Educational campaign to increase knowledge of pressure ulcers

The impact of healthcare assistant education on pressure ulcer prevention: a systematic review

OBJECTIVE

To investigate the impact of education for healthcare assistants (HCAs) on their knowledge and skills in pressure ulcer (PU) prevention and on the incidence of PUs. A secondary aim was to evaluate education methodologies used in PU prevention programmes.

METHOD

Using systematic review methodology, key databases were searched with no limitations on date of publication. The search was conducted in November 2021 using the following databases: CINAHL, Embase, Scopus, MEDLINE, Cochrane Wounds Group Specialist Register and Cochrane Central Register of Controlled Trials. Inclusion criteria focused on studies that employed the use of education as an intervention, delivered to HCAs in any setting. The PRISMA guidelines were followed. The methodological quality of the studies was evaluated using the Evidence-Based Librarianship (EBL) appraisal checklist. Data were analysed using narrative analysis and meta-analysis.

RESULTS

The systematic search yielded an initial 449 records, of which 14 studies met the inclusion criteria. Outcome measures of HCA knowledge scores were reported in 11 (79%) studies. Outcome measures related to PU prevalence/incidence were reported in 11 (79%) studies. An increase in knowledge scores of HCAs post-educational intervention was reported in five (38%) studies. A significant reduction in PU prevalence/incidence rates post-educational intervention was reported in nine (64%) studies.

CONCLUSION

This systematic review affirms the benefits of education of HCAs on their knowledge and skills of PU prevention, and on PU incidence. The results must be treated with caution due to quality appraisal issues of included studies.

Evaluating Nurses' Knowledge of Pressure Injury Prevention: A Descriptive Study

OBJECTIVE

To evaluate nurses' knowledge on pressure injury (PI) prevention.

METHODS

Four hundred six nurses in Turkey participated in this descriptive study between January and February 2020. Participants completed an information form and the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI). The PUPKAI contains 26 items across six themes: (1) development, (2) classification and observation, (3) risk assessment, (4) nutrition, (5) interventions to reduce the amount of pressure/rupture, and (6) interventions to reduce the duration of pressure/rupture.

RESULTS

The mean age of the nurses was 26.93 ± 6.72 years. The mean total PUPKAI score was 11.80 ± 3.28. Almost all participants (91.6%) had insufficient knowledge on PI prevention. Male nurses scored higher on themes 1 and 2 than female nurses (P = .046, P = .029, respectively). Nurses with a postgraduate degree scored higher in total and on themes 2, 3, 5, and 6 (P = .001, P = .006, P = .011, P = .044, P = .029, respectively), and nurses with more than 10 years of service scored higher in total and on themes 4, 5, and 6 (P = .001, P = .002, P = .001, P = .026, respectively).

CONCLUSIONS

The nurses who participated in this study do not have enough knowledge on PI prevention.

Repositioning Practice of Bedridden Patients: An Evolutionary Concept Analysis

Introduction

Repositioning practice is an essential pressure ulcer prevention intervention that has emerged in the history of nursing. Numerous terms are employed to indicate its meaning, such as turning, positioning, or posturing. However, there is no available analysis that distinguishes these terms or analyzes repositioning practice attributes.

Objective

To analyze repositioning practice as a concept of bedridden patients in hospitals by combining methods from Foucault's archeology of knowledge and Rodger's concept analysis.

Concept Description

Repositioning practice passes through three eras: classical, modern, and research. The repositioning practice is “turn a bedridden patient in a harmonized way and ends with anchor and documentation.” The analysis concludes seven attributes for the repositioning practice: pre-turn, assessment, turn, harmonization, anchor, documentation, and time. The analysis assumes bedridden patients, and assigned nurses on duty are the antecedents. Moreover, the main consequence is pressure ulcer prevention, while patient safety and quality of care are the secondary consequences.

Discussion

Repositioning practice understanding has grown with time. Each era has added to or removed from nursing's understanding for repositioning practice until it appears as it now. The current analysis expects further development in repositioning practice understanding and applications.

Conclusion

Repositioning practice is an important nursing intervention and has shown a dynamic movement over history. It is expected that this dynamic will continue in the future.

Knowledge of pressure injury in medical and surgical nurses in a tertiary level hospital: A cross-sectional study

BACKGROUND

Nurses play a vital role in pressure injury prevention (PIP) but require foundational knowledge to ensure appropriate PIP strategies are enacted.

AIMS

To describe and compare medical and surgical nurses' knowledge of pressure injury (PI) in a tertiary level hospital in China, and to identify predictors of PI knowledge among these groups.

