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Wu Z, Song B, Liu Y, Zhai Y, Chen S, Lin F. Barriers and facilitators to pressure injury prevention in hospitals: A mixed methods systematic review. J Tissue Viability 2023:S0965-206X(23)00055-4. [PMID: 37150650 DOI: 10.1016/j.jtv.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/28/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To systematically synthesize research evidence on barriers and facilitators to pressure injury prevention in hospital settings. METHODS A systematic literature review of quantitative, qualitative, and mixed methods research was undertaken using PubMed, MEDLINE, Embase, CINAHL, and Cochrane Library. Studies that reported barriers or/and facilitators to pressure injury prevention in the acute care settings and published in English from 2008 to 2022 were included. Studies were excluded if they were conducted in residential care facilities and nursing homes, or other long-term community care settings. Two authors independently screened articles against the inclusion and exclusion criteria. Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. Reported results were mapped to the Theoretical Domains Framework to identify the barriers and facilitators to pressure injury prevention. RESULTS A total of 78 studies were included. There were 65 quantitative studies, 11 qualitative studies, and two mix-methods studies. The most salient Theoretical Domains Framework domains identified in this review were "Knowledge", "Skills", "Environmental Context and Resources", "Optimism", "Social/Professional Role and Identity", and "Social influences". CONCLUSION The barriers and facilitators to pressure injury prevention in hospital settings identified in this systematic review were diverse, and included issues at both individual and organizational level. Healthcare organizations can address the barriers and facilitators from the influential Theoretical Domains Framework domains. Future research is required to investigate the effectiveness of behaviour change interventions that specifically target these barriers and facilitators to pressure injury prevention.
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Affiliation(s)
- Zijing Wu
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Bing Song
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Yu Liu
- School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, China.
| | - Yongzhen Zhai
- Department of Infectious Disease, Shengjing Hospital of China Medical University, No.39 Huaxiang Road, Tiexi District, Shenyang, Liaoning Province, China.
| | - Si Chen
- Department of Neurology, The Fourth Affiliated Hospital of China Medical University, No.4 Chongshan East Road, Huanggu District, Shenyang, Liaoning Province, China.
| | - Frances Lin
- School of Health, University of the Sunshine Coast, Queensland, Australia.
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Abrahams FR, Daniels ER, Niikondo HN, Amakali K. Students' knowledge, attitude and practices towards pressure ulcer prevention and management. Health SA 2023; 28:2180. [PMID: 36873786 PMCID: PMC9983280 DOI: 10.4102/hsag.v28i0.2180] [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: 09/17/2022] [Accepted: 11/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background Student nurses provide nursing care to patients during clinical allocation, and their competence may affect the quality of care given to the patients. Good knowledge and positive attitudes enhance early detection for prevention and management of pressure ulcers. Aim To determine undergraduate nursing students' knowledge, attitude and practices (KAP) towards prevention and management of pressure ulcers. Setting A nursing education institution in Windhoek, Namibia. Methods A quantitative, cross-sectional research design was used to conveniently sample (n = 50) student nurses and collect data using a self-administered questionnaire. Data were analysed using the statistical software programme (SPSS) version 27. Descriptive frequencies were applied, and Fishers exact test was performed. A statistical value of p < 0.05 was considered significant. Results Fifty (n = 50) student nurses consented to participate in the study. Student nurses reported good levels of knowledge (n = 35; 70%), attitude (n = 39; 78%), practices (n = 47; 94%). There was no statistically significant association between demographic variables and the level of knowledge, attitudes and practices, p > 0.05. Conclusion Student nurses have good knowledge, positive attitudes and practices on prevention and management of pressure ulcers. By the implications, the study concludes that the nursing students will competently manage the pressure ulcers occurring in the clinical setting. An observational study is recommended to assess practices in the clinical setting. Contribution The findings of this study will help to close the gap in the implementation of standard operating procedures for the prevention and management of pressure ulcers.
