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Song B, Wu Z, Liu M, Zhang Q, Ma X, Li X, Liu Y, Lin F. Barriers and facilitators of adherence to evidence-based pressure injury prevention clinical practice guideline among intensive care nurses: A cross-sectional survey. Intensive Crit Care Nurs 2024; 83:103665. [PMID: 38471401 DOI: 10.1016/j.iccn.2024.103665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals. RESEARCH METHODOLOGY/DESIGN This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation. SETTING Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China. RESULTS In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (β = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (β = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support. CONCLUSION ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators. IMPLICATIONS FOR CLINICAL PRACTICE Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.
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Affiliation(s)
- Bing Song
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China; School of Nursing and Midwifery, Griffith University, Queensland, Australia.
| | - Zijing Wu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China; School of Nursing and Midwifery, Griffith University, Queensland, Australia.
| | - Miao Liu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Qian Zhang
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Xiaolu Ma
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Yu Liu
- School of Nursing, China Medical University, Shenyang, Liaoning Province, PR China.
| | - Frances Lin
- School of Nursing and Midwifery, Griffith University, Queensland, Australia; College of Nursing and Health Sciences, Flinders University, South Australia, Australia; Caring Futures Institute, Flinders University, South Australia, Australia; School of Health, University of the Sunshine Coast, Queensland, Australia; Sunshine Coast Health Institute, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
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Gül G, Özyürek P. Evaluation of final-year nursing students' attitudes towards preventing medical device-related pressure ulcers using a ABC model of affect, behavior and cognitive dimensions. J Tissue Viability 2024; 33:472-480. [PMID: 38782614 DOI: 10.1016/j.jtv.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 05/08/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Half of the hospital-acquired pressure ulcers are associated with the use of medical devices. Nursing students provide care services to patients in clinical settings and intensive care units who have or are at risk for medical device-related pressure ulcers (MDRPUs). In the prevention and care of MDRPUs, the attitudes of nursing students towards preventing of pressure ulcers are as crucial as their knowledge level and clinical skills. AIM The aim of this descriptive study is to assess the attitudes of final-year nursing undergraduate students towards preventing MDRPUs across cognitive, affective, and behavioral dimensions of ABC model. MATERIALS AND METHODS Data of the study was handed between April 1 and December 31, 2021, with 147 final-year nursing students. Data were collected using the Student Information Form and the Attitude Towards Preventing Medical Device-Related Pressure Ulcers Questionnaire (ATP-MDRPUsQ). RESULTS The mean attitude score towards preventing MDRPUs was 3.98 ± 0.45 on a 5-point Likert scale. The mean scores for the cognitive, affective, and behavioral sub-dimensions were 3.88 ± 0.57, 4.15 ± 0.51, and 4.00 ± 0.672, respectively. A moderate positive relationship was found between the cognitive sub-dimension and both the affective and behavioral sub-dimensions (r = 0.451; r = 0.302; p < 0.01, respectively). Based on cluster analysis, the mean attitude scores of students towards MDRPU prevention were grouped into two clusters. The students in Cluster-2 and female students had higher mean attitude scores (p < 0.01). The item with the lowest mean score in the questionnaire pertained to the item, "I believe that I need training on the etiology and prevention of medical device-related pressure ulcers." CONCLUSION The general attitudes of final-year nursing students towards prevention MDRPU were satisfactory. However, their cognitive attitudes were less positive compared to their affective and behavioral attitudes. It is recommended to incorporate theoretical and practical courses focusing on the prevention of these injuries into nursing curricula to enhance students' knowledge and attitudes.
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Affiliation(s)
- Gülçin Gül
- Graduate Education Institute, Afyonkarahisar Health Sciences University, 03200, Afyonkarahisar, Turkey
| | - Pakize Özyürek
- Faculty of Health Science, Surgical Nursing Department, Afyonkarahisar Health Sciences University, 03200, Afyonkarahisar, Turkey.
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Arıburnu Ö, Korkmaz F. Nursing students' perceptions and experiences in pressure injury risk assessment: A qualitative study. Nurse Educ Pract 2024; 79:104039. [PMID: 38996581 DOI: 10.1016/j.nepr.2024.104039] [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: 04/01/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/14/2024]
Abstract
AIM This study aims to capture the perspectives of senior undergraduate nursing students concerning pressure injury risk assessment, shedding light on their practical experiences and insights. BACKGROUND Pressure injuries pose a significant challenge in healthcare, demanding vigilant attention from healthcare professionals. Central to mitigating this challenge is the imperative role of risk assessment, placing nurses at the forefront of prevention strategies. Given the critical nature of this responsibility, the need for a robust and well-structured integration of risk assessment teaching within undergraduate nursing education becomes increasingly apparent. DESIGN This study was conducted as a descriptive qualitative study. METHOD This research was conducted at the Nursing Faculty of a State University in Ankara/Turkey, involving 19 senior students enrolled in the nursing program. Data was collected online using in-depth interviews with semi-structured interview questions between November and December 2022. After data collection, transcripts were generated and subjected to thematic analysis. The study was reported following the COREQ Checklist. RESULTS The study revealed two overarching themes: Opinions and Experiences. Within the Opinions theme, subthemes emerged, including "Features of Teaching," "Pressure Injury Definition," and "Improving Teaching Methods." The Experiences theme encompassed sub-themes such as the "Limited Relationship between Theoretical Teaching and Clinical Practice" and "Assessing the Risk of Pressure Injury in Practice." CONCLUSION Participants affirmed that theoretical instruction sufficiently addressed pressure injury risk assessment yet expressed concerns about the inadequacy of clinical teaching. Additionally, they underscored the need for innovative teaching methods in the theoretical instructional process.
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Affiliation(s)
- Özlem Arıburnu
- Hacettepe University, Faculty of Nursing, Ankara, Turkey.
| | - Fatoş Korkmaz
- Hacettepe University, Faculty of Nursing, Ankara, Turkey
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Erbay Dallı Ö, Kelebek Girgin N. Medical Device-Related Pressure Injury Care and Prevention Training Program (DevICeU): Effects on intensive care nurses' knowledge, prevention performance and point prevalence. Intensive Crit Care Nurs 2024; 82:103622. [PMID: 38215558 DOI: 10.1016/j.iccn.2024.103622] [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: 09/28/2023] [Revised: 12/07/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE To determine the effect of the training given to intensive care unit (ICU) nurses to prevent medical device-related pressure injuries (MDRPIs) on nurses' knowledge levels, their prevention performance, and the point prevalence (PP) of MDRPIs. RESEARCH METHODOLOGY/DESIGN A pre-post test intervention study without a control group. SETTING The study was conducted between May and July 2023 with ICU nurses in three phases: pre-training phase (E0) (104 nurses, 116 patients), training implementation phase (E) and post-training phase (E1) (89 nurses, 120 patients). MAIN OUTCOME MEASURES The data were collected by using the Patient (E0, E1) and Nurse (E0) Characteristic Forms, MDRPI Follow-up and Prevalence Form (E0, E1), D.E.V.I.C.E Performance Observation Checklist (E0, E1), MDRPI Knowledge Assessment Questionnaire (E0, E1), Braden Pressure Ulcer Risk Assessment Scale (E0, E1), Pressure Injury Grading Form (E0, E1), and Feedback Form about the Training Process (E). RESULTS The mean MDRPI knowledge score of the nurses increased significantly from E0 to E1 (13.23 ± 1.43 vs. 20.02 ± 1.30, p = 0.001), with the highest improvement in the staging and prevention themes. Nurses' MDRPI prevention performance increased significantly from E0 to E1 (2.15 ± 1.01 vs. 11.17 ± 1.65, p = 0.001). There was a significant difference between the PP rate at E0 (61.2 %) and E1 (27.5 %) (p = 0.001). CONCLUSION The study indicated that the training on MDRPIs given to ICU nurses increased their knowledge and prevention performance and decreased the prevalence of MDRPIs. However, further studies with a larger sample size are needed to confirm these findings. IMPLICATIONS FOR CLINICAL PRACTICE Since MDRPIs have more complex staging and prevention practices than conventional PIs, they require the adoption of a training approach that includes visual materials and practical methods in addition to theoretical knowledge. Accurate definitions of medical device dimensions and fixation, skin assessment, and prevention practices will lead to the desired outcome of reducing MDRPIs in ICUs.
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Affiliation(s)
- Öznur Erbay Dallı
- Bursa Uludag University Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, BURSA 16059, Turkey.
| | - Nermin Kelebek Girgin
- Bursa City Hospital, Department of Anesthesiology and Reanimation, Division of Intensive Care, Nilüfer, BURSA 16110, Turkey
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Liang H, Hu H, Feng L, Wei H, Ying Y, Liu Y. The knowledge and attitude on the prevention of pressure ulcers in Chinese nurses: A cross-sectional study in 93 tertiary and secondary hospitals. Int Wound J 2024; 21:e14593. [PMID: 38151898 PMCID: PMC10961891 DOI: 10.1111/iwj.14593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023] Open
Abstract
Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care.