DESIGN

A cross-sectional survey was conducted between June and December 2020.

METHODS

Registered nurses from nine medical and fifteen surgical wards in a tertiary hospital were invited. The survey was composed of two parts; demographic and professional characteristics; and the Chinese translated version of the Pressure Ulcer Knowledge Assessment Tool 2.0 (PUKAT 2.0) where the total score ranged from 0 to 25; higher scores imply more knowledge. Medical and surgical nurses' knowledge test scores were compared using independent t-test. Multiple linear regression analysis was used to determine factors predictive of nurses' knowledge.

RESULTS

In total, 423 nurses from 24 wards participated the study and 404 nurses (95.5%) completed the knowledge test (Surgical n = 236, 58.4%; Medical n = 168, 41.6%). The PUKAT 2.0 mean score was 11.6 ± 3.0 (Surgical 12.2 ± 3.0; Medical 10.7 ± 2.8) with 335 (82.9%) nurses scoring <60%. Multiple linear regression showed working in surgical wards, nurse-in-charge position and previous PI training were significant predictors of knowledge scores.

CONCLUSION

Knowledge is a precursor to safe practice. Nurses demonstrated poor knowledge of PIP. Pressure injury related education may help improve nurses' knowledge but the extent to which it is used in place and impacts patients' outcome requires more investigation.

Factors affecting repositioning policy compliance: an integrative review

Objective

To explore the factors affecting nurses’ compliance with repositioning policy.

Methods

An integrative review was conducted following the Whittemore and Knafl methodology to identify the problem related to repositioning policy compliance. We searched the following databases: Coherence Wounds Group Specialized Register (Jan 1997 to Jun 2019), Ovid MEDLINE (Jan 1997 to Jun 2019), EBSCO CINAHL (Jan 1997 to Jun 2019), and Clinical Key database (Jan 2014 to Oct 2018).

Results

The review revealed three factors that influence repositioning compliance: nurse-related factors, patient-related factors, and Environment-related factors.

Conclusions

These factors directly impact one another and, in turn, influence the compliance of nurses to the repositioning policy. However, there is no evidence currently available that explains the collective impact of these factors and how they interact to affect repositioning policy compliance. Nevertheless, all these factors are important and should be considered to enhance and further improve the quality of nursing care and adherence to the repositioning policy.

Nurses' knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design

Background

Pressure ulcer is a preventable medical complication of immobility. It has psychological, economic and social impact on individual and family. Its cost of treatment is more than twice of cost of prevention. It is primarily the nurses’ responsibility to prevent pressure ulcer. The aim of this study was to assess the nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega.

Methods

A descriptive multicenter cross-sectional study design using quantitative method was employed to collect data from 212 randomly selected nurses. Data was collected using structured two validated self-administered instruments of pressure ulcer knowledge test evaluate nurses’ knowledge. Mean scores were compared using the Mann-Whitney U and Kruskal-Wallis tests. Means, standard deviation, and frequencies were used to describe nurses’ knowledge levels and barriers to pressure ulcer prevention.

Results

Analysis of the study displayed 91.5% had inadequate knowledge to pressure ulcer prevention. The mean of nurses’ knowledge in all theme and per item were 11.31 (SD = 5.97) and 0.43 (SD = 0.22).respectively. The study participants had the highest mean item score (2.65 ± 0.87) in nutrition theme, whereas, scored lowest on etiology and development (0.27 ± 0.18) and preventive measures to reduce duration of pressure (0.29 ± 0.18), The study also identified significant nurses read articles (0.000) and received training (p = 0.003). Shortage of pressure relieving devices, lack of staff and lack of training were the most commonly cited perceived barriers to practice pressure ulcer prevention.

Conclusions

This study highlights areas where measures can be made to facilitate pressure ulcer prevention in public hospitals in Wollega zones, such as increase regular adequate further training of nurses regarding pressure ulcer/its prevention points.

Electronic supplementary material

The online version of this article (10.1186/s12912-019-0346-y) contains supplementary material, which is available to authorized users.

Pressure ulcer prevention is everyone's business: the PUPS project

Prevention of pressure ulcers is one of the greatest healthcare challenges in terms of reducing patient harm. The literature shows that although numerous reports and policy documents have been published, pressure ulcer prevention remains an ongoing challenge. A number of innovations have been published offering practising nurses and managers ideas for raising awareness of skin care and preventing pressure ulcers. The majority of these have focused on patients in hospital settings with very little in the literature related to care-home and community initiatives. This article reports on an innovative approach to education for pressure ulcer prevention through collaboration between patients, carers and health and social care professionals.