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Affiliation(s)
- Franco R Abrahams
- Department of General Nursing Sciences, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| | - Edwin R Daniels
- Department of Allied Health, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| | - Hileni N Niikondo
- Department of General Nursing Sciences, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
| | - Kristofina Amakali
- Department of General Nursing Sciences, Faculty of Health Sciences, School of Nursing, University of Namibia, Windhoek, Namibia
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Ghorbani Vajargah P, Mollaei A, Falakdami A, Takasi P, Moosazadeh Z, Esmaeili S, Emami Zeydi A, Karkhah S. A systematic review of nurses' practice and related factors toward pressure ulcer prevention. Int Wound J 2022. [DOI: 10.1111/iwj.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Pooyan Ghorbani Vajargah
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Amirabbas Mollaei
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Atefeh Falakdami
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Poorya Takasi
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
| | - Zahra Moosazadeh
- Student Research Committee, School of Medicine, Sari Branch Islamic Azad University Sari Iran
| | - Shaqayeq Esmaeili
- Imam Khomeini Hospital Mazandaran University of Medical Sciences Sari Iran
| | - Amir Emami Zeydi
- Department of Medical‐Surgical Nursing, Nasibeh School of Nursing and Midwifery Mazandaran University of Medical Sciences Sari Iran
| | - Samad Karkhah
- Department of Medical‐Surgical Nursing, School of Nursing and Midwifery Guilan University of Medical Sciences Rasht Iran
- Burn and Regenerative Medicine Research Center Guilan University of Medical Sciences Rasht Iran
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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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Ramadan S, Hegab AM, Al-Awthan YS, Al-Duais MA, Tayel AA, Al-Saman MA. Comparison of the Efficiency of Lepidium sativum, Ficus carica, and Punica granatum Methanolic Extracts in Relieving Hyperglycemia and Hyperlipidemia of Streptozotocin-Induced Diabetic Rats. J Diabetes Res 2021; 2021:6018835. [PMID: 34970629 PMCID: PMC8714380 DOI: 10.1155/2021/6018835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a metabolic disorder characterized by high blood glucose levels that occurs either due to insufficient insulin production or mounting resistance to its action. The purpose of this study was to investigate if methanolic extracts of Lepidium sativum seeds, Ficus carica, and Punica granatum leaves had any effect on blood sugar levels in normal and streptozotocin (STZ) diabetic rats, as well as to explore the most effective extract. METHOD Healthy male albino rats weighing 185-266 g were divided into nine groups of eight rats each: normal control, diabetic control, diabetic rats with dietary supplements of L. sativum, F. carica, and P. granatum methanolic extracts, and diabetics treated with insulin. All of the rats were fed on ordinary diet with nutritional pellets and were given water ad libitum. To induce diabetes, all animals were administered with STZ intraperitoneal injection at a dose of 60 mg/kg body weight. For five weeks, the crude plant extracts were given orally to various groups of rats at doses of one hundred and two hundred mg/kg body weight. After that, animal groups were sacrificed and blood samples were taken. RESULTS Phytochemical analysis revealed that the highest amounts of polyphenolic compounds were present in L. sativum seeds and P. granatum leaves, while leaves of F. carica showed the highest amounts of alkaloid and flavonoid content compared to other extracts. Oral administration of F. carica and L. sativum extracts at the dosage of 100 and 200 mg/kg significantly reduced glucose, lipid profile, kidney, and liver enzyme levels. A significant increase in HbAlc levels was also observed with L. sativum extract at a dose of 200 mg/kg compared to diabetic controls. Mellitus rats supplemented with 100 and 200 mg/kg methanolic extracts of P. granatum had higher serum triglycerides and lower serum low-density lipoprotein cholesterol (LDL-C) than normal control rats. F. carica extract is more effective than L. sativum and P. granatum extracts in the prevention and control of type 2 diabetes mellitus (T2DM) and its consequences.
