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O'Brien N, Moore Z, Avsar P, Patton D, Nugent L, O'Connor T. The impact of healthcare assistant education on pressure ulcer prevention: a systematic review. J Wound Care 2023; 32:cxv-cxxvii. [PMID: 37405970 DOI: 10.12968/jowc.2023.32.sup7a.cxv] [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: 07/07/2023]
Abstract
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.
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Affiliation(s)
- Noreen O'Brien
- Milford Care Centre, Limerick, Ireland, The Royal College of Surgeons in Ireland
| | - Zena Moore
- Professor of Nursing, Head of School of Nursing and Midwifery and Director of the Skin Wounds and Trauma Research Centre, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin Ireland
- Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Professor, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium
- Honorary Professor, Lida Institute, Shanghai, China
- Adjunct Professor, School of Nursing & Midwifery, Griffith University, Queensland, Australia
| | - Pinar Avsar
- Senior Postdoctoral Fellow, Skin Wounds and Trauma Research Centre. The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Ireland
| | - Declan Patton
- Adjunct Professor, School of Nursing & Midwifery, Griffith University, Queensland, Australia
- Director of Nursing and Midwifery Research and Deputy Director of the Skin, Wounds and Trauma Research Centre, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Adjunct Associate Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- Honorary Senior Fellow, Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | - Linda Nugent
- Lecturer and Programme Director, School of Nursing and Midwifery, The Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Adjunct Assistant Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
| | - Tom O'Connor
- Adjunct Professor, School of Nursing & Midwifery, Griffith University, Queensland, Australia
- Director of Academic Affairs and Deputy Head of School, School of Nursing and Midwifery and Lead Researcher, Skin Wounds and Trauma Research Centre. The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
- Honorary Professor, Lida Institute, Shanghai, China
- Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
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Li J, Zhu C, Liu Y, Song B, Jin J, Liu Y, Wen X, Cheng S, Wu X. Critical Care Nurses’ Knowledge, Attitudes, and Practices Regarding Pressure Injury Treatment: A Nationwide Cross-Sectional Survey. Healthc Policy 2022; 15:2125-2134. [PMID: 36415220 PMCID: PMC9675999 DOI: 10.2147/rmhp.s389706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Pressure injury is a common problem in intensive care units. Critical care nurses play an important role in multidisciplinary teams performing pressure injury treatment. Identifying the clinical status of pressure injury treatment may contribute to improving care quality. Aim To identify the knowledge, attitudes, and practices regarding pressure injury treatment in critical care nurses. Design A cross-sectional survey. Methods Secondary data were extracted from a multicenter clinical trial. Knowledge and attitudes toward pressure injury treatment were assessed through a self-administered eight-item questionnaire. The observed practices were recorded using a case report form. The report was in accordance with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. Results A total of 950 critical care nurses in 15 hospitals from six provinces/municipalities of China were investigated. The mean knowledge score was 2.89 ± 1.16 (95% confidence interval: 2.82–2.97) out of a possible total of 5 points. The correct rates of selecting wound dressings and pain management were 34.4% and 45.6%, respectively. The mean attitude score was 9.07 ± 1.09 (95% confidence interval: 9.00–9.13) out of a possible total of 12 points. A total of 2092 patient days of pressure injury treatment practices were observed and recorded. Repositioning was the most commonly employed treatment measure (98.8%). Foam dressing was the common dressing for stage I (53.6%), stage II (47.5%), and more severe pressure injury (67.9%), including stage III, IV, unstageable, and suspected deep tissue injury. Conclusion Critical care nurses exhibited a generally low level of knowledge and moderate attitudes regarding pressure injury treatment. Practices of pressure injury treatment were generally acceptable.
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Affiliation(s)
- Jiamin Li
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Chen Zhu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Ying Liu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Baoyun Song
- Department of Nursing, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Jingfen Jin
- Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, People’s Republic of China
| | - Yilan Liu
- Department of Nursing, Wuhan Union Hospital, Jianghan District, Wuhan, People’s Republic of China
| | - Xianxiu Wen
- Department of Nursing, Sichuan Academy of Medical Sciences and Sichuan People’s Hospital, Chengdu, People’s Republic of China
| | - Shouzhen Cheng
- Department of Nursing, Sun Yat-sen University First Affiliated Hospital, Guangzhou, People’s Republic of China
| | - Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Xinjuan Wu, Email
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Chao WY, Wu YL, Liao WC. Psychometric Properties of the Taiwanese Pressure Ulcer Management Self-Efficacy Scale in Nursing Practice. Healthcare (Basel) 2022; 10:healthcare10101900. [PMID: 36292347 PMCID: PMC9601436 DOI: 10.3390/healthcare10101900] [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: 09/08/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Self-efficacy strongly predicts clinical performance and competence. In Taiwan, there is no reliable method for assessing self-efficacy in the management of pressure injury. This study aims to establish psychometric properties of the Pressure Ulcer Management Self-Efficacy Scale (PUM-SES) translated for Taiwan and determine the validity and reliability of the Taiwanese version of the PUM-SES. Materials and methods: The PUM-SES was translated for use in Taiwan using Brislin’s method. The translation’s content validity, concurrent validity, predictive validity, internal consistency, and test−retest reliability were evaluated. The Pressure Ulcer Management Self-Efficacy Scale, Taiwanese version (PUM-SES-T), the Attitude toward Pressure Injury Prevention Scale (APIPS) and the Practice toward Pressure Injury Prevention Scale (PPIPS) of preventing pressure injury, and the General Self-Efficacy Scale (GSES) were tested using Pearson’s correlation. A cross-sectional survey with 330 RNs in Taiwan was conducted. The PUM-SES-T was used to predict the PPIPS, and a predictive regression model was constructed considering nursing demographic variables. Results: Seven experts evaluated the PUM-SES-T with a CVI value of 0.995. An internal consistency, using Cronbach’s α, of 0.762 and a test−retest reliability of 0.997 were obtained. The PUM-SES-T was positively correlated with the GSES (p < 0.001). Multiple regression revealed that the PUM-SES-T predicted practice with a strong predictive validity (F = 8.077, p < 0.001), had an adjusted R2 of 0.455, but collinearity was insignificant. In this study, PUM-SES-T is a valid instrument for intervention-related educational programs to measure self-efficacy with good reliability and validity. It can be employed when intervening in related education strategies or promoting policies.
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Affiliation(s)
- Wen-Yi Chao
- Department of Public Health, China Medical University, Taichung 406040, Taiwan
- Department of Nursing, Nantou Hospital, Nantou 540234, Taiwan
| | - Yu-Lin Wu
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Wen-Chun Liao
- School of Nursing, China Medical University, Taichung 406040, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan
- Correspondence:
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Interactive Evidence-Based Pressure Injury Education Program for Hospice Nursing: A Quality Improvement Approach. J Wound Ostomy Continence Nurs 2022; 49:428-435. [PMID: 36108226 PMCID: PMC9481287 DOI: 10.1097/won.0000000000000911] [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] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this quality improvement (QI) project was to develop and implement an interactive, evidence-based pressure injury (PI) education program and evaluate the impact on frontline hospice nursing staff knowledge and practice. PARTICIPANTS AND SETTING The QI setting was a 12-bed inpatient hospice unit in a tertiary care Veterans Affairs (VA) Medical Center in Cleveland, Ohio. Nineteen licensed and unlicensed hospice nursing staff participated in this pre-/postworkshop project. APPROACH Chart audit determined baseline PI incidence and prevalence on the inpatient hospice unit. Interviews with key leaders informed the need to develop and implement innovative PI education opportunities. A literature review determined existing standards regarding the benefits of PI education for nursing staff but did not reveal measurable targets in hospice settings. We developed a PI education intervention based on Kolcaba's Theory of Comfort framework and a Plan-Do-Study-Act (PDSA) performance improvement model. Education was delivered in 7 workshops, lasting 2 hours each. Knowledge, practice, and comfort for inpatient hospice nursing staff were evaluated at baseline and 8 weeks following the final refresher visit. Workshop satisfaction was collected once using standard program evaluation forms after final workshop delivery. OUTCOMES We observed a significant improvement in staff PI knowledge (P = .001) and practice (P = .001) after initial workshop attendance and repeat engagement (P = .001). There was a large magnitude of effect for overall knowledge change (d = 1.04); similarly PI care planning and practice showed a large magnitude of effect and significant improvement (P = .001, d = 2.64). Staff comfort with job duties was stable with low effect size (mean 4.52, d = 0.04), and satisfaction with the workshop education was high (100% agreement with trainer effectiveness). IMPLICATIONS FOR PRACTICE We found that frontline hospice nursing staff knowledge and practice improved after attendance at our evidence-based PI education program. Results of this QI project have stimulated ongoing discussion on how to sustain this program in our hospice setting.
