Knowledge and Attitude of Intensive Care Nurses regarding the Prevention of Pressure Ulcer

The effect of knowledge levels of intensive care nurses about pressure injuries on their attitude toward preventing pressure injuries

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.

Performance checklist and its influence on knowledge and satisfaction of intensive care nurses: A quasi-experimental study

AIM

The purpose of this study was to evaluate the impact of using a performance checklist on knowledge and satisfaction of intensive care nurses.

METHOD

This study was a quasi-experimental study and performed on 70 intensive care nurses in two groups. Performance checklists had to be filled by the nurses in experiment group during central venous pressure (CVP) measurement procedure. Knowledge and the nurses about standards of CVP measurement and their satisfaction were evaluated in both groups by a researcher-made questionnaire. The data were analysed using the SPSS software.

RESULTS

In the experiment group, the level of knowledge significantly increased after the intervention (p = .001) and the majority of nurses (85.7%) had a high level of satisfaction. Also, there was a significant difference between mean knowledge scores of the two groups after the intervention (p = .006).

CONCLUSION

This showed that applying performance checklists can influence nurses' knowledge and should consider a simple indirect educational method.

Determining the pressure injury and staging knowledge of nurses at a hospital in Turkey

AIM

The aim of this research is to examine the nurses's knowledge level regarding pressure injury and its staging.

MATERIALS AND METHODS

The research was conducted in descriptive type. The data were collected at a hospital in Konya between September 1 and November 30, 2021. The sample of the study consisted of 158 nurses working in internal clinics, surgical clinics and intensive care units. "Sociodemographic Questionnaire Form" and "Modified Pieper Pressure Wound Knowledge Test (PUKT)" were used to collect data. Percentage, frequency, arithmetic mean, independent sample t-test and ANOVA tests were used to analyze the data.

RESULTS

It was found that 77.2% of the nurses had encountered pressure injuries and 63.1%had received training on pressure injuries. It was determined that 55.1% of them received this training as in-service training in the hospital. 96.8% of the nurses stated that pressure injury could be prevented with nursing care. The mean PUKT score of the nurses was 30.70 ± 7.15; staging mean score was 4.79 ± 1.87, wound description mean score was 4.43 ± 1.88; prevention/risk assessment score mean was determined as 20.78 ± 3.93. The average score obtained with the correct response rates to the test was 62.67%. There was no significant difference between nurses' education levels, years of employment and PUKT, wound description, staging and prevention/risk scores (p > .05). There was a significant difference between the mean PUKT score and staging mean score between those who received training on pressure injury and those who didn't, and between the units where the nurses worked and the mean PUKT score, wound description, staging and prevention/risk scores (p < .05).

CONCLUSION

It was found that the nurses's knowledge level was below satisfactory. It's recommended for nurses to attend trainings on pressure injury, to check the effectiveness of their training, to participate in scientific meetings and to encourage nurses to make research.

Pressure Injury Surveillance and Prevention in Australia: Monash Partners Capacity Building Framework

A hospital-acquired pressure injury (HAPI) is a common complication across the globe. The severity of HAPI ranges from skin redness and no skin breakdown to full skin and tissue loss, exposing the tendons and bones. HAPI can significantly impact the quality of life. In addition to the human cost, this injury carries a high economic burden with the cost of treatment far outweighing the preventative measures. The HAPI rates are a key indicator of health services performance. Globally, healthcare services aim to reduce its incidence. In Australia, the federal health minister has prioritised the need for improvement in HAPI surveillance and prevention. Capacity building is vital to optimise pressure injury (PI) surveillance and prevention in acute care services. In this perspective article, we provide a framework for capacity building to optimise HAPI prevention and surveillance in a large cross-sector collaborative partnership in Australia. This framework comprises six key action areas in capacity building to optimise the HAPI outcomes, such as research, organisational development, workforce development, leadership, collaboration, and consumer involvement.

Pressure Injury Prevention in COVID-19 Patients With Acute Respiratory Distress Syndrome

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019 and became a pandemic in a short period of time. While most infected people might have mild symptoms, older people and people with chronic illnesses may develop acute respiratory distress syndrome (ARDS). Patients with ARDS with worsening hypoxemia require prone positioning to improve the respiratory mechanics and oxygenation. Intubated patients may stay in a prone position up to 12–16 h, increasing the risk of pressure injury (PI). Frequent skin inspections and PI risk assessment in COVID-19 patients will be challenging due to hospital infection control measures aimed to reduce the risk for health professionals. In this perspective article, we summarize the best practice recommendations for prevention of PI in SARS-CoV-2-infected ARDS patients in prone positioning. Prior to positioning patients in prone position, the main recommendations are to (1) conduct a skin assessment, (2) use pressure redistribution devices, (3) select an appropriate mattress or an overlay, (4) ensure that the endotracheal tube securing device is removed and the endotracheal tube is secured with tapes, (5) use a liquid film-forming protective dressing, and (6) lubricate the eyes and tape them closed. Once a patient is in prone position, it is recommended to (1) use the swimmer's position, (2) reposition the patient every 2 h, and (3) keep the skin clean. When the patient is repositioned to supine position, healthcare professionals are advised to (1) assess the pressure points and (2) promote early mobilization.

The effect of educational intervention on the knowledge and attitude of intensive care nurses in the prevention of pressure ulcers

BACKGROUND

Pressure ulcers can cause disability, which can lead to a default in patients' safety and results in frequent complications for patients.

OBJECTIVES

This study aimed to determine the effect of educational intervention on nurses' knowledge and attitude in preventing pressure ulcers.

METHODS

In this study, 67 nurses of ICU wards at Ilam University of Medical Sciences were randomly assigned to the experimental or control group. Data collection tools included the demographic characteristics questionnaire, the Pieper Pressure Ulcer Knowledge test (PUKT) and the Attitude toward Pressure Ulcer tool (APuP). In the experimental group, the nurses were allocated into groups of four-five persons and for each group four face-to-face training sessions and two virtual training sessions by means of educational videos on bed sores were performed. Gathered data were analyzed using SPSS software version 16, and descriptive and analytical tests were performed.

RESULTS

PUKT questionnaire score in the experimental group improved from 15.68 (3.42) to 29.75 (12.33) (P = 0.000), while in the control group it was 16.40 (3.13) and 17.54 (6.62) before intervention, which was not significant (P > 0.05). Furthermore, the APUP questionnaire score in the experimental group improved from 27.12 (2.13) to 39.37 (3.21) (P = 0.000), while in the control group it was 27.65 (1.71) and 28.37 (5.00) before intervention, which was not significant (P > 0.05).

CONCLUSIONS

Since educational intervention improved the knowledge and attitude of nurses in preventing pressure ulcers, it is required to conduct appropriate educational interventions to improve their knowledge and attitude.