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Affiliation(s)
- Shimaa Ramadan
- Department of Industrial Biotechnology, Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat City, Egypt
| | - Amany Mohamed Hegab
- Developmental Pharmacology Department, The National Organization for Drug Control and Research (NODCAR), Egypt
| | - Yahya S. Al-Awthan
- Department of Biology, Faculty of Science, University of Tabuk, 71491 Tabuk, Saudi Arabia
| | - Mohammed Ali Al-Duais
- Biochemistry Department, Faculty of Science, University of Tabuk, 71491 Tabuk, Saudi Arabia
| | - Ahmed A. Tayel
- Faculty of Aquatic and Fisheries Sciences, Kafrelsheikh University, Egypt
| | - Mahmoud A. Al-Saman
- Department of Industrial Biotechnology, Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat City, Egypt
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Bates AN, Ercolano E. Development and Implementation of a Simple Wound Care Guideline for Minor Skin Lesions: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2021; 48:285-291. [PMID: 34186545 DOI: 10.1097/won.0000000000000778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this quality improvement project was to use the best available evidence and expert opinion to develop and implement a simple inpatient nursing care guideline ("The Guideline") for patients with minor skin lesions, including candidiasis, skin tears, incontinence-associated dermatitis, and stage 1 and stage 2 pressure injuries that would not require a WOC nurse consultation. PARTICIPANTS AND SETTING The Guideline was developed for nurses working on inpatient adult acute care units in a large community hospital in southwest Minnesota. APPROACH The Guideline was validated for its clarity and appropriateness by internal and external hospital-based wound care nurses and implemented through in-person rounding on the nursing units and distribution of badge cards and required completing an online education module. Surveys and wound documentation audits were conducted to measure changes in knowledge and skin care pre- and postimplementation of The Guideline. OUTCOMES We conducted wound documentation audits of approximately 491 records that assessed whether patients received appropriate treatment and found an improvement from 45% (104 of 231) to 80% (209 of 260). Nurses' self-rating of their knowledge about which dressings and topical treatment to use improved from 18% (16 of 89) agreement to 57% (55 of 96). Nurses' self-rating of their knowledge about when to change dressings and reapply topical treatments improved from 27% (24 of 89) agreement to 65% (62 of 96). IMPLICATIONS FOR PRACTICE Although there is evidence for a variety of dressings or products to treat wounds, this quality improvement project demonstrated increased adherence with providing appropriate care when fewer treatment options were recommended to nursing staff through our structured guideline. The Guideline continues to be used at the project site and is now being implemented at affiliate hospitals.
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Affiliation(s)
- Alexandra Nicole Bates
- Alexandra Nicole Bates, DNP, RN, Yale School of Nursing, Orange, Connecticut; and Mayo Clinic Health System, Mankato, Minnesota
- Elizabeth Ercolano, DNSc, RN, Yale School of Nursing, Orange, Connecticut
| | - Elizabeth Ercolano
- Alexandra Nicole Bates, DNP, RN, Yale School of Nursing, Orange, Connecticut; and Mayo Clinic Health System, Mankato, Minnesota
- Elizabeth Ercolano, DNSc, RN, Yale School of Nursing, Orange, Connecticut
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Sari SP, Everink IH, Amir Y, Lohrmann C, Halfens RJ, Moore Z, Beeckman D, Schols JM. Knowledge and Attitude of Community Nurses on Pressure Injury Prevention: A Cross-sectional Study in an Indonesian City. Int Wound J 2021; 18:422-431. [PMID: 33942519 PMCID: PMC8273589 DOI: 10.1111/iwj.13527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/12/2020] [Indexed: 12/26/2022] Open
Abstract
The objectives of this study were to examine the knowledge and attitude of Indonesian community nurses regarding Pressure Injury (PI) prevention. A cross‐sectional design was used and included the community nurses permanently working in the Public Health Center (Puskemas) in Bandung, West Java Indonesia. Knowledge was measured using the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0). Attitudes were measured using a predesigned instrument which included 11 statements on a five point Likert scale. All data were collected using paper‐based questionnaires. The response rate was 100%. Respondents (n = 235) consisted of 80 community nursing program coordinators (34.0%) and 155 community nurses (66.0%). Regarding knowledge, the percentage of correct answers in the total group of community nurses on the PUKAT 2.0 was 30.7%. The theme “Prevention” had the lowest percentage of correct answers (20.8%). Community nurses who had additional PI or wound care training had a higher knowledge score compared with community nurses who did not have additional PI training (33.7% vs 30.3%; Z = −1.995; P = 0.046). The median attitude score was 44 (maximum score 55; range 28–55), demonstrating a positive attitude among participants towards PI prevention. Further, the higher the education status of participants, the more positive the attitudes (H = 11.773; P = 0.003). This study shows that community nurses need to improve their basic knowledge of PI prevention. Furthermore, research should be performed to explore what community nurses need to strengthen their role in PI prevention.