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Affiliation(s)
- Hongyan Liang
- Department of NursingSir Run Run Shaw Hospital Zhejiang University School of Medicine, Zhejiang UniversityHangzhouChina
| | - Hongyang Hu
- Department of NursingSir Run Run Shaw Hospital Zhejiang University School of Medicine, Zhejiang UniversityHangzhouChina
| | - Liuqun Feng
- Department of NursingSir Run Run Shaw Hospital Zhejiang University School of Medicine, Zhejiang UniversityHangzhouChina
| | - Huiyan Wei
- Department of NursingSir Run Run Shaw Hospital Zhejiang University School of Medicine, Zhejiang UniversityHangzhouChina
| | - Yuai Ying
- Department of NursingSir Run Run Shaw Hospital Zhejiang University School of Medicine, Zhejiang UniversityHangzhouChina
| | - Yuanfei Liu
- Department of NursingThe Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang UniversityHangzhouChina
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Chuang ST, Lo SF, Liao PL, Lin PY, Tsay SF. Knowledge, attitude, perceived barriers of hard-to-healed wound care and the association with confidence: A cross-sectional study among community nurses. J Tissue Viability 2023; 32:487-492. [PMID: 37690960 DOI: 10.1016/j.jtv.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Shu-Ting Chuang
- Taichung Tzu Chi Hospital and Department of Nursing, Tzu Chi University, Taiwan
| | - Shu-Fen Lo
- Department of Nursing, Tzu Chi University, Taiwan.
| | - Pei-Lin Liao
- Buddhist Tzu Chi Foundation Tzu Chi Taichung Home-Based Long-Term Care Facilities, Taiwan
| | - Pi-Yu Lin
- Buddhist Compassion Relief Tzu Chi Foundation, Taiwan
| | - Shwu-Feng Tsay
- General Department of Nursing and Health Care, Ministry of Health and Welfare, Taiwan; Department of Health Services Administration, College of Public Health, China Medical University, Taiwan
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Appiah EO, Appiah S, Oti-Boadi E, Boadu BA, Kontoh S, Adams RI, Appiah C, Sarpong C. Attitude and preventive practices of pressure ulcers among orthopedic nurses in a tertiary hospital in Ghana. PLoS One 2023; 18:e0290970. [PMID: 37682963 PMCID: PMC10490930 DOI: 10.1371/journal.pone.0290970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Pressure ulcers (PUs), which affect millions of people worldwide, are among the five most prevalent hospitalized cases causing adverse impairment. Nevertheless, pressure ulcers are largely preventable, and their management depends on their severity. The authors, therefore, explored the attitude and preventive practices of pressure ulcers among orthopedic nurses in a tertiary hospital in Ghana. METHODS An exploratory descriptive qualitative approach was employed for this study to help researchers explore the attitude and practices toward PU (Pressure Ulcer). Purposive sampling approach was employed, and data was analyzed using thematic content analysis. The sample size for this study was 30 which was obtained based on saturation. Participants were engaged in face-to-face interviews which were transcribed verbatim. FINDINGS Two themes and eight subthemes were generated from the analysis of this study. The two themes were preventive practices and attitude towards PU. The study identified that there were no specific protocols illustrated on the wards for managing pressure ulcers. Nevertheless, the study participants were keen on preventing pressure ulcers and hence engaged in practices such as early patients' ambulation, early identification of PU signs, removing creases and crumps from patient beds, nutritional management for PU prevention, and dressing of PU wounds. CONCLUSION Practices of pressure ulcer management were highly valued by the orthopedics nurses. Hence, the nurses recommended the need for accepted guidelines on pressure ulcer management to be illustrated in the various orthopedic wards in the country.
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Affiliation(s)
- Evans Osei Appiah
- School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
- Purdue University, West Lafayette, IN, United States of America
| | - Stella Appiah
- Head of Nursing Department, School of Nursing and Midwifery, Valley View University, Accra, Ghana
| | - Ezekiel Oti-Boadi
- School of Nursing, Heritage Christian College, Valley View University, Accra, Ghana
| | | | - Samuel Kontoh
- Department of Mental Health, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | | | - Cyndi Appiah
- Ghana Christian University College, Amrahia, Ghana
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Majeed H, Hassan AF, Jasim AH, Al-Ganmi AH. Protective Health Behaviors among Critical Care Nurses Concerning Pressure Ulcer Prevention for Hospitalized Patients at Baghdad Teaching Hospitals. AL-RAFIDAIN JOURNAL OF MEDICAL SCIENCES ( ISSN 2789-3219 ) 2023; 5:205-210. [DOI: 10.54133/ajms.v5i.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Background: Pressure ulcers remain a serious complication for immobile patients and a burden for healthcare professionals. Objectives: To assess health behavior prevention among critical care nurses regarding pressure ulcer prevention for hospitalized patients and to find out the relationship between critical care nurses health behavior prevention and sociodemographic variables. Methods: A cross-sectional design study was carried out in critical care units at three teaching hospitals. The study period extended from November 1, 2022, to January 28, 2023. Non-probability purposive sampling, whose target population was 100 nurses who work in critical care units in Baghdad, Iraq. The data were collected using a self-administered questionnaire. The data was collected from November 10th through December 23rd, 2022. Study instruments consist of two parts. First, the demographic sheet included sociodemographic information about the participants. The second part includes nurses’ attitudes toward the pressure ulcer prevention instrument (APuP). The collected data was analyzed using SPSS version 26. Results: Findings of the current study showed nearly three-quarters (74%) of critical care nurses had positive health behaviors regarding pressure ulcer prevention based on a total mean score of 2.26. Conclusion: This study concluded that the critical care units’ nurses surveyed in this study demonstrate an acceptable level of knowledge regarding pressure ulcer prevention and treatment. Continuing education or in-service training should be provided to enhance critical care units’ nurses’ practices and positive health behaviors about pressure ulcer prevention.
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Avsar P, Renjith V, Chima C, Patton D, O'Connor T, Moore Z. Assessing nurses' attitudes towards pressure ulcer prevention: an updated systematic review. J Wound Care 2023; 32:544-554. [PMID: 37682786 DOI: 10.12968/jowc.2023.32.9.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE The aim of this systematic review was to critically appraise and synthesise the existing research literature pertaining to nurses' attitudes toward pressure ulcer (PU) prevention. METHOD The systematic review presented in our paper serves as an updated version of the definitive review conducted by Avsar et al. in 2019. Using systematic review methodology, we considered published quantitative studies focusing on nurses' attitudes toward PU prevention as measured using psychometric tests. The search was conducted in April 2022, using PubMed, CINAHL, Scopus, Cochrane and EMBASE databases, and returned 454 records, of which 35 met the inclusion criteria. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the evidence-based librarianship (EBL) appraisal checklist. RESULTS In most studies, distinct measurement instruments were used for measuring nurses' attitudes toward the prevention of PUs: the Moore and Price Attitude Scale and the Attitude towards Pressure Ulcer Prevention Instrument (APuP). In this first update, the mean attitude score was 69% (±14%, range: 33.6-89%). A separate analysis of the new studies alone included in this first update (n=14) indicated a mean attitude score of 62.25% (±17.9%; median: 14%), suggesting a 10.75% lower mean attitude score. In total, 46% (n=16) yielded a score ≥75%. Conversely, Avsar et al. in 2019, 86% (n=18) of studies yielded positive attitude results. Studies from the Middle East show the lowest mean attitude score (mean 55%; ±15%; median 53%; n=9), with studies from Europe displaying the highest mean attitude score (mean 79%; ±6%; median 79%; n=12). CONCLUSION The findings suggest that, overall, nurses are relatively positively disposed toward PU prevention. However, there are differences across continents. It is important to highlight also that the nurses have difficulties reflecting this positive attitude into actual preventative strategies.
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Affiliation(s)
- Pinar Avsar
- Lecturer and Programme Director, Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
| | - Vishnu Renjith
- Lecturer and Programme Director, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
| | - Comfort Chima
- Programme Director and Nurse Tutor, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
| | - Declan Patton
- Director of Nursing and Midwifery, School of Nursing and Midwifery. The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
- Adjunct Associate Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Honorary Senior Fellow, Faculty of Science, Medicine and Health, University of Wollongong, Australia
- Honorary Professor, Lida Institute, Shanghai, China
- Visiting Professor, University of Wales, Cardiff
| | - Tom O'Connor
- Honorary Professor, Lida Institute, Shanghai, China
- Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
| | - Zena Moore
- Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Professor of Nursing, Head of School of Nursing and Midwifery, Director of the Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin
- Professor, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
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Korkmaz S, Sönmez M, Gürlek Kısacık Ö. The effect of knowledge levels of intensive care nurses about pressure injuries on their attitude toward preventing pressure injuries. J Tissue Viability 2023; 32:325-332. [PMID: 37149433 DOI: 10.1016/j.jtv.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 03/28/2023] [Accepted: 04/15/2023] [Indexed: 05/08/2023]
Abstract
AIM The aim of this study was to determine the current knowledge levels of intensive care nurses about pressure injuries and their attitudes toward preventing pressure injuries, and to reveal the relationship between these variables. MATERIALS AND METHODS This descriptive cross-sectional study was conducted with 152 nurses, working in the Adult Intensive Care Units of a Training and Research Hospital. Data were collected between 10.08.2021 and 31.11.2021 with the Patient Information Form, Modified Pieper Pressure Ulcer Knowledge Test and Attitude toward Pressure Injury Prevention Scale. Frequency analysis, descriptive statistics, multiple logistic regression analysis and the structural equation modeling technique were used in the analysis of the study data. RESULTS The mean age of the nurses was 25.82 ± 3.42 years, 86.2% of them were female and 67.1% of them had a bachelor's degree. Total mean score of the Modified Pieper Pressure Ulcer Knowledge Test of the intensive care nurses was found to be 32.58 ± 6.58. The knowledge score of 113 out of 152 nurses was ≥60% or above. The total mean score of the Attitude toward Pressure Injury Prevention Scale was 42.00 ± 5.70 and a total of 76.97% (117 participants) of them were found to score 75% or above on the scale. The results of the regression analysis showed that educational degree, and status of having training about pressure injuries did not affect the total mean score of the Knowledge Test and the Attitude Scale. However, it revealed that the frequency of encountering a patient with pressure injuries in the unit where they work has affected the total mean score of the scales significantly (p < 0.05). As per the results of the structural equation model, the Modified Pieper Pressure Ulcer Knowledge Test scores of the nurses were found to have a statistically significant effect on the scores of the Attitude toward Pressure Injury Prevention Scale (p < 0.05). CONCLUSION This study revealed that intensive care unit nurses had a positive attitude toward Pressure Injury Prevention and their knowledge was sufficient and that as the Modified Pieper Pressure Ulcer Knowledge Test scores increase, their positive attitude toward Pressure Injury Prevention also increases.