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Yazıcı G, Aktaş D, Bulut H, Muslubaş N, Güler Demir S, Göçmen Baykara Z, Demircan A. Effectiveness of training in increasing awareness about managing pressure injuries in emergency departments. Int Emerg Nurs 2022; 60:101111. [PMID: 34952483 DOI: 10.1016/j.ienj.2021.101111] [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: 05/29/2021] [Revised: 09/16/2021] [Accepted: 10/27/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Emergency room conditions and the characteristics of the patients followed up pose a risk for pressure injury. AIM This study was conducted as a pilot study to assess the effectiveness of a training program in increasing the awareness of healthcare professionals working in an emergency department about how to manage pressure injuries. METHODS The study was a prospective, pre-test post-test intervention study without a control group. The study included 595 patients who were hospitalized in the emergency room for more than two hours and voluntarily agreed to participate, as well as 11 physicians and 17 nurses working in the emergency department between 15 April and 19 June 2019 2019. It was carried out in three stages. In the first stage, the 30-day pressure injury incidence rate in the emergency department was evaluated using the "Emergency Department Patients Information and Pressure Injury Assessment Form" and "The Braden Scale for Predicting Pressure Injury Risk". In the second stage, the healthcare professionals were given training about pressure injuries. The knowledge levels of healthcare professionals before and after the training were evaluated using "The Descriptive Characteristics Form for Emergency Department Personnel (doctors and nurses)" and "The Questionnaire for Identifying and Preventing Pressure Injury". In the third stage, the 30-day pressure injury incidence rate in the was re-evaluated after the training using the same two scales as before. The SPSS 25 package program was used to evaluate the data in terms of frequency, percentage, mean and standard deviation, and the Mann-Whitney U Test for independent groups, the t-test, the correlated sample t-test, the Wilcoxon Signed Rank test, Pearson Chi-square test, Yates Chi-square test and Fisher's Exact Chi-square test were also used. RESULTS The mean knowledge test score of the healthcare professionals working in the emergency department was determined as X¯±SD = 53.71 ± 14.70 before the training and X¯±SD = 58.57 ± 11.83 after the training. The average score on the prevention dimension of the Questionnaire for Identifying and Preventing Pressure Injury was found to be statistically significantly higher than before the training (p < 0.05). The pressure injury incidence in the emergency department was 12.5% before the training and 8.8% afterwards. CONCLUSION It was observed that the knowledge of healthcare professionals about pressure injury was insufficient and that training given on this topic both increased their knowledge and decreased the incidence of pressure injury. However, the difference was not statistically significant. Training about pressure injuries is important for preventing pressure injury, identifying the injury early, treating the injury appropriately and increasing the awareness of healthcare professionals.
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Affiliation(s)
- Gülay Yazıcı
- Ankara Yıldırım Beyazıt University Health Sciences, Faculity Nursing Department, Ankara, Turkey.
| | - Dilek Aktaş
- Ankara Yıldırım Beyazıt University Health Sciences, Faculity Nursing Department, Ankara, Turkey
| | - Hülya Bulut
- Gazi University, Health Sciences Faculty, Nursing Department, Ankara, Turkey
| | | | - Sevil Güler Demir
- Gazi University, Health Sciences Faculty, Nursing Department, Ankara, Turkey
| | | | - Ahmet Demircan
- Gazi University Hospital, Emergengy Service, Ankara, Turkey
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Li Z, Marshall AP, Lin F, Ding Y, Chaboyer W. Knowledge of pressure injury in medical and surgical nurses in a tertiary level hospital: A cross-sectional study. J Tissue Viability 2021; 31:24-29. [PMID: 34887153 DOI: 10.1016/j.jtv.2021.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/26/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Zhaoyu Li
- School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Queensland, 4222, Australia.
| | - Andrea P Marshall
- School of Nursing and Midwifery, Griffith University, Queensland, 4222, Australia; Nursing and Midwifery Education and Research Unit, Gold Coast Health, Gold Coast University Hospital, 4215, Australia.
| | - Frances Lin
- School of Nursing and Midwifery, Griffith University, Australia; School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Australia.
| | - Yanming Ding
- Nursing Department, Peking University First Hospital, Beijing, China.
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Queensland, 4222, Australia.
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Alshahrani B, Sim J, Middleton R. Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. J Clin Nurs 2021; 30:2151-2168. [PMID: 33590917 DOI: 10.1111/jocn.15709] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/15/2021] [Accepted: 02/05/2021] [Indexed: 02/02/2023]
Abstract
AIM To systemically synthesise the evidence on the most effective nursing interventions to prevent pressure injuries among critical care patients. BACKGROUND Although pressure injury (PI) prevention is a focus of nursing care in critical care units, hospital-acquired pressure injuries continue to occur in these settings. DESIGN A systematic review of literature guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Synthesis without meta-analysis (SWiM) guidelines. METHODS Four electronic databases were searched for relevant studies. Included studies were screened and then critically appraised using the appropriate Joanna Briggs Institute appraisal tool. Data were analysed and reported using a narrative synthesis. RESULTS The review included 14 studies. Randomised controlled trials, quasi-experimental, case series and cross-sectional studies were included. The review identified four broad categories of interventions that are the most effective for preventing pressure injuries: (a) PI prevention bundles, (b) repositioning and the use of surface support, (c) prevention of medical device-related pressure injuries and (d) access to expertise. All the included studies reported a reduction in pressure injuries following the interventions; however, the strength of the evidence was rated from moderate to very low. CONCLUSIONS Nurses are well qualified to lead in the prevention of pressure injuries in critical care units. Every critically ill patient requires interventions to prevent pressure injuries, and the prevention of PIs should be considered a complex intervention. Nurses must plan and implement evidence-based care to prevent all types of pressure injuries, including medical device-related pressure injuries. Education and training programmes for nurses on PI prevention are important for prevention of pressure injuries. RELEVANCE TO CLINICAL PRACTICE Nursing interventions should consist of evidence-based 'bundles' and be adapted to patients' needs. To prevent pressure injuries among critically ill patients, nurses must be competent and highly educated and ensure fundamental strategies are routinely implemented to improve mobility and offload pressure.
