healed wounds, treatment costs and physical discomfort. No patient-reported outcomes were assessed. CONCLUSION This review indicates that clinical-related outcomes were by far the most reported. Future studies should broaden the spectrum of outcomes to include more subjective parameters (e.g. pain, quality of life, stress, etc.), in order to gain a better understanding of the global impact of wound care practice on patients with pressure ulcers. RELEVANCE TO CLINICAL PRACTICE There is promising evidence of a positive impact of wound care nurses' practice on health and economic outcomes. Nonetheless, more robust and rigorous research is needed to provide stronger evidence in the field and support investment in these practitioners.
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Affiliation(s)
- Dario Monaco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing Midwifery and Paramedicin Australian Catholic University, Melbourne, Australia
| | | | | | - Francesco Zaghini
- Nursing Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Sili
- Nursing Department, Tor Vergata University Hospital, Rome, Italy
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Shiferaw WS, Aynalem YA, Akalu TY. Prevalence of pressure ulcers among hospitalized adult patients in Ethiopia: a systematic review and meta-analysis. BMC DERMATOLOGY 2020; 20:15. [PMID: 33160351 PMCID: PMC7649003 DOI: 10.1186/s12895-020-00112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/30/2020] [Indexed: 12/02/2022]
Abstract
Background Globally, PUs are recognized as one of the five most frequent causes of harm to clients. With millions affected globally, the national pooled prevalence of pressure ulcers in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to determine the prevalence of pressure ulcers among hospitalized clients in Ethiopia. Methods Studies were retrieved through search engines in PubMed, Scopus, WHO Afro Library, Google Scholar, Africa Journals Online, and Web of Science. Heterogeneity between-studies were checked using the I2 test. A funnel plot and Egger’s regression test was used to assess the presence of publication bias. The random-effect model was fitted to estimate summary effects and 95% confidence intervals (CIs) across studies. The analyses were performed using STATA™ Version 14 software. Results The pooled prevalence of pressure ulcer in Ethiopia was assessed using seven studies involving a total of 1881 participants. The pooled prevalence of pressure ulcers in Ethiopia was 11.7% (95% CI: 7.28, 16.13). The subgroup analysis showed that the estimated magnitude of pressure ulcers was 15.89% (95% CI: 13.32, 18.46); among studies, their sample size was greater than or equal to 250. Conclusion The current review reported that the pooled prevalence of pressure ulcers in Ethiopia was relatively high. Hence, policymaker and healthcare providers should give attention to reduce the magnitude of pressure ulcers. Furthermore, further a meta-analysis study could be conducted to identify individual and health care service-related factors related to the occurrence of pressure ulcers.
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Affiliation(s)
| | - Yared Asmare Aynalem
- Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Anthony D, Alosaimi D, Shiferaw WS, Korsah K, Safari R. Prevalence of pressure ulcers in africa: A systematic review and meta-analysis. J Tissue Viability 2020; 30:137-145. [PMID: 33129668 DOI: 10.1016/j.jtv.2020.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/10/2020] [Accepted: 10/23/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND A recent global review of pressure ulcers contained no studies from Africa. OBJECTIVE To identify the prevalence and incidence of pressure ulcers in Africa. DATA SOURCES Bibliographic databases, African specific databases, grey literature. STUDY ELIGIBILITY CRITERIA Studies with prevalence or incidence data of pressure ulcers from Africa since the year 2000. PARTICIPANTS Any age, including children, in any setting, specifically including hospital patients from any clinical area but not restricted to hospital settings. STUDY APPRAISAL AND SYNTHESIS METHODS Hoy score for bias, Joanna Briggs Institute Critical Appraisal Instrument. METHOD We followed the PRISMA guideline for systematic reviews. We searched Embase, Medline, Scopus, CINHAL, Google Scholar, specialist African databases and grey literature for studies reporting incidence or prevalence data. RESULTS Nineteen studies met the inclusion criteria and were included in the study. Point prevalence rates varied from 3.4% to 18.6% for medical/surgical and other general hospital units with a pooled prevalence of 11%, for grades II-IV 5%. For spinal injury units the pooled prevalence was 44%. LIMITATIONS restricted to English, French and Arabic. CONCLUSION Prevalence of pressure ulcers in Africa reported here is similar to figures from a recent review of prevalence in Europe and two recent global reviews of hospitalised patients. Prevalence of pressure ulcers in spinal cord injury patients is similar to figures from a review of developing countries. The reporting of prevalence is lacking in detail in some studies. Studies using an observational design employing physical examination of patients showed higher prevalence than those relying on other methods such as medical notes or databases. IMPLICATIONS OF KEY FINDINGS Further prevalence and incidence studies are needed in Africa. Reporting of such studies should ensure items in the "Checklist for Prevalence Studies" from Joanna Briggs Institute (or similar well regarded resources) are addressed and the PICOS model and PRISMA guidelines are employed. SYSTEMATIC REVIEW REGISTRATION NUMBER Prospero registration number CRD42020180093.