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Affiliation(s)
- Serap Korkmaz
- Gülhane Training and Research Hospital, Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara, Turkey.
| | - Münevver Sönmez
- Faculty of Health Science, Fundamentals of Nursing Department, Atılım University, 06830, Ankara, Turkey.
| | - Öznur Gürlek Kısacık
- Faculty of Health Science, Fundamentals of Nursing Department, Afyonkarahisar Health Science University, 03200, Afyonkarahisar, Turkey.
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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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Sari Y, Upoyo AS, Mulyono WA, Sumeru A, Taufik A, Nuriya N. Pressure injury prevention: Knowledge and attitude and their predictors in Indonesian nurses working in hospital settings. J Tissue Viability 2023; 32:242-247. [PMID: 37037689 DOI: 10.1016/j.jtv.2023.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 04/09/2023]
Abstract
AIM Nurses' knowledge and attitude are critical for pressure injury (PI) prevention. However, to date, there has been little research carried out on the knowledge and attitude of Indonesian nurses regarding PI prevention in hospital settings, and no study has investigated the predictors of knowledge and attitude of Indonesian nurses regarding PI prevention. This study therefore aims to investigate knowledge and attitude, and to identify the predictors of knowledge and attitude regarding PI prevention among Indonesian nurses in hospital settings. METHODS A cross-sectional study was conducted between 1st November 2021 and 5th March 2022. A total of 563 nurses from three general hospitals in Central Java Province participated. The Pressure Ulcer Knowledge Assessment Tool 2.0 and the Attitude Pressure Ulcer Prevention questionnaires were used. A multiple linear regression analysis was used to determine the predictors of nurses' knowledge and attitude regarding PI prevention. RESULTS The percentage of correct answers was 35.02%, indicating poor knowledge, while the percentage of nurses' attitudes was 75.46%, indicating a satisfactory attitude. The predictors of knowledge of PI prevention were found to be age (β = -0.127, p = 0.025), level of education (β = 0.153, p = 0.001) and income (β = 0.107, p = 0.021), while the predictors of attitude toward PI prevention were level of education (β = 0.101, p = 0.020) and professional position (β = 0.093, p = 0.033). CONCLUSION This is the first study to identify the predictors of attitude and knowledge regarding PI prevention in Indonesian nurses in a hospital setting. The results indicate a need for appropriate educational training based on the predictors to be given to Indonesian nurses working in hospital settings to increase their knowledge of PI prevention.
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Rapetti R, Pansera A, Visca S, Martolini M, Antoniotti S, Bertoncini F, Cirone M, Visca S. Pressure ulcers in hospital patients: incidence and risk factors. J Wound Care 2023; 32:29-34. [PMID: 36630116 DOI: 10.12968/jowc.2023.32.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE With an ageing population and a rising number of people with chronic conditions and disabilities, pressure ulcers (PUs) are a frequent problem. Prevention and treatment, especially targeted at older people, frail and non-self-sufficient patients, are central to care provided by nurses. The objective of this study is to establish the incidence of PUs in hospital inpatients and identify possible associated risk factors. METHOD A clinical observational study was conducted from May to November 2019 in a sample of patients admitted to Azienda Sociosanitaria Ligure 2 in Italy. Clinical and sociodemographic data were collected at admission and at discharge, through a questionnaire or collection card. The analysis was done using SAS 9.4 2017 software. RESULTS In 7% of the 515 participating patients, PUs occurred during hospitalisation; PUs at stages I and II were predominantly in the coccyx, heels and malleolus. CONCLUSION Significant associations were found between the development of lesions and age, certain pathologies, the degree of patient autonomy and the level of skin integrity.
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Affiliation(s)
- Roberta Rapetti
- Territorial Assistance Organization Health Professions Directorate, Azienda Sociosanitaria Ligure 2, Savona, Italy
| | - Antonio Pansera
- Territorial Assistance Organization Health Professions Directorate, Azienda Sociosanitaria Ligure 2, Savona, Italy
| | - Simona Visca
- Territorial Assistance Organization Health Professions Directorate, Azienda Sociosanitaria Ligure 2, Savona, Italy
| | - Manuela Martolini
- Primary Care Department CoordinatorTerritorial Assistance Organization Health Professions Directorate, Azienda Sociosanitaria Ligure 2, Savona, Italy
| | - Sara Antoniotti
- Department of Statistics, DIMA, University of Genoa, Genoa, Italy
| | - Fabio Bertoncini
- Nursing Coordinator Urgent Care Medicine, Ospedale degli Infermi, Biella, Italy
| | - Monica Cirone
- Territorial Assistance Organization Health Professions Directorate, Azienda Sociosanitaria Ligure 2, Savona, Italy
| | - Sara Visca
- Nephrology Department, San Gerardo Hospital, ASST Monza, Monza, Italy
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Ghorbani Vajargah P, Mollaei A, Falakdami A, Takasi P, Moosazadeh Z, Esmaeili S, Emami Zeydi A, Karkhah S. A systematic review of nurses' practice and related factors toward pressure ulcer prevention. Int Wound J 2022. [DOI: 10.1111/iwj.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Pooyan Ghorbani Vajargah
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Amirabbas Mollaei
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Atefeh Falakdami
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Poorya Takasi
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Zahra Moosazadeh
- Student Research Committee, School of Medicine, Sari Branch Islamic Azad University Sari Iran
| | - Shaqayeq Esmaeili
- Imam Khomeini Hospital Mazandaran University of Medical Sciences Sari Iran
| | - Amir Emami Zeydi
- Department of Medical‐Surgical Nursing, Nasibeh School of Nursing and Midwifery Mazandaran University of Medical Sciences Sari Iran
| | - Samad Karkhah
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
- Burn and Regenerative Medicine Research Center Guilan University of Medical Sciences Rasht Iran
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Formal Caregiver Experiences of Caring for Individuals at Risk for or with a Pressure Injury: A Metasynthesis. Adv Skin Wound Care 2022; 35:680-687. [PMID: 35895590 DOI: 10.1097/01.asw.0000855044.92545.af] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To explore formal caregiver experiences caring for patients with a pressure injury (PI) or who are at risk of developing a PI. DATA SOURCES In November 2019, the researchers searched CINAHL (Cumulative Index to Nursing and Allied Health Literature) and MEDLINE databases for articles related to caregivers and their experiences with PI prevention and care. STUDY SELECTION Twenty-eight qualitative studies were included in this review. DATA EXTRACTION Literature was graded and critiqued with regard to design and research quality and then synthesized utilizing a narrative approach. DATA SYNTHESIS Four themes were found within the literature: knowledge and education, environment and resources, collaboration and role clarity, and risk assessment. CONCLUSIONS Across healthcare settings, formal caregivers noted the importance of effective PI knowledge and education. Recognizing both barriers and facilitators to PI prevention and management within the healthcare environment can help decision-makers make informed choices to improve PI management within their settings. In addition, developing interprofessional team skills and relationships, rather than practicing in silos, may have an impact on PI management. Although there are many interventions that reduce PI risk and assist in the management of PIs, not every intervention is appropriate for every healthcare setting. Clinician education on PIs, along with new interventions, could significantly impact the effectiveness of patient care.
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Asiri S, Alqahtani N. Factors Associated with Intensive Care Units' Nurses Frequency of Performing Pressure Injury Prevention: A Cross-sectional Study. Appl Nurs Res 2022; 68:151640. [PMID: 36473718 DOI: 10.1016/j.apnr.2022.151640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/11/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
AIM To explore factors associated with frequency of performing pressure injury prevention measures among a sample of intensive care units' nurses. BACKGROUND Pressure injuries may be unavoidable in specific circumstances; however, most pressure injuries may be considered preventable. Nursing actions at the point of care play a significant role in shaping pressure injury prevention. METHODS A cross-sectional, descriptive correlational design was used. Using convenience sampling method, 162 intensive care units' nurses were recruited from three hospitals in Riyadh, Saudi Arabia. The participants completed a survey that included Nurses' Practice of Pressure Ulcer Prevention Questionnaire, Pressure Ulcer Knowledge Assessment Tool, Attitude toward Pressure Ulcer Prevention, Pressure Ulcer Prevention Barriers instrument, and Intention to Use Pressure Injury Preventive Measures instrument. Data were analyzed using descriptive and inferential statistics. RESULTS Nurses lack of knowledge about pressure injury preventions. However, they possessed positive attitudes toward pressure injury preventions. Nurses faced some barriers to prevent pressure injuries. Most nurses agreed that there was social pressure to prevent pressure injury. They had an intention to use preventive measures to prevent pressure injury. Nurses performed pressure injury prevention frequently. The bivariate and multivariate analyses showed only barriers to prevent pressure injury were negatively associated with frequency of performing pressure injury prevention. CONCLUSIONS Several factors that may influence ICU nurses' behavior to perform PIPs have been identified. The participants reflected positive attitude, positive social pressure, and intention to perform PIPs. Nevertheless, they need to improve their knowledge of PIPs and reduce the barriers prevented them from performing PIPs.
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Affiliation(s)
- Saeed Asiri
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia.
| | - Naji Alqahtani
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia.