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Affiliation(s)
- Bassam Alshahrani
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.,Taibah University, Medina, Saudi Arabia.,Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
| | - Jenny Sim
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW, Australia
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Yan B, Dandan H, Xiangli M. Effect of training programmes on nurses' ability to care for subjects with pressure injuries: A meta-analysis. Int Wound J 2021; 19:262-271. [PMID: 34114729 PMCID: PMC8762546 DOI: 10.1111/iwj.13627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 02/02/2023] Open
Abstract
We performed a meta-analysis to evaluate the education effects on nurses' ability to care for subjects with pressure injuries. A systematic literature search up to April 2021 was carried out, and 29 studies included 5704 nurses at the start of the study; 3800 of them were experiment or post-training and 3804 were control or per-training. They were reporting relationships between the education effects on nurses' ability to care for subjects with pressure injuries. We calculated the odds ratio (OR) or the mean difference (MD) with 95% confidence intervals (CIs) to assess the education effects on nurses' ability to care for subjects with pressure injuries using the dichotomous or continuous method with a random or fixed-effect model. Experiment or post-trained nurses had significantly higher knowledge score (MD, 10.00; 95% CI, 7.61-12.39, P < .001), number of nurses with proper knowledge (OR, 20.70; 95% CI, 10.80-39.67, P < .001), practice score (MD, 12.39; 95% CI, 5.37-19.42, P < .001), and number of nurses with proper practice (OR, 3.56; 95% CI, 1.75-7.25, P < .001), attitudes score (MD, 7.46; 95% CI, 2.94-11.99, P < .001) compared with control or pertained nurses. Training may have a beneficial effect on improving the nurses' ability to care for subjects with pressure injuries, which was obvious in improving knowledge, practice, and attitudes post-training. Further studies are required to validate these findings.
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Affiliation(s)
- Bao Yan
- Department of OutpatientThe Fourth Affiliated Hospital Zhejiang University School of MedicineJinhuaChina
| | - Huang Dandan
- Department of Neurosurgery WardShaoxing People's HospitalShaoxingChina
| | - Meng Xiangli
- Department of General WardShaoxing Central HospitalShaoxingChina
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Effect of a Multistage Educational Skill-Based Program on Nurse's Stress and Anxiety in the Intensive Care Setting: A Randomized Controlled Trial. Behav Neurol 2021; 2021:8811347. [PMID: 33986878 PMCID: PMC8093071 DOI: 10.1155/2021/8811347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 11/24/2022] Open
Abstract
Background Psychological problems such as stress and anxiety are prevalent among working nurses in the intensive care units (ICUs). This study was aimed at investigating the effects of three skill-based educational programs on stress and anxiety among critical care nurses. Methods Using a randomized controlled trial, 160 nurses were assigned to four groups including one control and three intervention groups. A standard skill-based educational program was delivered to three intervention groups using booklet, booklet+oral presentation, and booklet+oral presentation+clinical teaching over a period of one month to reduce different types of stress and anxiety. The control group received routine education only. Perceived stress, state anxiety, trait anxiety, and work-related stress were assessed at baseline and three times after the intervention (15 days, 3 months, and 21 months). Repeated-measure analysis of variance was used for data analysis. Results There was no significant change in the control group in terms of study variables during follow-up assessments, whereas measures of stress and anxiety were reduced after intervention in the trial groups except trait anxiety. Nurses in the mixed-method group (booklet+oral presentation+clinical teaching) showed less stress and anxiety during follow-ups. Although the stress and anxiety scores decreased in the first and second follow-ups, there was no significant reduction in the third follow-up. Conclusions To improve the mental health and performance of the intensive care unit nurses, knowledge-based and skill-based training programs seem useful. Continuous training may help to maintain the effectiveness of these programs over time.
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Kielo E, Suhonen R, Ylönen M, Viljamaa J, Wahlroos N, Stolt M. A systematic and psychometric review of tests measuring nurses' wound care knowledge. Int Wound J 2020; 17:1209-1224. [PMID: 32496632 PMCID: PMC7948782 DOI: 10.1111/iwj.13417] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022] Open
Abstract
Wound care is an important realm of nurses' clinical responsibilities, and a broad knowledge and range of skills are needed to perform efficient and safe patient care. Nurses' knowledge on this matter can be measured using knowledge tests. This study aims to identify, define, and analyse the knowledge tests developed for the measurement of nurses' wound care knowledge, and to evaluate the psychometric properties of the tests. This study was a systematic literature review. A total of 52 studies and 18 instruments were found. Of the 18 instruments, only 5 had been used more than once and were successful in a psychometric evaluation. These five instruments were analysed on the basis of their psychometric properties by using Zwakhalen et al.'s (2006) psychometric testing framework. According to the analysis, the Pressure Ulcer Knowledge Test (PUKT) and the Pressure Ulcer Knowledge Assessment Tool (PUKAT) were the most valid and reliable instruments for measuring nurses' wound care knowledge. Most of the instruments identified and analysed focused on pressure ulcers, indicating that future instruments could focus more on other types of wounds or on wound care in general in order to receive a broader understanding of nurses' wound care knowledge.
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Affiliation(s)
- Emilia Kielo
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
| | - Riitta Suhonen
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
- Turku University HospitalTurkuFinland
- City of Turku, Welfare DivisionTurkuFinland
| | - Minna Ylönen
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
- City of Turku, Welfare DivisionTurkuFinland
| | - Jaakko Viljamaa
- Department of Vascular SurgeryTurku University HospitalTurkuFinland
- University of TurkuTurkuFinland
| | - Niina Wahlroos
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
| | - Minna Stolt
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
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KARAKAYA Y, ÖZKAYA H, TUZCULAR E, GÖNENÇ I. Palyatif bakım hastalarında basınç ülserleri ile bakım verenlerin bilgi düzeyleri arasındaki ilişki. FAMILY PRACTICE AND PALLIATIVE CARE 2020. [DOI: 10.22391/fppc.670074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kim G, Park M, Kim K. The Effect of Pressure Injury Training for Nurses: A Systematic Review and Meta-analysis. Adv Skin Wound Care 2020; 33:1-11. [DOI: 10.1097/01.asw.0000653164.21235.27] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Seo Y, Roh YS. Effects of pressure ulcer prevention training among nurses in long-term care hospitals. NURSE EDUCATION TODAY 2020; 84:104225. [PMID: 31698290 DOI: 10.1016/j.nedt.2019.104225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/27/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Nurses caring for elderly patients with a high risk of pressure ulcer at long-term care hospitals require the necessary knowledge, behaviors, and attitudes regarding preventing pressure ulcers. OBJECTIVES To identify the effects of pressure ulcer prevention training on nurses' knowledge, behaviors, and attitudes regarding pressure ulcer prevention. DESIGN A comparison group pretest-posttest design. SETTINGS Long-term care hospitals in a metropolitan area of the Republic of Korea. PARTICIPANTS Participants were conveniently assigned to team-based learning (n = 30) or lecture-based learning (n = 30) groups. METHODS We examined pre-post differences in the scores for pressure ulcer prevention knowledge, behaviors, and attitudes in each group using the paired t-test. Additionally, pre-post difference scores were compared between the two groups using the independent samples t-test. RESULTS Both groups exhibited significant increases in scores for pressure ulcer prevention knowledge, behaviors, and attitudes after the intervention as compared before it. However, we found no significant differences in the pre-post difference scores for any of the variables between the two groups. CONCLUSIONS Pressure ulcer prevention training, regardless of whether it utilizes team-based or lecture-based learning, is useful for enhancing nurses' pressure ulcer prevention knowledge, behaviors, and attitudes. Further study is needed to verify the longitudinal effects of pressure ulcer prevention training on nurses' actual performance and the incidence of pressure ulcers among patients.
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Affiliation(s)
- Yukyeong Seo
- Graduate School of Nursing and Health Professions, Chung-Ang University, Seoul, Republic of Korea
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul 06974, Republic of Korea.