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Affiliation(s)
- Sheizi Prista Sari
- Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia.,Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Irma Hj Everink
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - Christa Lohrmann
- Department of Nursing Science, Medical University of Graz, Graz, Austria
| | - Ruud Jg Halfens
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Zena Moore
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland
| | - Dimitri Beeckman
- School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.,Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden.,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,School of Nursing and Midwifery, Monash University, Clayton, Australia
| | - Jos Mga Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Nurses' Knowledge and Attitudes towards Prevention of Pressure Ulcers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041705. [PMID: 33578837 PMCID: PMC7916577 DOI: 10.3390/ijerph18041705] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pressure ulcers (PU) remain a serious complication of immobile patients and a burden for healthcare professionals. The incidence and prevalence remain alarming. Knowledge and attitudes of nurses play a fundamental role in prevention. The aim of this study was to determine the knowledge and attitudes of nurses towards the prevention of PU in selected Slovak hospitals and find relationships and differences among selected variables. METHODS A quantitative exploratory cross-sectional design was chosen. Validated instruments were used. From the 460 randomly selected nurses, 225 (49%) participated in this research. RESULTS Results showed insufficient knowledge (45.5%) and attitudes (67.9%) of nurses towards PU prevention. There was a significant positive correlation found between the knowledge and attitudes (ρ = 0.300; p = 0.000). Nurses´ knowledge was significantly different within the level of education (p = 0.031) and work department (p = 0.048). CONCLUSIONS Results showed insufficiencies in the knowledge and attitudes of nurses towards PU prevention. Therefore, it is essential to focus on general education and continuing education and practice of nurses. Further development of educational programs and frequent measurement of these two parameters can lead to a significant improvement in the quality of care provided.
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Akhkand SS, Seidi J, Ebadi A, Ghanei Gheshlagh R. Examination of the psychometric properties of the Persian version of the attitude towards pressure ulcer prevention instrument in nurses. J Tissue Viability 2020; 30:116-120. [PMID: 33187791 DOI: 10.1016/j.jtv.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/11/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Pressure ulcer development is a known indicator of the quality of care. Negative attitudes towards the prevention of pressure ulcers can lead to preventive care with suboptimal quality. There is no valid and reliable instrument in Iran to assess clinicians' attitudes towards pressure ulcer prevention; therefore, this study aimed to examine the psychometric properties of the Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) in Nurses. METHODS In this cross-sectional study, 250 nurses were selected using a convenience sampling method. Face, content, and construct validity were examined using exploratory factor analysis (EFA). Internal consistency was assessed using the McDonald's omega (ω), and reliability was assessed using the test-retest method. RESULTS In the EFA, five factors of Competence, Responsibility, Perceived Consequences of Pressure Ulcers on Patients, Priority, and Confidence in the Effectiveness of Prevention were extracted that together explained 50.26% of the total variance. A McDonald's ω of 0.891 demonstrated the internal consistency of the total scale, and internal consistencies ranging from 0.70 to 0.86 were found for different dimensions of the instrument. In addition, an intraclass correlation coefficient (ICC) of 0.876 was found that indicated the reliability (stability) of the total scale (95% Confidence Interval [CI]: 0.736-0.963). CONCLUSION The Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) has good validity and reliability in Iranian nurses and can be used in future clinical studies.
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Affiliation(s)
- Shadi Sohrabi Akhkand
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Jamal Seidi
- Clinical Care Research Center, Health Development Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Kaba E, Triantafyllou A, Fasoi G, Kelesi M, Stavropoulou A. Investigating Nurses' Views on Care of Mentally Ill Patients with Skin Injuries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207610. [PMID: 33086753 PMCID: PMC7589511 DOI: 10.3390/ijerph17207610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 11/24/2022]
Abstract
Background: Individuals with mental illness are at increased risk of skin injuries. The role of nurses in skin injury prevention and management is crucial and therefore their views on wound care may provide useful information for improving the quality of the care provided. Aim: To investigate nurses’ views on care of mentally ill patients with skin injuries. Method: A qualitative research design based on the principles of grounded theory approach was followed. Unstructured interviews were conducted with seven nurses working in psychiatric wards with frequent skin injuries. Data were analyzed using the constant comparative method of analysis. Results: Two main themes were emerged from data analysis. The first main theme, namely factors affecting the care of patients with skin injuries, included seven categories: (a) shortage of hospital supplies, equipment and services (b) staff shortages, (c) lack of knowledge, (d) nurses’ resistance to change, (e) difficulty in collaborating with patients, (f) patients’ physical conditions and (g) nurses’ attitudes as an obstacle to care. The second main theme, namely nurses’ suggestions for optimizing care, included five categories: (a) need for additional staff, (b) need for increasing hospital supplies and equipment availability, (c) need for training (d) need of changing nurses’ attitudes towards care and (e) need of changing the patients’ approach to collaboration. Conclusion: The care of mentally ill patients with skin injuries is affected by multidimensional factors that have a direct impact on the quality of nurses’ work and patients’ hospitalization. Specific efforts are needed to overcome the obstacles that hinder the care provided and to improve clinical practice.