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Chuang ST, Liao PL, Lo SF, Chang YT, Hsu HT. Effectiveness of an E-Book App on the Knowledge, Attitudes and Confidence of Nurses to Prevent and Care for Pressure Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15826. [PMID: 36497905 PMCID: PMC9737897 DOI: 10.3390/ijerph192315826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
AIMS This study evaluates the effectiveness of an interactive E-book app training program in improving nurses' knowledge, attitudes, and confidence to prevent and care for pressure injury. DESIGN Randomized experimental study. METHODS Participants were recruited from a teaching hospital in Taiwan. The study was carried out between 20 March 2014 to 1 April 2016. In total, 164 participants were randomly assigned to a pressure injury E-book app training program (n = 86) or a conventional education program (n = 78) with a one-month follow-up. Outcome variables were levels of pressure injury knowledge, attitudes, and confidence of pressure injury care. RESULTS Participants answered 51.96% of the pressure injury knowledge questions correctly before the intervention and 75.5% after the intervention. The pressure injury attitude score was slightly positive, with moderate confidence in pressure injury care. The knowledge, attitudes, and confidence of pressure injury care of the two groups in the pretest and posttest groups increased significantly. Analysis of covariance indicated that nurses in the pressure injury E-book app group had significantly greater improvement in knowledge, attitudes, and pressure injury care confidence as compared with the control group. CONCLUSION The pressure injury E-book app interactive training program was effective in improving nurses' knowledge and attitudes toward pressure injury care and in enhancing their confidence in pressure injury care; therefore, this program has potential for nurses' in-service education in both Taiwan and worldwide. IMPACT E-book apps allow individuals to control the time and place of learning. Direct observation of procedural skills can provide feedback to trainees on techniques to ensure learning effectiveness and pressure injury care quality.
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Affiliation(s)
- Shu-Ting Chuang
- Taichung Tzu Chi Hospital, No. 88, Section 1, Fengxing Road, Taichung 427, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, No. 880, Section 2, Jianguo Road, Hualien 970046, Taiwan
| | - Pei-Lin Liao
- Tzu Chi Fondation Tzu Chi Taichung Home-Based Long-Term Care Facilities, No. 88, Section 1, Fengxing Road, Tanzih District, Taichung 427, Taiwan
| | - Shu-Fen Lo
- Department of Nursing, Tzu Chi University, No. 701, Section 3, Zhongyang Road, Hualien 97004, Taiwan
| | - Ya-Ting Chang
- Taichung Tzu Chi Hospital, No. 88, Section 1, Fengxing Road, Taichung 427, Taiwan
| | - Hsiang-Tzu Hsu
- Tzu Chi Foundation Long-Term Care Promotion Center, No. 88, Section 1, Fengxing Road, Taichung 427, Taiwan
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Zhang Q, Li X, Zhang K, Lv L, Jin Y. Psychometric properties of the Chinese version of the knowledge, attitudes and practices of the incontinence‐associated dermatitis questionnaire (C‐KAP‐IAD‐Q) used with Chinese nurses. Int J Nurs Pract 2022:e13107. [DOI: 10.1111/ijn.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Qi Zhang
- School of Nursing Peking University Beijing China
| | - Xintong Li
- Faculty of Nursing Fenyang College of Shanxi Medical University Lvliang China
| | - Ke Zhang
- Faculty of Education Science and Technology Shanxi Datong University Datong China
| | - Lijun Lv
- Department of Nursing The Affiliated Hospital of Changzhi Chinese Medicine Research Institute Changzhi China
| | - Yi Jin
- Department of Nursing Tianjin Huanhu Hospital Tianjin China
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Sari Y, Upoyo AS, Sumeru A, Yusuf S, Haryanto, Nuriya, Taufik A. Nursing student's knowledge and attitude toward diabetic ulcer care and their contributing factors in Indonesia. Int J Nurs Sci 2022; 9:496-503. [PMID: 36285084 PMCID: PMC9587391 DOI: 10.1016/j.ijnss.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022] Open
Abstract
Objective The prevalence of diabetic foot ulcer in Indonesia is far greater than the global prevalence. Nursing students are expected to have good knowledge and positive attitudes regarding diabetic ulcer care in order to deliver high-quality wound care during clinical practice. This study aimed to assess nursing students’ knowledge and attitudes toward diabetic ulcer care and to investigate the factors related to them. Methods A cross-sectional study was conducted on 396 academic and clinical phases in three nursing schools in Indonesia from September 2021 to February 2022. Participants completed a survey including a questionnaire about knowledge and attitudes regarding diabetic ulcer care. The data were analyzed using a Chi-square test and multivariate logistic regression analysis. Results The results show that 43.2% (171/396) of nursing students had inadequate knowledge of diabetic ulcer care. However, 88.9% (352/396) had a favorable attitude toward the topic. Nursing students lacked knowledge about the characteristics of diabetic ulcers, diabetic neuropathy, wound infection, and adjunctive therapy for diabetic ulcers, and many of them believe that diabetic ulcer care is too time-consuming to carry out. Students in the clinical phase of their studies had significantly better knowledge than those in the academic phase (aOR = 9.99, 95% CI 4.96–20.08, P < 0.001). Male nursing students were significantly less likely to have positive attitude toward the topic than female students (aOR = 0.42, 95% CI 0.19–0.96, P = 0.048), and students accustomed to sharing with peers as a source of knowledge had better attitudes than those who were not (aOR = 2.76, 95% CI 1.40–5.41, P = 0.003). Conclusion Findings show that almost half of the nursing students have insufficient knowledge of diabetic ulcer care. Curriculum developers and educators need to improve the curriculum regarding diabetic wound care and provide strategic programs to improve students’ knowledge and attitudes based on the factors discovered in this study.
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Lovegrove J, Fulbrook P, Miles SJ. Use of a Sacral Foam Dressing to Prevent Pressure Injury in At-Risk Subacute Hospitalized Older Adults: A Pilot Randomized Controlled Trial. J Wound Ostomy Continence Nurs 2022; 49:322-330. [PMID: 35809008 DOI: 10.1097/won.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this pilot study was to inform a future trial aimed at comparing the effectiveness of a prophylactic sacral dressing plus standard care to standard care only to reduce sacral pressure injuries (PIs) in at-risk older adults admitted to a subacute hospital setting. DESIGN A pilot study with a pragmatic, open-label, randomized controlled trial design. SAMPLE AND SETTING One hundred thirty participants were randomized (intervention n = 66, 50.8%; control n = 64, 49.2%). Protocol violations occurred in 48 participants (intervention n = 33, 68.8%; control n = 15, 31.3%). The study setting was a subacute hospital inpatient care unit located in Queensland, Australia. METHODS Participants were randomly allocated 1:1 to the intervention (prophylactic dressing plus standard care) or control group (standard care). Standard care included regular PI risk and skin assessments, and selection and implementation of preventive interventions (eg, support surfaces and increased repositioning) from a PI prevention care plan. The sacral dressing was applied for intervention participants immediately following recruitment. Ward and research staff collected data and assessed skin integrity daily; participants were followed up until onset of a PI or up to 28 days without PI occurrence. In addition, retrospective chart reviews were undertaken to verify PI occurrences. Patient comfort and dressing utility were also evaluated. RESULTS Two (3.0%) participants in the intervention group and 1 (1.6%) in the control group developed a sacral PI. The difference was not statistically significant. Only 1 PI was recorded prospectively, while 2 PIs were identified via retrospective chart review. Participants rated dressing comfort highly, particularly during the first 2 weeks, and nurses rated utility highly. Based on the intention-to-treat results, a sample size of 1799 per arm would be required in a definitive trial. CONCLUSIONS A definitive trial is feasible and warranted. However, the large sample size required in a definitive trial indicates the need for multiple sites.
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Affiliation(s)
- Josephine Lovegrove
- Josephine Lovegrove, RN, BN(Hons), Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paul Fulbrook, PhD, MSc, RN, BSc(Hons), PGDip Educ, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sandra J. Miles, PhD, RN, RM, MN (Ch&Adol), BN, CCYPN, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
| | - Paul Fulbrook
- Josephine Lovegrove, RN, BN(Hons), Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paul Fulbrook, PhD, MSc, RN, BSc(Hons), PGDip Educ, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sandra J. Miles, PhD, RN, RM, MN (Ch&Adol), BN, CCYPN, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
| | - Sandra J Miles
- Josephine Lovegrove, RN, BN(Hons), Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paul Fulbrook, PhD, MSc, RN, BSc(Hons), PGDip Educ, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sandra J. Miles, PhD, RN, RM, MN (Ch&Adol), BN, CCYPN, Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia
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Tesfa Mengist S, Abebe Geletie H, Zewudie BT, Mewahegn AA, Terefe TF, Tsegaye Amlak B, Tadesse B, GebreEyesus FA, Tsehay T, Solomon M, Chekole Temere B, Geze Tenaw S, Mesfin Y. Pressure ulcer prevention knowledge, practices, and their associated factors among nurses in Gurage Zone Hospitals, South Ethiopia, 2021. SAGE Open Med 2022; 10:20503121221105571. [PMID: 35756351 PMCID: PMC9218504 DOI: 10.1177/20503121221105571] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
A pressure ulcer is a localized skin injury and underlying tissue, usually as a result of friction or pressure against the surface of the skin. The global mortality rate of pressure ulcers was above 60% for hospitalized patients who wait 1 year of hospital stay. Nurses are the primary responsible body and forefront line care providers for the prevention of pressure ulcers, so nurses’ knowledge and practices are the major rollers to handling this preventable problem.