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Abstract
OBJECTIVE To evaluate the effect of a pressure injury prevention algorithm on pressure injury prevention. DESIGN, SETTING, AND PARTICIPANTS This intervention study was conducted in the anesthesiology and reanimation ICU (ARICU) of a university hospital. The study included two sample groups (nurses and patients). All patients older than 18 years (prealgorithm, n = 80; postalgorithm, n = 74) in the ARICU who verbally consented were included in the study. All 15 nurses who worked in the ARICU during the postalgorithm period agreed to participate in the study. INTERVENTIONS The study was performed in four phases. In the first phase, pressure injury incidence was evaluated in the ARICU (prealgorithm period; April 1 to September 30, 2016). At the same time, a pressure injury prevention algorithm was developed. In the second phase, ARICU nurses were provided education on how to prevent pressure injury and use the pressure injury prevention algorithm. In the third phase, the nurses provided care based on the pressure injury prevention algorithm (postalgorithm period; November 1, 2016, to April 30, 2017). In the fourth phase, the incidence of pressure injury in the pre- and postalgorithm periods was compared, and the effectiveness of the algorithm was evaluated. MAIN RESULTS The pressure injury incidence was 46.10 per 1,000 patient-days in the prealgorithm period and 9.21 per 1,000 patient-days in the postalgorithm period. The decline was statistically significant (z = 9.590, P < .001). CONCLUSIONS Nursing education and the evidence-based pressure injury prevention algorithm reduced pressure injury rates. Further study of this algorithm in other ICUs and among various care populations is recommended to fully establish its efficacy.
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Ebi WE, Hirko GF, Mijena DA. Nurses' knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design. BMC Nurs 2019; 18:20. [PMID: 31139012 PMCID: PMC6528293 DOI: 10.1186/s12912-019-0346-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background Pressure ulcer is a preventable medical complication of immobility. It has psychological, economic and social impact on individual and family. Its cost of treatment is more than twice of cost of prevention. It is primarily the nurses’ responsibility to prevent pressure ulcer. The aim of this study was to assess the nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega. Methods A descriptive multicenter cross-sectional study design using quantitative method was employed to collect data from 212 randomly selected nurses. Data was collected using structured two validated self-administered instruments of pressure ulcer knowledge test evaluate nurses’ knowledge. Mean scores were compared using the Mann-Whitney U and Kruskal-Wallis tests. Means, standard deviation, and frequencies were used to describe nurses’ knowledge levels and barriers to pressure ulcer prevention. Results Analysis of the study displayed 91.5% had inadequate knowledge to pressure ulcer prevention. The mean of nurses’ knowledge in all theme and per item were 11.31 (SD = 5.97) and 0.43 (SD = 0.22).respectively. The study participants had the highest mean item score (2.65 ± 0.87) in nutrition theme, whereas, scored lowest on etiology and development (0.27 ± 0.18) and preventive measures to reduce duration of pressure (0.29 ± 0.18), The study also identified significant nurses read articles (0.000) and received training (p = 0.003). Shortage of pressure relieving devices, lack of staff and lack of training were the most commonly cited perceived barriers to practice pressure ulcer prevention. Conclusions This study highlights areas where measures can be made to facilitate pressure ulcer prevention in public hospitals in Wollega zones, such as increase regular adequate further training of nurses regarding pressure ulcer/its prevention points. Electronic supplementary material The online version of this article (10.1186/s12912-019-0346-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Werku Etafa Ebi
- 1Department of Nursing, Institute of Health Science, Wollega University, P.O. Box 395, Nekemte, Ethiopia
| | - Getahun Fetensa Hirko
- 1Department of Nursing, Institute of Health Science, Wollega University, P.O. Box 395, Nekemte, Ethiopia
| | - Diriba Ayala Mijena
- 2Department of Midwifery, Institute of Health Science, Wollega University, P.O. Box 395, Nekemte, Ethiopia
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Porter‐Armstrong AP, Moore ZEH, Bradbury I, McDonough S. Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev 2018; 5:CD011620. [PMID: 29800486 PMCID: PMC6494581 DOI: 10.1002/14651858.cd011620.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pressure ulcers, also known as bed sores or pressure sores, are localised areas of tissue damage arising due to excess pressure and shearing forces. Education of healthcare staff has been recognised as an integral component of pressure ulcer prevention. These educational programmes are directed towards influencing behaviour change on the part of the healthcare professional, to encourage preventative practices with the aim of reducing the incidence of pressure ulcer development. OBJECTIVES To assess the effects of educational interventions for healthcare professionals on pressure ulcer prevention. SEARCH METHODS In June 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs, that evaluated the effect of any educational intervention delivered to healthcare staff in any setting to prevent pressure ulceration. DATA COLLECTION AND ANALYSIS Two review authors independently assessed titles and abstracts of the studies identified by the search strategy for eligibility. We obtained full versions of potentially relevant studies and two authors independently screened these against the inclusion criteria. MAIN RESULTS We identified five studies that met the inclusion criteria for this review: four RCTs and one cluster-RCT. The study characteristics differed in terms of healthcare settings, the nature of the interventions studied and outcome measures reported. The cluster-RCT, and two of the RCTs, explored the effectiveness of education delivered to healthcare staff within residential or nursing home settings, or nursing home and hospital wards, compared to no intervention, or usual practices. Educational intervention in one of these studies was embedded within a broader, quality improvement bundle. The other two individually randomised controlled trials explored the effectiveness of educational intervention, delivered in two formats, to nursing staff cohorts.Due to the heterogeneity of the studies identified, pooling was not appropriate and we have presented a narrative overview. We explored a number of comparisons (1) education versus no education (2) components of educational intervention in a number of combinations and (3) education delivered in different formats. There were three primary outcomes: change in healthcare professionals' knowledge, change in healthcare professionals' clinical behaviour and incidence of new pressure ulcers.We are uncertain whether there is a difference in health professionals' knowledge depending on whether they receive education or no education on pressure ulcer prevention (hospital group: mean difference (MD) 0.30, 95% confidence interval (CI) -1.00 to 1.60; 10 participants; nursing home group: MD 0.30, 95% CI -0.77 to 1.37; 10 participants). This was based on very low-certainty evidence from one study, which we downgraded for serious study limitations, indirectness and imprecision.We are uncertain whether there is a difference in pressure ulcer incidence with the following comparisons: training, monitoring and observation, versus monitoring and observation (risk ratio (RR) 0.63, 95% CI 0.37 to 1.05; 345 participants); training, monitoring and observation, versus observation alone (RR 1.21, 95% CI 0.60 to 2.43; 325 participants) or, monitoring and observation versus observation alone (RR 1.93, 95% CI 0.96 to 3.88; 232 participants). This was based on very low-certainty evidence from one study, which we downgraded for very serious study limitations and imprecision. We are uncertain whether multilevel intervention versus attention control makes any difference to pressure ulcer incidence. The report presented insufficient data to enable further interrogation of this outcome.We are uncertain whether education delivered in different formats such as didactic education versus video-based education (MD 4.60, 95% CI 3.08 to 6.12; 102 participants) or e-learning versus classroom education (RR 0.92, 95% CI 0.80 to 1.07; 18 participants), makes any difference to health professionals' knowledge of pressure ulcer prevention. This was based on very low-certainty evidence from two studies, which we downgraded for serious study limitations and study imprecision.None of the included studies explored our other primary outcome: change in health professionals' clinical behaviour. Only one study explored the secondary outcomes of interest, namely, pressure ulcer severity and patient and carer reported outcomes (self-assessed quality of life and functional dependency level respectively). However, this study provided insufficient information to enable our independent assessment of these outcomes within the review. AUTHORS' CONCLUSIONS We are uncertain whether educating healthcare professionals about pressure ulcer prevention makes any difference to pressure ulcer incidence, or to nurses' knowledge of pressure ulcer prevention. This is because the included studies provided very low-certainty evidence. Therefore, further information is required to clarify the impact of education of healthcare professionals on the prevention of pressure ulcers.