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Affiliation(s)
- Denis Anthony
- Health and Social Care Research Centre, University of Derby, UK.
| | | | | | - Kwadwo Korsah
- School of Nursing and Midwifery, University of Ghana, Ghana.
| | - Reza Safari
- Health and Social Care Research Centre, University of Derby, UK.
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Muhammed EM, Bifftu BB, Temachu YZ, Walle TA. Nurses' knowledge of pressure ulcer and its associated factors at Hawassa University comprehensive specialized hospital Hawassa, Ethiopia, 2018. BMC Nurs 2020; 19:51. [PMID: 32549784 PMCID: PMC7296692 DOI: 10.1186/s12912-020-00446-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 06/08/2020] [Indexed: 12/03/2022] Open
Abstract
Background Pressure ulcer is largely avoidable, but its prevalence rate increased more than 80% in a 13 years study. Nurses have a great position to advance best practices towards the prevention of pressure ulcers. Therefore they should be knowledgeable of the signs and symptoms of pressure ulcers, and preventive strategies to reduce its incidence, but there is limited evidence on nurses’ knowledge and its associated factors to prevent pressure ulcers in Ethiopia. Methods A hospital-based cross-sectional study was conducted from March 25 – April 23/ 2018. A total of 356 nurses were selected by stratification with a simple random sampling technique. Pretested structured questionnaire with closed and open-ended questions was used to collect data. Frequency distribution and percentage were computed to describe each variable. Bivariate and multivariable logistic regression with a 95% confidence interval was also carried out to see the effect of each independent variable on the dependent variable and declared statistically significant association with P < 0.05. Result The mean knowledge score of nurses was 25.22 out of 41 item questions. Fifty-two point 5 % of nurses score above the mean. Males [AOR = 0.44, 95% CI (0.26–0.73)], working a maximum of eight hours [AOR = 3.57, 95% CI (1.48–8.61), not having training [(AOR = 2.31, 95% CI (1.14–4.61)], Low salary [AOR = 3.47, 95% CI (1.03–11.67)] were significantly associated with inadequate knowledge. Conclusion Generally a nurse’s knowledge of pressure ulcers was inadequate. Being female, working less than or equal to eight hours, not having the training and low working salary are contributors to a low level of knowledge for pressure ulcers.