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Affiliation(s)
- Shegaw Tesfa Mengist
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Haimanot Abebe Geletie
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Bitew Tefera Zewudie
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Agerie Ayinalem Mewahegn
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Tamene Fetene Terefe
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Baye Tsegaye Amlak
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Betelhem Tadesse
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Tadesse Tsehay
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Mamo Solomon
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Bogale Chekole Temere
- Department of Nursing, College of Medicine and Health Science, Wolkite University (WKU), Wolkite, Ethiopia
| | - Shegaw Geze Tenaw
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University(WKU), Wolkite, Ethiopia
| | - Yibeltal Mesfin
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University(WKU), Wolkite, Ethiopia
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Emami Zeydi A, Ghazanfari MJ, Esmaeili S, Mobayen M, Soltani Y, Emami Sigaroudi A, Fast O, Karkhah S. Knowledge, attitude, and practice of Iranian nurses towards pressure ulcer prevention: A systematic review. J Tissue Viability 2022; 31:444-452. [PMID: 35718594 DOI: 10.1016/j.jtv.2022.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/04/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Pressure ulcer (PU), as a long-term disabling condition, is an important indicator for patient safety and quality of nursing care in hospitals. This systematic review aimed to evaluate the knowledge, attitude, and practice of Iranian nurses towards PU prevention. METHODS A systematic search was conducted on PubMed, Web of Science, Scopus databases, Google Scholar Search Engine, as well as Magiran, Iranmedex, and Scientific Information Database (SID) Persian databases using the relevant keywords, from the earliest date available to August 21, 2020. Studies were appraised using the appraisal tool for cross-sectional studies (AXIS tool). FINDINGS Among a total of 1,543 Iranian nurses included in the 9 studies, 80.53% were female with a mean age of 31.14 (SD = 5.52) years. The mean work experience of the participants was 7.94 years (SD = 5.44). The knowledge and practice of Iranian nurses toward PU prevention were insufficient and relatively desirable, respectively. Also, the present study showed that nurses' attitudes toward PU prevention were contradictory. Age, gender, level of education, work experience, and participation in previous educational workshops were possible factors related to nurses' knowledge about PU prevention. Women with higher work experience had a more positive attitude. CONCLUSION This review found inappropriate knowledge, attitude, and practice of Iranian nurses toward PU prevention and highlights the importance of regular upgrading of nurses' knowledge and practice related to PU prevention.
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Affiliation(s)
- Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
| | - Shaqayeq Esmaeili
- Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Yasaman Soltani
- Medical Education Research Center, Educational Development Center, Guilan University of Medical Sciences, Rasht, Iran.
| | - Abdolhossien Emami Sigaroudi
- Cardiovascular Diseases Research Center, Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran.
| | - Olive Fast
- Mount Royal University, Calgary, Alberta, Canada.
| | - Samad Karkhah
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran; Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Erbay Dalli Ö, Kelebek Girgin N. Knowledge, perception and prevention performance of intensive care unit nurses about medical device-related pressure injuries. J Clin Nurs 2022; 31:1612-1619. [PMID: 34423489 DOI: 10.1111/jocn.16014] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/21/2021] [Accepted: 08/12/2021] [Indexed: 02/03/2023]
Abstract
AIM AND OBJECTIVE To examine intensive care unit (ICU) nurses' knowledge, perceptions and prevention performance about medical device-related pressure injuries (MDRPIs). BACKGROUND Prevention of MDRPIs has been an important part of nursing care, and there is a limited number of studies on nurses' level of knowledge or perception about MDRPIs. DESIGN This study was designed as a cross-sectional survey and conducted according to STROBE Guidelines. METHOD The data of the study were collected with the Nurse Information Form and the MDRPI Knowledge Assessment Questionnaire. In the first phase, the psychometric properties of the questionnaire were evaluated (content validity, internal consistency and test-retest). A pilot study was conducted with 20 nurses for the test-retest phase. These nurses were excluded from the general sample. RESULTS The study was conducted with 142 ICU nurses. The average percent knowledge score of ICU nurses on MDRPIs was 68.4%. In the survey, the highest rate of correct response was found in the expressions about MDRPIs skin assessment (83.6%), and the lowest was in those about follow-up (50.8%). There was no significant relationship between the total score and age, work experience and specialties (p > .05 for each). However, scores were significantly higher in females than males (65.5 vs. 47.8, p = .020) and in those with a postgraduate degree than those with a bachelor's degree (81.8 vs. 57.9, p = .008). CONCLUSIONS Our study demonstrated that nurses do not have sufficient perception of MDRPIs. The findings of the study can be used to improve nursing policies and practices in acute care settings. Additional studies will be needed with nurses and healthcare professionals working in different clinical settings. RELEVANCE TO THE CLINICAL PRACTICE This study demonstrates the nurses' need for more knowledge about MDRPIs and will help inform healthcare institutions and their management teams in developing programs and improving protocols to reduce the incidence of MDRPIs.
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Affiliation(s)
- Öznur Erbay Dalli
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, Uludag University, Nilüfer, Bursa, Turkey
| | - Nermin Kelebek Girgin
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, Uludag University, Nilüfer, Bursa, Turkey
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Designing devices to communicate effectively with intensive care nurses to prevent pressure injuries: A qualitative study. Intensive Crit Care Nurs 2022; 71:103244. [DOI: 10.1016/j.iccn.2022.103244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 11/23/2022]
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Fallahi M, Soroush A, Sadeghi N, Mansouri F, Mobaderi T, Mahdavikian S. Comparative Evaluation of the Effect of Aloe Vera Gel, Olive Oil, and Compound Aloe Vera Gel-Olive Oil on Prevention of Pressure Ulcer: A Randomized Controlled Trial. Adv Biomed Res 2022; 11:6. [PMID: 35284353 PMCID: PMC8906091 DOI: 10.4103/abr.abr_121_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/01/2021] [Accepted: 08/01/2021] [Indexed: 01/16/2023] Open
Abstract
Background One of the most common problems in the intensive care units (ICUs) is pressure ulcers (PUs). The present study aimed to evaluate the effectiveness of aloe vera gel, olive oil, and compound aloe vera gel-olive oil in the prevention of PUs. Materials and Methods This randomized clinical trial was conducted on 240 patients. They were randomly divided into four groups, aloe vera gel (n = 60), olive oil (n = 60), aloe vera gel-olive oil combination (n = 60), and control (n = 60). Braden scale and National Pressure Ulcer Advisory Panel scale were used to collect data. The intervention was performed for 30 days. In the intervention and control groups, the patient received routine care. In each intervention group, 10-15 ml of olive oil or aloe vera gel or a combination of olive oil and aloe vera was rubbed into body areas under pressure. Results There were no PUs detected in all groups before the intervention; after the intervention, 12 patients in the olive group, 20 patients in the aloe vera group, 10 patients in the aloe vera-olive combination group, and 22 patients in the control group developed PUs. The results reported 40% of the patients with stage 1 PU and 10% of them with stage 2. Conclusion Due to the effectiveness of olive oil and aloe vera-olive oil combination in preventing PU, it is recommended to use these herbal compounds in preventing PU on ICU patients.
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Affiliation(s)
- Masoud Fallahi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Soroush
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Sadeghi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Feizollah Mansouri
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Tofigh Mobaderi
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Somayeh Mahdavikian
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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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: 3] [Impact Index Per Article: 1.5] [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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Antony L, Thelly AS. Knowledge on Prevention of Pressure Ulcers Among Caregivers of Patients Receiving Home-based Palliative Care. Indian J Palliat Care 2022; 28:75-79. [PMID: 35673375 PMCID: PMC9165463 DOI: 10.25259/ijpc_84_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives: Pressure Ulcer (PUs) remains one of the most crucial aspects of any home-based palliative care setting. The objective of this need assessment study was to assess caregivers’ knowledge regarding the prevention of pressure ulcers (PUs) among home-based palliative care patients. Materials and Methods: Study design: This study was a quantitative cross-sectional survey. Setting: The study was conducted among caregivers of home-based palliative care patients residing in Olavanna Panchayath, Kozhikode. Population: Caregivers of home-based palliative care patients at risk of developing bedsores. Sample and sample size: Using the purposive sampling technique, the need assessment was conducted among 20 caregivers of home-based palliative care patients. Data were collected using a structured knowledge interview schedule. Data analysis: The obtained data were analyzed using descriptive statistics. Results: Knowledge assessment among care providers reveals that 10% had good knowledge, 40% had average knowledge, 50% had poor knowledge, and none had very good or very poor knowledge. Conclusion: Providing evidence-based clinical practice guidelines and structured teaching programs can improve the knowledge of caregivers. Measures to improve the availability of helping hands at home through volunteer training, ensuring the necessary equipment and regular supervision are crucial for contributing to patient comfort and safety, which will enhance the quality of life of palliative care patients
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Affiliation(s)
- Lovely Antony
- Department of Community Health Nursing, SIMET College of Nursing, Palakkad, Kerala, India,
| | - Anu Savio Thelly
- Department of Palliative Medicine, Palliative Care Nursing, Mahatma Gandhi Medical College and Research Institute, Pillayarkuppam, Pondicherry, India,
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Furtado K, Lopes T, Afonso A, Infante P, Voorham J, Lopes M. Content Validity and Reliability of the Pressure Ulcer Knowledge Test and the Knowledge Level of Portuguese Nurses at Long-Term Care Units: A Cross-Sectional Survey. J Clin Med 2022; 11:jcm11030583. [PMID: 35160035 PMCID: PMC8836429 DOI: 10.3390/jcm11030583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Improvement in pressure ulcer care depends both on the dissemination of knowledge and its implementation. This study aims to translate the Pressure Ulcer Knowledge Test into Portuguese from Portugal and evaluate the internal consistency of the questionnaire. The second aim is to assess nurses’ pressure ulcer knowledge level. (2) Methods: The Pressure Ulcer Knowledge Test was translated into Portuguese, and the translated test’s internal consistency and content validity were assessed. Further, the authors conducted a cross-sectional survey using the test among 221 nurses working in long-term care units. (3) Results: The Cronbach’s alpha internal coefficient of reliability recorded for the 47 items was 0.738, which is higher than the minimum acceptable level of 0.7. The Cronbach’s alpha for the subscales was 0.709 for prevention/risk and less than 0.5 for staging and wound description. Only two of the 221 nurses achieved a score of 90% correct answers or more. The nurses scored lower in questions related to prevention/risk (Me = 67.4%, IQR = 60.6–75.8% vs. staging: ME = 85.7%, IQR = 71.4–85.7%, description: ME = 85.7%, IQR = 71.4–85.7%, p < 0.001). (4) Conclusion: The internal consistency of the instrument was acceptable. The instrument can accurately measure Portuguese nurses’ knowledge of pressure ulcers, and its information can help improve education and implementation of best practices.