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Affiliation(s)
| | - Zena EH Moore
- Royal College of Surgeons in IrelandSchool of Nursing & Midwifery123 St. Stephen's GreenDublinIrelandD2
| | | | - Suzanne McDonough
- Ulster UniversityCentre for Health and Rehabilitation Technologies (CHaRT), Institute of Nursing and Health ResearchSchool of Health SciencesRoom 1F118NewtownabbeyCo AntrimUKBT37 0QB
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Etafa W, Argaw Z, Gemechu E, Melese B. Nurses' attitude and perceived barriers to pressure ulcer prevention. BMC Nurs 2018; 17:14. [PMID: 29686535 PMCID: PMC5902867 DOI: 10.1186/s12912-018-0282-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 03/14/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The presence or absence of pressure ulcers has been generally regarded as a performance measure of quality nursing care and overall patient health. The aim of this study- wasto explorenurses' attitude about pressure ulcer prevention'and to identify staff nurses' perceived barriers to pressure ulcer prevention public hospitals in Addis Ababa, Ethiopia. METHODS A self-reported multi-center institutional based cross sectional study design was employed to collect data from staff nurses (N = 222) working in six (6) selected public hospitals in Addis Ababa, from April 01-28/2015. RESULTS Majority of the nurses had (n = 116, 52.2%) negative attitude towards pressure ulcer prevention. The mean scores of the test for all participants was 3.09out of 11(SD =0.92, range = 1-5). Similarly, the study revealed several barriers need to be resolved to put in to practice the strategies of pressure ulcer prevention; Heavy workload and inadequate staff (lack of tie) (83.1%), shortage of resources/equipment (67.7%) and inadequate training (63.2%) were among the major barriers identified in the study. CONCLUSIONS The study finding suggests that Addis Ababa nurses have negative attitude to pressure ulcer prevention. Also several barriers exist for implementing pressure ulcer prevention protocols in public hospitals in Addis Ababa, Ethiopia. Suggestion for improving this situation is attractive.
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Affiliation(s)
- Werku Etafa
- Department of Nursing, College of Health Science, Wollega Unversity, Samara, Ethiopia
| | - Zeleke Argaw
- School of Nursing, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Endalew Gemechu
- School of Nursing, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Belachew Melese
- Department of Statistics, College of Natural and Computational Sciences, Arsi University, Asella, Ethiopia
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Miller DM, Neelon L, Kish-Smith K, Whitney L, Burant CJ. Pressure Injury Knowledge in Critical Care Nurses. J Wound Ostomy Continence Nurs 2017. [PMID: 28650412 DOI: 10.1097/won.0000000000000350] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. DESIGN Postintervention descriptive study. SETTING AND SAMPLE The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States. METHODS Critical care RNs were asked to participate in this project over a 3-week period following a multimodal 2-year education initiative. Nurses completed the paper version of the 72-item Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) to determine pressure injury knowledge level. Calculated mean cumulative scores and subscores for items related to prevention and staging, respectively. Pearson correlations were used to examine associations between nursing staff characteristics and the PZ-PUKT prevention and staging scores. RESULTS The cumulative score on the PZ-PUKT was 51.66 (72%); nurses with 5 to 10 years' experience had a higher mean score than nurses with experiences of 20 years or more (mean ± SD = 54.25 ± 4.37 vs 49.5 ± 7.12), but the difference was not statistically significant. Nurses scored higher on the staging system-related items as compared to the prevention-related items (81% vs 70%). Nurses achieved higher staging subscale scores if they were younger (r =-0.41, P < .05), had less experience (r =-0.43, P < .05), and if they worked in the medical intensive care unit (r = 0.37, P < .05). CONCLUSIONS Study findings indicate gaps in knowledge related to pressure injury practice; participants had greater knowledge of staging rather than prevention. Cumulative and subscale findings can be used to direct educational efforts needed to improve and maintain an effective pressure injury prevention program.
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Affiliation(s)
- Donna M Miller
- Donna M. Miller, DNP, MSN, MEd, RN, Acute Care Nursing, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio. Lisa Neelon, MSN, RN, CCRN, MICU/CICU, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio. Kathleen Kish-Smith, BSN, RN, MICU/CICU, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio. Laura Whitney, BS, RN, CCM, MICU/CICU, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio. Christopher J. Burant, PhD, FGSA, Statistical Resource Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio; Geriatric Research, Education & Clinical Center, Cleveland, Ohio; and Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
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Ayello EA, Zulkowski K, Capezuti E, Jicman WH, Sibbald RG. Educating Nurses in the United States about Pressure Injuries. Adv Skin Wound Care 2017; 30:83-94. [PMID: 28106637 DOI: 10.1097/01.asw.0000511507.43366.a1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
GENERAL PURPOSE To provide information about the current state of educating nurses about wound care and pressure injuries with recommendations for the future. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to:1. Discuss the importance of pressure injury education and wound care for nurses and identify the current state of nursing education on the subject. 2. Identify strategies that can be used to put improved wound care and pressure injury education into practice. ABSTRACT Wound care nursing requires knowledge and skill to operationalize clinical guidelines. Recent surveys and studies have revealed gaps in nurses' knowledge of wound care and pressure injuries and their desire for more education, both in their undergraduate programs and throughout their careers. Data from baccalaureate programs in the United States can pinpoint areas for improvement in nursing curriculum content. Lifelong learning about wound care and pressure injuries starts with undergraduate nursing education but continues through the novice-to-expert Benner categories that are facilitated by continuing professional development. This article introduces a pressure injury competency skills checklist and educational strategies based on Adult Learning principles to support knowledge acquisition (in school) and translation (into clinical settings). The responsibility for lifelong learning is part of every nurse's professional practice.
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Affiliation(s)
- Elizabeth A Ayello
- Elizabeth A. Ayello, PhD, RN, ACNS-BC, CWON, ETN, MAPWCA, FAAN • Faculty • Excelsior College School of Nursing • Albany, New York • Senior Advisor • Hartford Institute for Geriatric Nursing • New York, New York • Course Director • IIWCC-New York University • New York, New York • President • Ayello, Harris and Associates, Inc, • Copake, New York • Clinical Editor, Advances in Skin & Wound Care • Philadelphia, Pennsylvania Karen Zulkowski, DNS, RN • Executive Editor • WCET Journal • Associate Professor (ret) • Montana State University • Bozeman, Montana Elizabeth Capezuti, PhD, RN, FAAN • Hearst Chair • Gerontology • Hunter-Bellevue School of Nursing • Hunter College of the City University of New York • New York Wendy Harris Jicman, BSN, BSHS, RN • Staff Nurse • Temple University Medical Center • Philadelphia, Pennsylvania R. Gary Sibbald, MD, FRCPC (Med, Derm), MACP, FAAD, Med, MAPWCA • Faculty • School of Public Health Sciences and Faculty of Medicine • University of Toronto • Ontario, Canada • Director • International Interprofessional Wound Care Course and Masters of Science in Community Health • Dalla Lana School of Public Health • University of Toronto • Toronto, Ontario, Canada • Clinical Editor, Advances in Skin & Wound Care • Philadelphia, Pennsylvania
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Manderlier B, Van Damme N, Vanderwee K, Verhaeghe S, Van Hecke A, Beeckman D. Development and psychometric validation of PUKAT 2·0, a knowledge assessment tool for pressure ulcer prevention. Int Wound J 2017; 14:1041-1051. [PMID: 28547752 DOI: 10.1111/iwj.12758] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to develop a tool to measure the knowledge of nurses on pressure ulcer prevention. PUKAT 2·0 is a revised and updated version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) developed in 2010 at Ghent University, Belgium. The updated version was developed using state-of-the-art techniques to establish evidence concerning validity and reliability. Face and content validity were determined through a Delphi procedure including both experts from the European Pressure Ulcer Advisory Panel (EPUAP) and the National Pressure Ulcer Advisory Panel (NPUAP) (n = 15). A subsequent psychometric evaluation of 342 nurses and nursing students evaluated the item difficulty, discriminating power and quality of the response alternatives. Furthermore, construct validity was established through a test-retest procedure and the known-groups technique. The content validity was good and the difficulty level moderate. The discernment was found to be excellent: all groups with a (theoretically expected) higher level of expertise had a significantly higher score than the groups with a (theoretically expected) lower level of expertise. The stability of the tool is sufficient (Intraclass Correlation Coefficient = 0·69). The PUKAT 2·0 demonstrated good psychometric properties and can be used and disseminated internationally to assess knowledge about pressure ulcer prevention.