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Afzali Borojeny L, Albatineh AN, Hasanpour Dehkordi A, Ghanei Gheshlagh R. The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis. Int J Prev Med 2020; 11:171. [PMID: 33312480 PMCID: PMC7716611 DOI: 10.4103/ijpvm.ijpvm_182_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/20/2020] [Indexed: 12/30/2022] Open
Abstract
Pressure ulcer is a health problem worldwide that is common among inpatients and elderly people with physical-motor limitations. To deliver nursing care and prevent the development of pressure ulcers, it is essential to identify the factors that affect it. This global systematic review and meta-analysis was conducted with the aim of evaluating the incidence of pressure ulcers in observational studies. In this study, databases including Web of Science, Embase, PubMed, Scopus, and Google Scholar were searched to collect data. Articles published from 1997 to 2017 about the factors influencing the incidence of pressure ulcers were retrieved and their results were analyzed using meta-analysis according to the Random-Effects Model. The heterogeneity of studies was investigated using the I2 statistic. Data were analyzed using the R and Stata software (version 14). In this study, 35 studies were included in the final analysis. The results showed that the pooled estimate of the incidence rate of pressure ulcer was 12% (95% CI: 10-14). The incidence rates of the pressure ulcers of the first, second, third, and fourth stages were 45% (95% CI: 34-56), 45% (95% CI: 34-56), 4% (95% CI: 3-5), and 4% (95% CI: 2-6), respectively. The highest incidence of pressure ulcers was observed among inpatients in orthopedic surgery ward (18.5%) (95% CI: 11.5-25). According to the final results, better conditions should be provided to decrease the incidence of pressure ulcers in different wards, especially orthopedics, and in patients with diabetes.
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Affiliation(s)
| | - Ahmed N. Albatineh
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait
| | - Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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WUWHS 2020 Global Healing Changing Lives, Abu Dhabi, UAE March 8-12. J Wound Care 2020; 29:1-314. [PMID: 32686975 DOI: 10.12968/jowc.2020.29.sup7b.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The abstract book contains the abstracts of keynote lectures, global gelebration, focus sessions, symposia, regional view, workshops, sponsored symposia, oral presentations, posters and the index.
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Scientific and Clinical Abstracts From WOCNext 2020 Reimagined. J Wound Ostomy Continence Nurs 2020. [DOI: 10.1097/won.0000000000000650] [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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Wong G, Gabison S, Dolatabadi E, Evans G, Kajaks T, Holliday P, Alshaer H, Fernie G, Dutta T. Toward mitigating pressure injuries: Detecting patient orientation from vertical bed reaction forces. J Rehabil Assist Technol Eng 2020; 7:2055668320912168. [PMID: 32284876 PMCID: PMC7137131 DOI: 10.1177/2055668320912168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 02/06/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Prolonged bed rest without repositioning can lead to pressure injuries. However, it can be challenging for caregivers and patients to adhere to repositioning schedules. A device that alerts caregivers when a patient has remained in the same orientation for too long may reduce the incidence and/or severity of pressure injuries. This paper proposes a method to detect a person's orientation in bed using data from load cells placed under the legs of a hospital grade bed. METHODS Twenty able-bodied individuals were positioned into one of three orientations (supine, left side-lying, or right side-lying) either with no support, a pillow, or a wedge, and the head of the bed either raised or lowered. Breathing pattern characteristics extracted from force data were used to train two machine learning classification systems (Logistic Regression and Feed Forward Neural Network) and then evaluate for their ability to identify each participant's orientation using a leave-one-participant-out cross-validation. RESULTS The Feed Forward Neural Network yielded the highest orientation prediction accuracy at 94.2%. CONCLUSIONS The high accuracy of this non-invasive system's ability to a participant's position in bed shows potential for this algorithm to be useful in developing a pressure injury prevention tool.