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Affiliation(s)
- Katia Furtado
- Out patient Department, Hospital of Portalegre, Unidade Local de Saúde do Norte Alentejano, 7300-312 Portalegre, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, Portugal;
- Correspondence:
| | - Teresa Lopes
- Emergency Department, University Hospitalar Center Cova da Beira, 6200-000 Covilhã, Portugal;
- Department of Nursing, Health School, Polyctechnic Institute of Guarda, 6300-000 Guarda, Portugal
| | - Anabela Afonso
- CIMA, IIFA, Universidade de Évora, 7000-671 Évora, Portugal; (A.A.); (P.I.)
- Departamento de Matemática, ECT, Universidade de Évora, 7000-671 Évora, Portugal
| | - Paulo Infante
- CIMA, IIFA, Universidade de Évora, 7000-671 Évora, Portugal; (A.A.); (P.I.)
- Departamento de Matemática, ECT, Universidade de Évora, 7000-671 Évora, Portugal
| | - Jaco Voorham
- DTIRS—Data to Insights Research Solutions, 1750-307 Lisboa, Portugal;
| | - Manuel Lopes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, Portugal;
- São João de Deus School of Nursing, Universidade de Évora, 7000-671 Évora, Portugal
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Ghazanfari MJ, Karkhah S, Maroufizadeh S, Fast O, Jafaraghaee F, Gholampour MH, Zeydi AE. Knowledge, attitude, and practice of Iranian critical care nurses related to prevention of pressure ulcers: A multicenter cross-sectional study. J Tissue Viability 2022; 31:326-331. [DOI: 10.1016/j.jtv.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
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Factors Predicting Pressure Injury Incidence in Older Adults Following Elective Total Hip Arthroplasty: A Longitudinal Study. Adv Skin Wound Care 2022; 35:48-55. [PMID: 34935722 DOI: 10.1097/01.asw.0000801540.04621.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To identify the factors associated with pressure injury (PI) development in older adult patients who underwent elective total hip arthroplasty (THA). METHODS A nonexperimental longitudinal prospective study was conducted with a sample of 40 patients undergoing elective THA. Patients were evaluated for PI at hospital admission, 24 hours postsurgery, at discharge, and 1 month after surgery. RESULTS The incidence of PIs (category 1 or category 2) in this study was 7.9% 24 hours after surgery and 24.3% at discharge. The most common PI location was the sacrum/coccyx or the ischial tuberosity. This study found significant relationships between PIs and female sex (odds ratio [OR], 8.75), body fat mass percentage (OR, 1.15), and the motor score from a Functional Independence Measure scale (OR, 0.89). Finally, the following variables were also associated with PIs (P < .1): skeletal muscle mass (OR, 0.82), lower limb with osteoarthritis weight (OR, 0.61), lower limb without osteoarthritis weight (OR, 0.62), and geriatric depression scale (OR, 1.12). CONCLUSIONS This work identifies those patients at higher risk of PI, enabling targeted prevention and treatment in the population of patients undergoing elective THA. The findings of this study are in line with extant literature and suggest that women with a higher percentage of body fat and less mobility had a higher risk of PI.
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Rostamvand M, Abdi K, Gheshlagh RG, Khaki S, Dehvan F, Barzgaran R. Nurses' attitude on pressure injury prevention: A systematic review and meta-analysis based on the pressure ulcer prevention instrument (APuP). J Tissue Viability 2021; 31:346-352. [PMID: 34952775 DOI: 10.1016/j.jtv.2021.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prevention of pressure ulcers (PU) is one of the most important indicators of the quality of patient care that may be influenced by the attitude of nurses. Nurses are responsible for maintaining the integrity of the skin and preventing its complications. The aim of this study was to assess the overall attitude of nurses on PU prevention based on their scores on the Attitude towards Pressure ulcer Prevention instrument (APuP). METHODS In this systematic review and meta-analysis, databases including Web of Science, Science Direct, PubMed, and Scopus were searched, using the following keywords: Pressure Ulcer, Pressure injury, Bedsore, Pressure Sore, Decubitus Ulcer, Attitude, and their possible combinations. Heterogeneity of studies was assessed with I2 index and Cochrane-Q test. Based on heterogeneity between the studies, the data were analyzed using a random effects model. All the analyses were performed using STATA v.16 software. RESULTS Twelve studies with a sample size of 7824 people were analyzed. The overall score of attitude towards pressure ulcer prevention was 70.84% (95% CI: 66.34-75.35) and the highest and lowest scores were related to the dimensions of individual priority (78.83%, 95% CI: 74.69-82.97) and competence (70.11%, 95% CI: 67.24-72.94), respectively. The percentage of the total score of attitude towards pressure ulcer prevention in nurses was higher than nursing students (72.15%, 95% CI: 67.10-77.20 vs. 67%, 95% CI: 53.80-80.20). Sensitivity analysis confirmed the stability of the results. Publication bias was significant (p = 0.036). CONCLUSION The attitude of nurses and nursing students towards the prevention of pressure ulcers was moderate, and providing the necessary training to these groups was essential.
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Affiliation(s)
- Maryam Rostamvand
- MSc in Psychiatric Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Mazandaran, Iran.
| | - Kamel Abdi
- Nursing Department, Faculty of Medicine, Komar University of Science and Technology, Sulimaniya City, Kurdistan Region, Iran.
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Soore Khaki
- Department of Nursıng, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Fazel Dehvan
- Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Raziyeh Barzgaran
- Instructor, Faculty Member of the Nursing Department, School of Nursing and Midwifery, Islamic Azad University, Birjand, Iran.
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Hu L, Sae-Sia W, Kitrungrote L. Intensive Care Nurses' Knowledge, Attitude, and Practice of Pressure Injury Prevention in China: A Cross-Sectional Study. Risk Manag Healthc Policy 2021; 14:4257-4267. [PMID: 34703338 PMCID: PMC8524251 DOI: 10.2147/rmhp.s323839] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background Pressure injury (PI) remains a critical health issue worldwide. The global incidence of hospital-acquired PI is 8.4%, and among intensive-care unit (ICU) patients, it is even higher, ranging from 6.60% to 36.80%. It is important to investigate ICU nurses’ PI prevention knowledge, attitudes, and practices (KAP). Aim The aim of this study was to describe the level of Chinese ICU nurses’ knowledge, attitudes, and self-reported practices of PI prevention. Materials and Methods From March 31 to April 30, 2019, we recruited a total of 510 ICU nurses into the current study using convenience sampling. The Modified Pressure Ulcer Knowledge Assessment Tool version 2.0, Attitudes toward Pressure Ulcer Prevention instrument, and Questionnaire to evaluate nurses’ Adherence to Recommendations for Preventing Pressure Ulcers were used for data collection. We used one-way analysis of variance, Student’s t-test, and the Mann–Whitney U-test to assess differences in knowledge, attitudes, and self-reported practices of PI prevention among ICU nurses, whom we categorized by their demographic characteristics. Results Mean scores of participants’ knowledge, attitude, and their self-report practice were 65.82 ± 9.29, 76.65 ± 8.62, and 83.35 ± 13.55, respectively. Participants with bachelor’s degrees or higher, who worked in tertiary hospitals, and who had received training on PI prevention over the last year had higher scored on PI prevention knowledge (all P < 0.05). Participants who had received training on PI prevention over the last year scored higher on attitude than those who had not received such training over the last year (P = 0.001). Conclusion ICU nurses surveyed in this study did not demonstrate an acceptable level of knowledge about PI prevention, while their attitudes and self-reported practices were acceptable. Continuing education or in-service training should be provided to enhance ICU nurses’ knowledge of PI prevention.
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Affiliation(s)
- Li Hu
- Breast Surgery Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, People's Republic of China.,Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Wipa Sae-Sia
- Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Luppana Kitrungrote
- Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
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Rummel E, Evans EM, O'Neal PV. Educating Certified Nursing Assistants to Communicate Skin Changes to Reduce Pressure Injuries. J Gerontol Nurs 2021; 47:21-28. [PMID: 34309451 DOI: 10.3928/00989134-20210624-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Pressure injuries (PIs) are common and costly complications in long-term care (LTC) residents. Educating and coaching certified nursing assistants (CNAs) to communicate early skin changes is a PI surveillance strategy that may influence PI outcomes. A communication guide related to Skin, Clean, Activity, and Nutrition was developed for CNAs to promote prompt upstream communication to licensed nurses. A pre-/post-intervention design measured PI knowledge and skills in 24 CNAs, and PI incidence was tracked over a 6-week time period. CNAs demonstrated improvement in their PI surveillance role, comfort in identifying and reporting skin changes, keeping skin clean and dry, and resident nutritional status. Baseline PI incidence of 9.6% decreased to 0% by Week 3, and no new PIs occurred over 6 weeks. CNAs developed role awareness and knowledge in primary PI surveillance and were instrumental in a team approach to decrease PIs in a LTC setting. [Journal of Gerontological Nursing, 47(8), 21-28.].