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Affiliation(s)
- Bénédicte Manderlier
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Nele Van Damme
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Katrien Vanderwee
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,O.L.V. van Lourdes Ziekenhuis Waregem, Waregem, Belgium
| | - Sofie Verhaeghe
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Dimitri Beeckman
- Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
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Mirshekari L, Tirgari B, Forouzi M. Intensive care unit nurses' perceived barriers towards pressure ulcer prevention in south east Iran. J Wound Care 2017; 26:145-151. [DOI: 10.12968/jowc.2017.26.3.145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L. Mirshekari
- Razi School of Nursing and Midwifery, University of Kerman Medical Sciences, Kerman, Iran
| | - B. Tirgari
- Assistant professor, Kerman Neuroscience Research Center and Neuropharmacology Institue, Kerman University of Medical Sciences, Kerman, Iran
| | - M.A. Forouzi
- Kerman Neuroscience Research Center and Neuropharmacology Institue, Kerman University of Medical Sciences, Kerman, Iran
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Baron MV, Reuter CP, Burgos MS, Cavalli V, Brandenburg C, Krug SBF. Experimental study with nursing staff related to the knowledge about pressure ulcers. Rev Lat Am Enfermagem 2016; 24:e2831. [PMID: 27878223 PMCID: PMC5173304 DOI: 10.1590/1518-8345.1134.2831] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 08/14/2016] [Indexed: 11/22/2022] Open
Abstract
Objective to compare the scores of knowledge in teams participating or not participating in educational interventions about pressure ulcers. Method a quantitative study with experimental design. Data were collected through a validated questionnaire. The study included 71 individuals, including nurses and nursing technicians from three intensive care units, divided into intervention group and control group. Data analysis considered the scores of the groups in the moment before and after intervention. To check the average rate of correct answers, we calculated the mean and standard deviation. We carried out the Mann-Whitney test for analysis of two independent samples, and the Wilcoxon test for related samples. Results The mean percentage of correct answers, at the baseline was 74.1% (SD = 26.4) in the intervention group and 76.0% (SD = 22.9) in the control group and post time -intervention, was 87.8% (SD = 18.8) in the group receiving educational intervention, considering that in the control group it was 79.1% (SD = 22.2). The group that participated in educational interventions did not reach the proper average of 90% correct answers for the test. Conclusion educational interventions on staging, evaluation and prevention of pressure ulcers contributed significantly to the increase of correct responses score in the knowledge test of the intervention group and improved their knowledge on the subject.
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Affiliation(s)
- Miriam Viviane Baron
- MSc, Researcher, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cézane Priscila Reuter
- MSc, Assistant Professor, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Miria Suzana Burgos
- PhD, Full Professor, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, RS, Brazil
| | - Veniria Cavalli
- Intensive care specialist, RN, Hospital Santa Cruz, Santa Cruz do Sul, RS, Brazil
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Tulek Z, Polat C, Ozkan I, Theofanidis D, Togrol RE. Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument. J Tissue Viability 2016; 25:201-208. [DOI: 10.1016/j.jtv.2016.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/10/2016] [Accepted: 09/14/2016] [Indexed: 11/27/2022]
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Dung PT, Chinh ND, Hanh BM, Notter J. Evaluating a training programme at Viet Duc University Hospital in Vietnam. ACTA ACUST UNITED AC 2016; 25:S14-21. [DOI: 10.12968/bjon.2016.25.12.s14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Phan Thi Dung
- Medical Education, Training and Guideline Center, President of the Vietname Surgical Nursing Branch Office, Vietnam
| | - Nguyen Duc Chinh
- Chief of Septic Surgery and Deputy Chief of Planninng Department, Viet Duc Hospital, Vietnam
| | - Bui My Hanh
- Director, Curriculum Development Center for Human Resources in Health, Hanoi Medical University, Vietnam
| | - Joy Notter
- Professor of Community Health Care Studies, Faculty of Health, Education and Life Sciences, Birmingham City University
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Porter-Armstrong AP, Moore ZEH, Bradbury I, McDonough S. Education of healthcare professionals for preventing pressure ulcers. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Alison P Porter-Armstrong
- University of Ulster; School of Health Sciences; Shore Road Newtownabbey Belfast Co Antrim UK BT37 0QB
| | - Zena EH Moore
- Royal College of Surgeons in Ireland; School of Nursing & Midwifery; 123 St. Stephen's Green Dublin Ireland D2
| | - Ian Bradbury
- University of Ulster; CHART; Shore Road Jordanstown UK
| | - Suzanne McDonough
- University of Ulster; Health and Rehabilitation Sciences; School of Health Sciences Room 14J15 Newtownabbey Co Antrim UK BT37 0QB
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Predicting pressure ulcer risk with the Braden Q Scale in Chinese pediatric patients in ICU. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.cnre.2015.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ramoo V, Abdullah KL, Tan PS, Wong LP, Chua PY. Intervention to improve intensive care nurses' knowledge of sedation assessment and management. Nurs Crit Care 2014; 21:287-94. [PMID: 25271143 DOI: 10.1111/nicc.12105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/25/2014] [Accepted: 04/30/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Sedation management is an integral component of critical care practice. It requires the greatest attention of critical care practitioners because it carries significant risks to patients. Therefore, it is imperative that nurses are aware of potential adverse consequences of sedation therapy and current sedation practice recommendations. AIMS AND OBJECTIVES To evaluate the impact of an educational intervention on nurses' knowledge of sedation assessment and management. DESIGNS AND METHODS A quasi-experimental design with a pre- and post-test method was used. The educational intervention included theoretical sessions on assessing and managing sedation and hands-on sedation assessment practice using the Richmond Agitation Sedation Scale. Its effect was measured using self-administered questionnaire, completed at the baseline level and 3 months following the intervention. RESULTS Participants were 68 registered nurses from an intensive care unit of a teaching hospital in Malaysia. Significant increases in overall mean knowledge scores were observed from pre- to post-intervention phases (mean of 79·00 versus 102·00, p < 0·001). Nurses with fewer than 5 years of work experience, less than 26 years old, and with a only basic nursing education had significantly greater level of knowledge improvement at the post-intervention phase compared to other colleagues, with mean differences of 24·64 (p = 0·001), 23·81 (p = 0·027) and 27·25 (p = 0·0001), respectively. A repeated-measures analysis of variance revealed a statistically significant effect of educational intervention on knowledge score after controlling for age, years of work and level of nursing education (p = 0·0001, ηp (2) = 0·431). CONCLUSION An educational intervention consisting of theoretical sessions and hands-on sedation assessment practice was found effective in improving nurses' knowledge and understanding of sedation management. RELEVANCE TO CLINICAL PRACTICE This study highlighted the importance of continuing education to increase nurses' understanding of intensive care practices, which is vital for improving the quality of patient care.