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Ebi WE, Hirko GF, Mijena DA. Nurses' knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design. BMC Nurs 2019; 18:20. [PMID: 31139012 PMCID: PMC6528293 DOI: 10.1186/s12912-019-0346-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background Pressure ulcer is a preventable medical complication of immobility. It has psychological, economic and social impact on individual and family. Its cost of treatment is more than twice of cost of prevention. It is primarily the nurses’ responsibility to prevent pressure ulcer. The aim of this study was to assess the nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega. Methods A descriptive multicenter cross-sectional study design using quantitative method was employed to collect data from 212 randomly selected nurses. Data was collected using structured two validated self-administered instruments of pressure ulcer knowledge test evaluate nurses’ knowledge. Mean scores were compared using the Mann-Whitney U and Kruskal-Wallis tests. Means, standard deviation, and frequencies were used to describe nurses’ knowledge levels and barriers to pressure ulcer prevention. Results Analysis of the study displayed 91.5% had inadequate knowledge to pressure ulcer prevention. The mean of nurses’ knowledge in all theme and per item were 11.31 (SD = 5.97) and 0.43 (SD = 0.22).respectively. The study participants had the highest mean item score (2.65 ± 0.87) in nutrition theme, whereas, scored lowest on etiology and development (0.27 ± 0.18) and preventive measures to reduce duration of pressure (0.29 ± 0.18), The study also identified significant nurses read articles (0.000) and received training (p = 0.003). Shortage of pressure relieving devices, lack of staff and lack of training were the most commonly cited perceived barriers to practice pressure ulcer prevention. Conclusions This study highlights areas where measures can be made to facilitate pressure ulcer prevention in public hospitals in Wollega zones, such as increase regular adequate further training of nurses regarding pressure ulcer/its prevention points. Electronic supplementary material The online version of this article (10.1186/s12912-019-0346-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Werku Etafa Ebi
- 1Department of Nursing, Institute of Health Science, Wollega University, P.O. Box 395, Nekemte, Ethiopia
| | - Getahun Fetensa Hirko
- 1Department of Nursing, Institute of Health Science, Wollega University, P.O. Box 395, Nekemte, Ethiopia
| | - Diriba Ayala Mijena
- 2Department of Midwifery, Institute of Health Science, Wollega University, P.O. Box 395, Nekemte, Ethiopia
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Bereded DT, Salih MH, Abebe AE. Prevalence and risk factors of pressure ulcer in hospitalized adult patients; a single center study from Ethiopia. BMC Res Notes 2018; 11:847. [PMID: 30497485 PMCID: PMC6267874 DOI: 10.1186/s13104-018-3948-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The main objective of this study was to assess the prevalence of pressure ulcer and its risk factors among adult hospitalized patients at Dessie Referral Hospital, Northeast Ethiopia, 2016 G. C RESULT A cross-sectional institutional based study with a single population proportion formula was used to determine the sample size. The total sample size of 355 patients was distributed proportionally to the respected wards. Every other patient was selected by systematic random sampling technique from each ward with a response rate of 100% A total of 53 patients with pressure ulcer were detected giving the prevalence rate of 14.9%. The lack of regular positioning and activity, friction/shear, and prolonged hospitalization were risk factors for pressure ulcer.
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Affiliation(s)
| | - Mohammed Hassen Salih
- School of Nursing, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Abebaw Eredie Abebe
- School of Nursing, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
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12
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Etafa W, Argaw Z, Gemechu E, Melese B. Nurses' attitude and perceived barriers to pressure ulcer prevention. BMC Nurs 2018; 17:14. [PMID: 29686535 PMCID: PMC5902867 DOI: 10.1186/s12912-018-0282-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/14/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The presence or absence of pressure ulcers has been generally regarded as a performance measure of quality nursing care and overall patient health. The aim of this study- wasto explorenurses' attitude about pressure ulcer prevention'and to identify staff nurses' perceived barriers to pressure ulcer prevention public hospitals in Addis Ababa, Ethiopia. METHODS A self-reported multi-center institutional based cross sectional study design was employed to collect data from staff nurses (N = 222) working in six (6) selected public hospitals in Addis Ababa, from April 01-28/2015. RESULTS Majority of the nurses had (n = 116, 52.2%) negative attitude towards pressure ulcer prevention. The mean scores of the test for all participants was 3.09out of 11(SD =0.92, range = 1-5). Similarly, the study revealed several barriers need to be resolved to put in to practice the strategies of pressure ulcer prevention; Heavy workload and inadequate staff (lack of tie) (83.1%), shortage of resources/equipment (67.7%) and inadequate training (63.2%) were among the major barriers identified in the study. CONCLUSIONS The study finding suggests that Addis Ababa nurses have negative attitude to pressure ulcer prevention. Also several barriers exist for implementing pressure ulcer prevention protocols in public hospitals in Addis Ababa, Ethiopia. Suggestion for improving this situation is attractive.