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Cheshmeh S, Hojati N, Mohammadi A, Rahmani N, Moradi S, Pasdar Y, Elahi N. The use of oral and enteral tube-fed arginine supplementation in pressure injury care: A systematic review and meta-analysis. Nurs Open 2021; 9:2552-2561. [PMID: 34170617 PMCID: PMC9584468 DOI: 10.1002/nop2.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/01/2021] [Accepted: 06/02/2021] [Indexed: 02/02/2023] Open
Abstract
AIM Pressure injuries (PIs) are one of the most common complications related to immobility, especially in hospitalized patients, which lead to increased morbidity, infection and overall decreased quality of life. Arginine supplementation may prevent the development of PIs. This study has summarized the findings of studies on the effect of arginine supplementation on PI healing. DESIGN Systematic review and meta-analysis. METHODS This study was conducted on online electronic databases including PubMed, Scopus, Web of Science, Google Scholar and Embase to identify relevant clinical trial studies up to September 2020. The pooled effect size of arginine supplement effects on PI was evaluated with standard mean difference (SMD) with 95% confidence interval (CI). RESULTS Eight studies met the inclusion criteria for this meta-analysis with 196 patients. PIs were significantly improved with Arginine supplementation (SMD: -0.6; CI 95%: -0.9 to -0.3, I2 : 72.5%, p = .001). Subgroup analysis showed that administering Arginine supplement more than 15 g/day had more beneficial effects on the healing of PIs (SMD: -2.8; CI 95%: -4.08 to -1.52, I2 : 54.7%, p = .138). CONCLUSIONS Our findings suggest that the administration of Arginine supplement in patients with PIs can accelerate the healing of this type of ulcer. Arginine is a supplement, and primary treatment is still needed to optimize PI healing. Therefore, arginine supplementation in addition to primary treatment seems to be an appropriate approach for the healing of PIs. Further well-designed studies are necessary to prevent the development of PIs compared to their primary treatment.
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Affiliation(s)
- Sahar Cheshmeh
- School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Niloofar Hojati
- School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Arman Mohammadi
- Department of PediatricSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Negin Rahmani
- Julius Maximillian University of WuerzburgWuerzburgGermany
| | - Shima Moradi
- Department of Nutritional SciencesResearch Center for Environmental Determinants of Health (RCEDH)Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Yahya Pasdar
- Department of Nutritional SciencesResearch Center for Environmental Determinants of Health (RCEDH)Health InstituteKermanshah University of Medical SciencesKermanshahIran
| | - Negin Elahi
- School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
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Parisod H, Holopainen A, Kielo-Viljamaa E, Puukka P, Beeckman D, Haavisto E. Attitudes of nursing staff towards pressure ulcer prevention in primary and specialised health care: A correlational cross-sectional study. Int Wound J 2021; 19:399-410. [PMID: 34121328 PMCID: PMC8762573 DOI: 10.1111/iwj.13641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 01/03/2023] Open
Abstract
The aim of this correlational, cross‐sectional study was to assess the pressure ulcer prevention attitudes of the nursing staff and to identify factors associated with it both in primary and special health care. The study was conducted with nursing staff (N = 554) working in primary and special health care units in two hospital districts in Finlandin 2018 to 2019. Attitude towards Pressure ulcer Prevention instrument was used for data collection. Demographic data, Pressure Ulcer Prevention Knowledge test, and Pressure Ulcer Prevention Practice instrument were used as background variables. Data were analysed with statistical tests. Nursing staff working in primary care (n = 327) had more positive attitudes towards pressure ulcer prevention than those in specialised care (n = 209; P = .047). Working as a wound care nurse (P = .0005), working experience after graduation (P = .0017), self‐reported pressure ulcer prevention and early detection skills (P < .0001), pressure ulcer prevention knowledge (P = .0002), and views about the realisation of their unit's pressure ulcer prevention practices (P < .0001) independently explained variation in participants' attitudes. Attention should be placed on the pressure ulcer prevention attitudes of nurses who are less experienced or less skilled and who have lower pressure ulcer prevention knowledge. Positive organisational culture towards evidence‐based pressure ulcer prevention practices should be promoted.
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Affiliation(s)
- Heidi Parisod
- Nursing Research Foundation, Helsinki, Finland.,WHO Collaborating Center for Nursing, Helsinki, Finland.,Department of Nursing Science, University of Turku, Turku, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland.,WHO Collaborating Center for Nursing, Helsinki, Finland.,The Finnish Centre for Evidence-Based Health Care: A JBI Centre of Excellence, Helsinki, Finland
| | - Emilia Kielo-Viljamaa
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
| | - Pauli Puukka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden.,Department of Clinical Research, Faculty of Health Sciences, Research Unit of Plastic Surgery, Odense, Denmark
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Hospital District, Pori, Finland
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Lesão por pressão decorrente do posicionamento cirúrgico e fatores associados. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao00642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kang MK, Kim MS. Effects of Attitude, Barriers/Facilitators, and Visual Differentiation on Oral Mucosa Pressure Ulcer Prevention Performance Intention. Healthcare (Basel) 2021; 9:76. [PMID: 33466903 PMCID: PMC7830508 DOI: 10.3390/healthcare9010076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/01/2021] [Accepted: 01/12/2021] [Indexed: 11/28/2022] Open
Abstract
Oral mucosa pressure ulcers (PUs) can result in frequent pain and discomfort, and have negative effects on quality of life. We aimed to examine attitude, barriers/facilitators of oral mucosa PU prevention, the ability to differentiate oral mucosa PU, and to identify factors influencing PU prevention performance intention. This was a cross-sectional descriptive study of 112 nurses in seven tertiary hospitals and three secondary hospitals. The data collection period was from August to December 2018. For data analysis, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were used. The mean score of attitudes toward oral mucosa PU prevention was 3.74 ± 0.39. Barriers to oral mucosa PU prevention were 5.65 ± 1.66, and facilitators were 5.35 ± 1.34. The mean correct answer rate of visual differentiation ability was 13%. The factors affecting intention to perform oral mucosa PU prevention were facilitators of oral mucosa PU prevention (β = 0.32, p = 0.001) and attitude (β = 0.26, p = 0.005). To increase intention to perform oral mucosa PU prevention, positive attitudes and enhanced facilitators should be encouraged. Therefore, standardized guidelines and strategies, such as educational opportunities and allocation of resources and personnel focused on oral mucosa PU prevention, need to be provided.
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Affiliation(s)
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, Busan 48513, Korea;
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Prevention and treatment of pressure injuries: A meta-synthesis of Cochrane Reviews. J Tissue Viability 2020; 29:227-243. [DOI: 10.1016/j.jtv.2020.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/13/2020] [Accepted: 05/29/2020] [Indexed: 12/21/2022]
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Rodríguez JEC, Gamboa SG. Prevención de lesiones por presión: conocimientos y actitudes del personal de enfermería. J Wound Care 2020; 29:6-15. [PMID: 33054619 DOI: 10.12968/jowc.2020.29.latam_sup_2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Identify, analyse and summarise the empirical evidence on nurses' knowledge and attitudes towards pressure ulcer (PU) prevention. METHOD A systematic literature review on articles published between 2008 y 2019 was performed following PRISMA guidelines. Databases were checked for the following terms in Spanish, English and Portuguese: attitude, knowledge, pressure ulcer, and nursing staff. RESULTS A total of 33 articles with a quantitative descriptive approach were included in this review. The authors found a lack of knowledge on PU prevention among nursing staff. The nurses' attitudes were considered positive. Few studies examined the correlation between knowledge, attitude and clinical practice. CONCLUSION There is a need for continued professional education in terms of PU prevention among nurses. Research on alternative ways to organise nursing staff's work is needed. Studying up-to-date guidelines on PU prevention on a regular basis and attending training in this subject might be beneficial to improve nurses' knowledge and attitudes towards PU prevention.
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Rodríguez JEC, Gamboa SG. Prevención de lesiones por presión: conocimientos y actitudes del personal de enfermería. J Wound Care 2020; 29:6-15. [PMID: 33048017 DOI: 10.12968/jowc.2020.29.sup10.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Identify, analyse and summarise the empirical evidence on nurses' knowledge and attitudes towards pressure ulcer (PU) prevention. METHOD A systematic literature review on articles published between 2008 y 2019 was performed following PRISMA guidelines. Databases were checked for the following terms in Spanish, English and Portuguese: attitude, knowledge, pressure ulcer, and nursing staff. RESULTS A total of 33 articles with a quantitative descriptive approach were included in this review. The authors found a lack of knowledge on PU prevention among nursing staff. The nurses' attitudes were considered positive. Few studies examined the correlation between knowledge, attitude and clinical practice. CONCLUSION There is a need for continued professional education in terms of PU prevention among nurses. Research on alternative ways to organise nursing staff's work is needed. Studying up-to-date guidelines on PU prevention on a regular basis and attending training in this subject might be beneficial to improve nurses' knowledge and attitudes towards PU prevention.
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Kwong EWY, Chen LY, Kwan RYC, Lee PH. The effectiveness of a pressure injury prevention program for nursing assistants in private for-profit nursing homes: A cluster randomized controlled trial. J Adv Nurs 2020; 76:1780-1793. [PMID: 32285486 DOI: 10.1111/jan.14391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 03/18/2020] [Accepted: 03/30/2020] [Indexed: 02/04/2023]
Abstract
AIM To examine the effectiveness of a pressure injury prevention program for private for-profit nursing homes. DESIGN This study was a two-arm cluster randomized controlled trial. Ten private for-profit nursing homes made up the clusters. METHODS The participants were nursing home residents who aged 60 or above regardless of whether or not having pre-existing pressure injuries and also three types of nursing home assistants who provided direct care to the residents from 10 private for-profit nursing homes. These 10 nursing homes were randomly assigned to either the experimental or the control group. There were 477 and 536 resident participants and 51 and 62 nursing assistant participants in the experimental and control groups, respectively. The residents were the study participants and the nursing assistant participants were the interveners. The experimental group had the pressure injury prevention program implemented while the control group received the usual care. The primary study outcome which was the pressure injury incidence was analysed by GEE. Significance was set at a p-value of ≤.05. The data were collected between September 2017-March 2018. RESULT There were significant interactive effects of time and group on the incidence of pressure injuries (p = .0015) and on the skill performance of the nursing assistant participants (p < .0001). CONCLUSIONS An evidence-based pressure injury prevention program reduced the development of the pressure injuries and improved the skill performance of the nursing assistant participants. It is highly recommended that private for-profit nursing homes with high proportion of non-professional nursing assistants and insufficient nurses adopt this program for improving the prevention care of pressure injuries. IMPACT This research has an impact on prevention care of pressure injury in private for-profit nursing homes with high proportion non-professional nursing assistants which have the similar characteristics as the nursing homes studied in various regions and countries. TRIAL REGISTRATION The Controlled Trial registration ID is NCT02270385.