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Affiliation(s)
- Vimala Ramoo
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khatijah L Abdullah
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Patrick Sk Tan
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Li P Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya and Julius Centre University of Malaya (JCUM), Kuala Lumpur, Malaysia
| | - Piaw Y Chua
- Institute of Educational Leadership & Unit for the Enhancement of Academic Performance (ULPA), University of Malaya, Kuala Lumpur, Malaysia
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Cameron R, Rodgers A, Welsh L, McGown K. Developing eLearning for pressure ulcer prevention and management. ACTA ACUST UNITED AC 2014; 23:S16, S18, S20 passim. [PMID: 25117595 DOI: 10.12968/bjon.2014.23.sup15.s16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The impact of pressure ulcers is psychologically, physically and clinically challenging for both patients and NHS staff. NHS Greater Glasgow and Clyde (NHS GGC), in line with the Scottish Best Practice Statement for the Prevention and Management of Pressure Ulcers ( Quality Improvement Scotland, 2009 ), and the NHS Health Improvement Scotland (2011) Preventing Pressure Ulcers Change Package, launched an awareness campaign throughout the organisation in April 2012 and has more recently adopted a 'zero-tolerance' approach to pressure damage. The tissue viability service in NHS GGC recognised that in order to achieve this aim, education of front-line staff is essential. An educational framework for pressure ulcer prevention was developed for all levels of healthcare staff involved in the delivery of patient care. As a means to support the framework, an initiative to develop web-based eLearning modules has been taken forward. This has resulted in the creation of an accessible, cost-effective, stimulating, relevant, and evidence-based education programme designed around the educational needs of all healthcare staff. In conjunction with the organisation's 'top ten tools' for pressure ulcer prevention and management, the modular online education programme addresses the aims of quality improvement and zero tolerance by supporting the provision of safe and effective person-centered care.
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Abstract
OBJECTIVE The objective of this study was to determine critical care physicians' attitudes, beliefs, and knowledge toward pressure ulcer (PrU) prevention and treatment in critical care patients. DESIGN Descriptive, correlational PARTICIPANTS 56 critical care physicians MAIN OUTCOME MEASURES Survey instrument developed to collect demographic information and information regarding attitudes and beliefs about PrUs and PrU knowledge. RESULTS The majority of physicians (69%) reported poor to adequate basic medical education training on PrU prevention and treatment. Sixty percent reported never attending a PrU lecture. Most physicians reported their role to be important to very important in the areas of PrU prevention (71.4%) and treatment (67.9%). Physicians' perceived knowledge regarding PrU prevention and treatment was most frequently reported as adequate (48%) and poor (37%). The mean score on the knowledge test was 18.1 (range, 12-24; SD, 2.26), equating to a percentage score of 75%. No significant relationship was found between physicians' perceived PrU knowledge and actual knowledge score. CONCLUSIONS Prevalence rates of acquired PrUs in critical care adult patients are cited as the highest among hospitalized patients; thus, critical care physicians encounter patients at risk for or with PrUs regularly in clinical practice. Management of a critically ill patient requires a cohesive, multidisciplinary approach, including prevention and/or management of PrUs. The critical care physician, as a vital member of this team, may benefit from PrU education in an effort to heighten awareness of this phenomenon in critical care patients.
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A Method of Comparing Effectiveness of Mattresses for Pressure Management for Pediatric Patients. J Nurs Care Qual 2014; 29:66-73. [DOI: 10.1097/ncq.0b013e3182982e1b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gottrup F, Apelqvist J, Bjarnsholt T, Cooper R, Moore Z, Peters E, Probst S. EWMA Document: Antimicrobials and Non-healing Wounds: Evidence, controversies and suggestions. J Wound Care 2013; 22:S1-89. [DOI: 10.12968/jowc.2013.22.sup5.s1] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- F Gottrup
- Professor of Surgery, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Apelqvist
- Senior Consultant, Associate Professor, Skåne University Hospital, Malmö, Sweden
| | - T Bjarnsholt
- Associate Professor, University of Copenhagen and Copenhagen University Hospital, Copenhagen, Denmark
| | - R Cooper
- Professor of Microbiology, Cardiff Metropolitan University, Cardiff, Wales, United Kingdom
| | - Z Moore
- Lecturer in Wound Healing & Tissue Repair, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - E.J.G. Peters
- Internist- Infectious Diseases Specialist, VU University Medical Center, Amsterdam, the Netherlands
| | - S Probst
- Lecturer, Zurich University of Applied Sciences, Winterthur, Switzerland
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Romero-Collado A, Homs-Romero E, Zabaleta-del-Olmo E. Knowledge about medications and products to prevent and treat pressure ulcers: a cross-sectional survey of nurses and physicians in a primary health care setting. J Clin Nurs 2013; 22:2562-71. [PMID: 23551561 DOI: 10.1111/jocn.12175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To report on a study of what primary care nurses and physicians know about medications and healthcare products to prevent and treat pressure ulcers. BACKGROUND The prevention and treatment of pressure ulcers has generally become the responsibility of the nursing staff; this has resulted in studies of nurses' knowledge of this task, although few studies include physicians in their analysis. DESIGN Cross-sectional survey conducted in North Girona (Province) Primary Care Services from February to April 2010. METHODS The study questionnaire had three sections: sociodemographic data, questions about division of responsibility for the care of patients with pressure ulcers or at risk of developing them, and 36 statements based on the recommendations in clinical practice guidelines provided by well-recognised national and international institutions. RESULTS Eighty-one nurses (64·8%) and 46 physicians (36·8%) responded to this study. Nurses had greater responsibility for the care of pressure ulcers, made greater use of medical prescriptions to obtain supplies if not available in the primary care centre, were more familiar with the site's clinical practice guidelines on the topic and showed better adherence to their recommendations. Nurses also had better knowledge than the participating physicians of the use of medications and healthcare products to heal or to prevent pressure ulcers. CONCLUSIONS Nurses had sufficient knowledge and more appropriate skills than the participating physicians for the prescription of medications and healthcare products for the prevention and treatment of pressure ulcers. RELEVANCE TO CLINICAL PRACTICE The data demonstrated that nurses have sufficient knowledge and skill to provide wound care and could safely write these prescriptions, although Spanish law permitting nurse prescription is not fully implemented.
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Sutherland-Fraser S, McInnes E, Maher E, Middleton S. Peri-operative nurses' knowledge and reported practice of pressure injury risk assessment and prevention: A before-after intervention study. BMC Nurs 2012; 11:25. [PMID: 23176368 PMCID: PMC3573907 DOI: 10.1186/1472-6955-11-25] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 11/14/2012] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED BACKGROUND Patients are at risk of developing pressure injuries in the peri-operative setting. Studies evaluating the impact of educational interventions on peri-operative nurses' knowledge and reported practice are scarce. The purpose of this study was to evaluate the effect of a multifaceted intervention on peri-operative nurses' (a) knowledge of pressure injury risks, risk assessment and prevention strategies for patients in the operating suite; and (b) reported practice relating to risk assessment practices and implementation of prevention strategies for patients in the operating suite. METHODS A before-after research design was used. A convenience sample of all registered and enrolled nurses employed in two hospitals' operating suites was recruited. A multifaceted intervention was delivered which comprised a short presentation, educational materials and reminder posters. A 48-item survey tool was completed pre-and post-intervention to measure self-reported knowledge and practice. RESULTS 70 eligible peri-operative nurses completed both surveys. Post-intervention, statistically significant improvements were seen in knowledge of correct descriptions of pressure injury stages (p=0.001); appropriate reassessment for patients with a new pressure injury (p=0.05); appropriate actions for patients with an existing stage 1 (p=0.02) and stage 2 pressure injury (p=0.04). Statistical improvements were also seen in reported practice relating to an increase in the use of a risk assessment tool in conjunction with clinical judgement (p=0.0008); verbal handover of patients' pressure injury risk status from the operating room nurse to the recovery room (p=0.023) and from the recovery room nurse to the postoperative ward nurse (p=0.045). The number of participants reporting use of non-recommended and recommended pressure-relieving strategies was unchanged. CONCLUSION A multi-faceted educational intervention can improve some aspects of perioperative nurses' knowledge and reported practice such as risk assessment practices but not others such as use of recommended pressure-relieving devices. Further research is required to ascertain effective interventions which improve all areas of practice and knowledge, particularly in the use of appropriate pressure-relieving devices in order to prevent pressure injuries in surgical patients.