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Affiliation(s)
- Werku Etafa
- Department of Nursing, College of Health Science, Wollega Unversity, Samara, Ethiopia
| | - Zeleke Argaw
- School of Nursing, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Endalew Gemechu
- School of Nursing, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Belachew Melese
- Department of Statistics, College of Natural and Computational Sciences, Arsi University, Asella, Ethiopia
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Coyer F, Tayyib N. Risk factors for pressure injury development in critically ill patients in the intensive care unit: a systematic review protocol. Syst Rev 2017; 6:58. [PMID: 28320459 PMCID: PMC5359849 DOI: 10.1186/s13643-017-0451-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 03/06/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population. METHOD/DESIGN The review will follow the PRISMA reporting guidelines for systematic reviews. Electronic databases (Cochrane; PubMed/MEDLINE; CINAHL (EBSCOhost); Embase; Scopus; PsycINFO; Proquest; Networked Digital Library of Theses and Dissertations; Australian Digital Theses Program, Grey literature, Google scholar, and Clinical Trial Registries) will be systematically searched. A suite of search terms will identify articles that have examined the patient-centred risk factors for PI development in adult intensive care units. The search strategy will be designed to retrieve studies published since inception to 2016 in English language. Quality of the studies will be assessed by using an assessment framework designed to appraise quality in prognostic studies and methodological considerations in the analysis and publication of observational studies. Screening, study selection process, and data extraction will be undertaken by two independent reviewers. Disagreement will be resolved by discussion and, if required, a third independent reviewer. Clinical and methodological heterogeneity across studies will be assessed and, if possible, meta-analyses will be performed. DISCUSSION The evidence synthesis arising from this review will identify person-centred risk factors that are associated with PI development among critically ill patients in intensive care. Findings from this review will demonstrate potential patient risk factors that may influence practice and research priorities to prevent PI development and improve the quality of care provided. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037690.
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Affiliation(s)
- Fiona Coyer
- School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia. .,Intensive Care Services, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland, 4006, Australia. .,Institute for Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK.
| | - Nahla Tayyib
- School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, 4059, Australia.,School of Nursing, Umm Al-Qura University, Mecca, Saudi Arabia
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Kaddourah B, Abu-Shaheen AK, Al-Tannir M. Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: a cross-sectional study. BMC Nurs 2016; 15:17. [PMID: 26949373 PMCID: PMC4779255 DOI: 10.1186/s12912-016-0138-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/24/2016] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Bayan Kaddourah
- Ambulatory Care Centre, Executive Administration of Nursing Services, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Amani K Abu-Shaheen
- Research Center, King Fahad Medical City, P.O Box 59046, 11525 Riyadh, Saudi Arabia
| | - Mohamad Al-Tannir
- Research Center, King Fahad Medical City, P.O Box 59046, 11525 Riyadh, Saudi Arabia
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Assessment of Nurses’ Knowledge, Attitude, and Perceived Barriers to Expressed Pressure Ulcer Prevention Practice in Addis Ababa Government Hospitals, Addis Ababa, Ethiopia, 2015. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/796927] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background. Although pressure ulcer development is now generally considered as an indicator for quality of nursing care, questions and concerns about situations in which they are unavoidable remain. Awareness about the significance of the problem, positive attitude towards prevention, and an adequate level of knowledge are cornerstones to effectively prevent pressure ulcers. Objective. To assess nurses’ knowledge, attitudes, and perceived barriers to expressed pressure ulcer prevention practice in Addis Ababa government hospitals. Methods and Materials. This is a cross-sectional study by design. A total of 217 eligible nurses participated in the study and data were collected through pretested self-administered questionnaire. Results. When queried, 61.2% of the respondents had adequate knowledge on pressure ulcer prevention practices, while 68.4% had favorable attitudes towards prevention practices. Moreover, 67.3% of participants had good pressure ulcer prevention practices. Conclusion and Recommendation. More than half of the nurses were found to have adequate knowledge about pressure ulcer prevention and their attitude towards it was overall favorable. Expressed pressure ulcer prevention practice was affected by the participant’s level of knowledge, attitude, and barriers of care. To provide effective prevention of pressure ulcer, nurses’ level of knowledge and attitude should be enhanced besides resolving these barriers.
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Nuru N, Zewdu F, Amsalu S, Mehretie Y. Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC Nurs 2015; 14:34. [PMID: 26034398 PMCID: PMC4450466 DOI: 10.1186/s12912-015-0076-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 04/30/2015] [Indexed: 12/05/2022] Open
Abstract
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 20th 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.
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Affiliation(s)
| | - Fisseha Zewdu
- Department of Nursing, University of Gondar, Gondar, Ethiopia
| | - Senafikish Amsalu
- Department of Reproductive Health, Institute of Public health, University of Gondar, Gondar, Ethiopia
| | - Yohannes Mehretie
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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