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Affiliation(s)
- Enid W-Y Kwong
- School of Nursing, Putian University, Putian, Fujian Province, China.,School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Liang Y Chen
- School of Nursing, Putian University, Putian, Fujian Province, China
| | - Rick Y-C Kwan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Paul H Lee
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Murugiah S, Ramuni K, Das U, Hassan HC, Abdullah SKBF. The knowledge of pressure ulcer among nursing students and related factors. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Avsar P, Patton D, O'Connor T, Moore Z. Do we still need to assess nurses' attitudes towards pressure ulcer prevention? A systematic review. J Wound Care 2020; 28:795-806. [PMID: 31825774 DOI: 10.12968/jowc.2019.28.12.795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To critically appraise and synthesise existing research literature pertaining to nurses' attitudes towards pressure ulcer (PU) prevention. METHOD Using systematic review methodology, published quantitative studies focusing on nurses' attitudes towards PU prevention measured by psychometric tests were included. The search was conducted in May 2019 using PubMed, CINAHL, Scopus, Cochrane and EMBASE databases, and returned 442 records, of which 21 met the inclusion criteria. Data were extracted using a pre-designed extraction tool and all included studies were quality appraised using the checklist. RESULTS Of the included studies, 20 employed a cross-sectional design and one author employed a validation study. In measuring nurses' attitudes toward PU prevention two distinct instruments were used: the 'Moore and Price Attitude Scale' and the 'Attitude towards Pressure Ulcer Prevention Instrument'. The mean attitude score within the studies was 73% (standard deviation=9.2%). The lowest attitude score was 51%, while the highest score was 89%. The results obtained from the studies indicated that 86% (n=18) yielded positive attitude results. CONCLUSION The findings suggest that, overall, nurses are positively disposed towards PU prevention. However, it is important to highlight that the nurses have difficulties translating this positive attitude into actual PU prevention strategies.
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Affiliation(s)
- Pinar Avsar
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Skin Wounds and Trauma Research Centre, RCSI
| | - Declan Patton
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Skin Wounds and Trauma Research Centre, RCSI.,Honorary Senior Fellow, Faculty of Science, Medicine and Health, Wollongong, Australia.,Adjunct Associate Professor, School of Nursing, Fakeeh College, Jeddah, Saudi Arabia
| | - Tom O'Connor
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Skin Wounds and Trauma Research Centre, RCSI.,Honorary Doctor, Lida Institute, Shanghai.,Adjunct Professor, School of Nursing, Fakeeh College, Jeddah, Saudi Arabia
| | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), Skin Wounds and Trauma Research Centre, RCSI.,Adjunct Professor, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Professor, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.,Honorary Professor, Lida Institute, Shanghai.,Senior Tutor, University of Wales.,Adjunct Professor, School of Nursing, Fakeeh College, Jeddah, Saudi Arabia
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Berihu H, Wubayehu T, Teklu T, Zeru T, Gerensea H. Practice on pressure ulcer prevention among nurses in selected public hospitals, Tigray, Ethiopia. BMC Res Notes 2020; 13:207. [PMID: 32276650 PMCID: PMC7149915 DOI: 10.1186/s13104-020-05049-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 03/30/2020] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Hagos Berihu
- School of Nursing, College of Health Sciences and Comprehensive Specialized Hospital, Aksum University, P.O.Box: 298, Tigray, Ethiopia
| | - Tewolde Wubayehu
- School of Medicine, College of Health Sciences and Comprehensive Specialized Hospital, Aksum University, Tigray, Ethiopia
| | - Tewolde Teklu
- Departement of pharmacy, College of Health Sciences and Comprehensive Specialized Hospital, Aksum University, Tigray, Ethiopia
| | - Teklay Zeru
- School of Nursing, College of Health Sciences and Comprehensive Specialized Hospital, Aksum University, P.O.Box: 298, Tigray, Ethiopia
| | - Hadgu Gerensea
- School of Nursing, College of Health Sciences and Comprehensive Specialized Hospital, Aksum University, P.O.Box: 298, Tigray, Ethiopia.
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Khojastehfar S, Najafi Ghezeljeh T, Haghani S. Factors related to knowledge, attitude, and practice of nurses in intensive care unit in the area of pressure ulcer prevention: A multicenter study. J Tissue Viability 2020; 29:76-81. [PMID: 32061501 DOI: 10.1016/j.jtv.2020.02.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/12/2020] [Accepted: 02/02/2020] [Indexed: 10/25/2022]
Abstract
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.
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Affiliation(s)
- Shahrokh Khojastehfar
- Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi St, Valiasr St, Tehran, Iran.
| | - Tahereh Najafi Ghezeljeh
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi St, Valiasr St, Tehran, Iran.
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Yilmazer T, Inkaya B, Tuzer H. Care under the guidance of pressure injury prevention protocol: a nursing home sample. Br J Community Nurs 2019; 24:S26-S33. [PMID: 31804884 DOI: 10.12968/bjcn.2019.24.sup12.s26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pressure injury is a healthcare problem frequently encountered in nursing homes. This study evaluated the effects of the care delivered under the guidance of a protocol for pressure injury prevention at a nursing home. It was implemented in four phases. In the pre-protocol period, the pressure injury incidence and nurses' care practices were evaluated. In the second phase, nurses were trained to use the protocol. In the third phase, the nurses provided care under the guidance of the protocol (post-protocol period). In the fourth phase, the incidence of pressure injury and nurses' care practices were compared between the pre- and post-protocol periods. The average age of the older residents was 78.40±7.12 years, and all were at high or very high risk of pressure injury according to the Braden scale scores. Some 30% were bed bound; 90% had faecal and urinary incontinence; and 70% had malnutrition. The results showed that the pressure injury incidence reduced from 17.39% in the pre-protocol period to 10.87% in the post-protocol period, while the nurses' care practices improved in the post-protocol period. Thus, use of pressure injury-prevention protocols can reduce the incidence of these injuries in vulnerable care home residents.
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Affiliation(s)
- Tuba Yilmazer
- The Department of Nursing, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bahar Inkaya
- The Department of Nursing, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Hilal Tuzer
- The Department of Nursing, Faculty of Health Sciences, Ankara Yildirim Beyazit University, Ankara, Turkey
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Kısacık ÖG, Sönmez M. Pressure ulcers prevention: Turkish nursing students' knowledge and attitudes and influencing factors. J Tissue Viability 2019; 29:24-31. [PMID: 31759832 DOI: 10.1016/j.jtv.2019.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/23/2019] [Accepted: 11/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Öznur Gürlek Kısacık
- Faculty of Health Science, Nursing Department, Afyonkarahisar University of Health Science, 03200, Afyonkarahisar, Turkey.
| | - Münevver Sönmez
- Faculty of Health Science, Nursing Department, Bülent Ecevit University of Health Science, 67000, Zonguldak, Turkey
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Lotfi M, Aghazadeh AM, Asgarpour H, Nobakht A. Iranian nurses' knowledge, attitude and behaviour on skin care, prevention and management of pressure injury: A descriptive cross-sectional study. Nurs Open 2019; 6:1600-1605. [PMID: 31660188 PMCID: PMC6805304 DOI: 10.1002/nop2.365] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Mojgan Lotfi
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina HospitalTabriz University of Medical SciencesTabrizIran
| | - Ahmad Mirza Aghazadeh
- Department of Basic sciences, Paramedical FacultyTabriz University of Medical SciencesTabrizIran
| | - Hossein Asgarpour
- Department of Internal SurgeryFaculty Member of Çanakkale onsekiz martÇanakkaleTurkey
| | - Afsaneh Nobakht
- Faculty of Nursing and Midwifery, Sina HospitalTabriz University of Medical SciencesTabrizIran
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Duarte FHDS, Santos WND, Silva FSD, Lima DMD, Fernandes SF, Silva RARD. Terms of specialized nursing language for people with pressure injury. Rev Bras Enferm 2019; 72:1028-1035. [PMID: 31432962 DOI: 10.1590/0034-7167-2018-0492] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/26/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to validate the terms of the specialized nursing language used in care for hospitalized patients with Pressure Injury, identified in nurses' records, mapping them with the terms of the International Classification for Nursing Practice (ICNP® 2017). METHODS methodological study, carried out at a School Hospital in 2018. It was performed: extraction of terms of medical records; normalization; cross-mapping between extracted terms and those in ICNP®; distribution in the seven axes; theoretical definition and validation of terms. RESULTS 27,756 terms were extracted. The normalization resulted in 370 relevant terms, being: 225 listed and 145 not listed in the ICNP®, being 60 similar, 13 more comprehensive, 38 more restricted and 34 without agreement, all of which are validated. CONCLUSION this study identified and validated terms used by nurses to assist people with Pressure Injury. These may contribute to the unification of professional nursing language in care for these clients.
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