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Affiliation(s)
- Sally Sutherland-Fraser
- Clinical Nurse Consultant for Peri-operative Practice Development, St Vincents Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Elizabeth McInnes
- EM Deputy Director, EMaher Research Assistant, Nursing Research Institute, St Vincents & Mater Health Sydney and Australian Catholic University, St Vincent's Hospital, Level 5, deLacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Elizabeth Maher
- EM Deputy Director, EMaher Research Assistant, Nursing Research Institute, St Vincents & Mater Health Sydney and Australian Catholic University, St Vincent's Hospital, Level 5, deLacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
| | - Sandy Middleton
- EM Deputy Director, EMaher Research Assistant, Nursing Research Institute, St Vincents & Mater Health Sydney and Australian Catholic University, St Vincent's Hospital, Level 5, deLacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- Director, Nursing Research Institute, St Vincents & Mater Health Sydney and Australian Catholic University. Director, Executive Office, Level 5, deLacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
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Na S, Kuan WS, Mahadevan M, Li CH, Shrikhande P, Ray S, Batech M, Nguyen HB. Implementation of early goal-directed therapy and the surviving sepsis campaign resuscitation bundle in Asia. Int J Qual Health Care 2012; 24:452-62. [PMID: 22899698 DOI: 10.1093/intqhc/mzs045] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To examine the impact of implementing sepsis bundle in multiple Asian countries, having 'team' vs. 'non-team' models of patient care. DESIGN Prospective cohort study. SETTING Eight urban hospitals, five countries in Asia. PARTICIPANTS Adult patients with severe sepsis or septic shock. INTERVENTIONS Implementation was divided into six quartiles: Baseline, Education and four Quality Improvement quartiles. MAIN OUTCOME MEASURES Quarterly bundle compliance and in-hospital mortality with respect to bundle completion and implementation model. METHODS In the team model, the implementation was championed by intensivists, where the bundle was completed in the intensive care unit. The non-team model led by emergency physicians completed the bundle in the emergency department as part of standard care. RESULTS Five hundred and fifty-six patients were enrolled. The overall in-hospital mortality rate was 29.9%, and 67.1% of the patients had septic shock. Compliance to the bundle was 13.3, 26.9, 37.5, 45.9, 48.8 and 54.5% over the six quartiles of implementation (P < 0.01). With team model, compliance increased from 37.5% baseline to 88.2% in the sixth quartile (P < 0.01), whereas hospitals with a non-team model increased compliance from 5.2 to 39.5% (P < 0.01). Crude in-hospital mortality was better in the patients who received the entire bundle (24.5 vs. 32.7%, P = 0.04). Bundle completion was associated with crude in-hospital mortality reduction (odds ratio 0.67, 95% confidence interval 0.45-0.99), but this survival benefit disappeared after adjustment for confounding variables. CONCLUSIONS Through education and quality improvement efforts, initially low sepsis bundle compliance was improved in Asia. A team model was more effective in achieving bundle compliance compared with a non-team model.
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Affiliation(s)
- Sungwon Na
- Department of Emergency Medicine and Department of Medicine, Pulmonary and Critical Care, Loma Linda University, Loma Linda, CA 92354, USA
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Scientific and Clinical Abstracts From the WOCN® Society's 44th Annual Conference. J Wound Ostomy Continence Nurs 2012. [DOI: 10.1097/won.0b013e3182546a04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Moore Z. Commentary on Kwong E, Lau A, Lee R & Kwan R (2011) A pressure ulcer prevention programme specially designed for nursing homes: does it work? Journal of Clinical Nursing 20, 2777-2786. J Clin Nurs 2012; 21:1189-90. [DOI: 10.1111/j.1365-2702.2011.04046.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Iranmanesh S, Rafiei H, Foroogh Ameri G. Critical care nurses' knowledge about pressure ulcer in southeast of Iran. Int Wound J 2011; 8:459-64. [PMID: 21722315 DOI: 10.1111/j.1742-481x.2011.00817.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Pressure ulcer prevention needs nurses' awareness of sore classification/onset, its item characteristics, and its prevention. Using Pieper's Pressure Ulcer Knowledge Test, 126 critical care nurses' knowledge about pressure ulcer was examined. The questionnaire was divided into three categories including: (1) sore classification/onset; (2) wound characteristics, and (3) preventive measure. The level of nurse's knowledge was insufficient. The highest rate of correct answers belonged to section 2 - prevention of pressure ulcer. Programs aimed at raising nurses' knowledge accompanied by interventions intended to decrease incidence of pressure ulcer are important parts in educational programs. Continuing education may need to be added to the pressure ulcer care to improve the quality of care at intensive care units.
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Affiliation(s)
- Sedigheh Iranmanesh
- Razi Faculty of Nursing and Midwifery, Kerman Medical University, Kerman, Iran
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El Enein NYA, Zaghloul AA. Nurses' knowledge of prevention and management of pressure ulcer at a Health Insurance Hospital in Alexandria. Int J Nurs Pract 2011; 17:262-8. [DOI: 10.1111/j.1440-172x.2011.01933.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Miyazaki MY, Caliri MHL, Santos CBD. Knowledge on Pressure Ulcer Prevention Among Nursing Professionals. Rev Lat Am Enfermagem 2010; 18:1203-11. [DOI: 10.1590/s0104-11692010000600022] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 07/19/2010] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe and to analyze knowledge on pressure ulcer prevention among nursing team members working in direct care to adult and elderly patients at a university hospital. A descriptive and exploratory research was carried out between January and March 2009, after approval by the Research Ethics Committee at the study institution. Data were collected through a validated questionnaire. Participants were 386 professionals, of whom 64.8% were nursing auxiliaries/technicians and 35.2% baccalaureate nurses (BSN). The mean percentage of correct answers on the knowledge test was 79.4% (SD=8.3%) for nurses and 73.6% (SD=9.8%) for nursing auxiliaries/technicians. Both professional categories display knowledge deficits in some areas related to the theme. The identification of deficient areas can guide strategic planning with a view to the dissemination and adoption of prevention measures by the team.
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Knowledge, attitudes and barriers towards prevention of pressure ulcers in intensive care units: A descriptive cross-sectional study. Intensive Crit Care Nurs 2010; 26:335-42. [DOI: 10.1016/j.iccn.2010.08.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Revised: 08/03/2010] [Accepted: 08/23/2010] [Indexed: 11/23/2022]
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Cox J, Roche S, Van Wynen E. The effects of various instructional methods on retention of knowledge about pressure ulcers among critical care and medical-surgical nurses. J Contin Educ Nurs 2010; 42:71-8. [PMID: 20704094 DOI: 10.3928/00220124-20100802-03] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 06/24/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND To determine whether there was a difference in retention of knowledge about pressure ulcers with a traditional lecture versus computer-based instruction. METHODS A quasi-experimental, pretest/posttest design was used. Medical-surgical and critical care nurses (N = 60) were randomly assigned to a lecture, to computer-based instruction, or to a control group. Study participants were given the pressure ulcer knowledge test before and immediately after the program and at 3-month and 6-month intervals. RESULTS Analysis of variance showed statistically significant differences in pretest and posttest scores [F(2, 57) = 35.784, p = .000] and in posttest to 3-month scores [F(2, 57) = 18.427, p = .000] among the three groups. CONCLUSION The most significant loss of pressure ulcer knowledge, regardless of educational method, occurred within the first 3 months. Based on these findings, quarterly education in pressure ulcer prevention is recommended to maintain knowledge. Computer-based instruction is a viable option for acquisition and retention of knowledge about pressure ulcer prevention.
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Affiliation(s)
- Jill Cox
- Englewood Hospital and Medical Center, Englewood, NJ 07631, USA.
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Affiliation(s)
- Zena Moore
- Wound Healing and Tissue Repair, and Research Methodology Faculty of Nursing and Midwifery,Royal College of Surgeons in Ireland
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