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Affiliation(s)
- Gordon Wong
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Sharon Gabison
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Elham Dolatabadi
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Gary Evans
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Tara Kajaks
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Pamela Holliday
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hisham Alshaer
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Geoff Fernie
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Tilak Dutta
- KITE, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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Lotfi M, Aghazadeh AM, Asgarpour H, Nobakht A. Iranian nurses' knowledge, attitude and behaviour on skin care, prevention and management of pressure injury: A descriptive cross-sectional study. Nurs Open 2019; 6:1600-1605. [PMID: 31660188 PMCID: PMC6805304 DOI: 10.1002/nop2.365] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022] Open
Abstract
AIM Pressure injuries as an indicator measuring the quality of nursing care and patient safety is a major health care problem worldwide. The aim of this study was to assess the knowledge, attitude and behaviour of nurses in preventing pressure injuries. DESIGN Descriptive cross-sectional study. METHODS This descriptive cross-sectional study enrolled 214 registered nurses in Iran. Patient satisfaction was assessed using pieker pressure ulcer knowledge test, attitude towards pressure ulcer tool and behaviour of pressure ulcer questionnaire. Data analysed by SPSSv.24 applying descriptive and inferential statistics. RESULTS The mean scores of knowledge, attitude and behaviour of nurses on the prevention of pressure injury were 27.24 (SD 5.23), 38.55 (SD 6.43) and 51.24 (SD 7.54), respectively. There was a correlation between knowledge, attitude and behaviour with the history of pressure injury training. Also, there was a significant relationship between knowledge with educational level and attitude with work experience. Knowledge, attitude and behaviour of nurses were in moderate level. Necessary measures to overcome problems such as the availability of pressure reducing equipments, motivating the nurses, eliminating the shortage of nurses and empowering nurses by holding practical workshops are important in providing patients safety.
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Affiliation(s)
- Mojgan Lotfi
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina HospitalTabriz University of Medical SciencesTabrizIran
| | - Ahmad Mirza Aghazadeh
- Department of Basic sciences, Paramedical FacultyTabriz University of Medical SciencesTabrizIran
| | - Hossein Asgarpour
- Department of Internal SurgeryFaculty Member of Çanakkale onsekiz martÇanakkaleTurkey
| | - Afsaneh Nobakht
- Faculty of Nursing and Midwifery, Sina HospitalTabriz University of Medical SciencesTabrizIran
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Nursing Education Program for Hospital-Acquired Pressure Injury Prevention in Adult Acute Care Setting: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2019; 46:161-164. [PMID: 30844873 DOI: 10.1097/won.0000000000000511] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this Quality Improvement project was to develop a multimedia hospital-acquired pressure injury (HAPI) prevention education program. The project setting was 3 adult critical care units plus a step-down unit located in the Mid-Atlantic region of the United States. A multimedia educational intervention was developed, which comprised 4 modules designed to improve nursing knowledge and competency in HAPI prevention. A posteducation program staff survey was also administered to evaluate nurse satisfaction with the program. Nurse knowledge of HAPI prevention was measured before and following implementation of the educational intervention. One hundred twenty-nine participants completed the education program, and 117 completed the satisfaction survey. Analysis revealed a statistically significant increase in knowledge after the education course (P < .05). Findings also indicated participants were satisfied that the program met stated aims.
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Australian Nurses' Knowledge of Pressure Injury Prevention and Management: A Cross-sectional Survey. J Wound Ostomy Continence Nurs 2019; 46:106-112. [PMID: 30801563 PMCID: PMC6519779 DOI: 10.1097/won.0000000000000508] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE: The aim of this study was to assess nurses' knowledge of pressure injuries in order to gather benchmark data, identify knowledge gaps, and based on results, implement educational strategies to improve practice. DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: The study setting was a large Australian tertiary general hospital employing approximately 2500 nurses in both full-time and part-time roles. A proportional sample (25%) stratified by experience, preparation, and facility-generated categories (nursing grade) was generated. The sample included nursing students and nursing assistants. Three hundred six participants completing the survey. INSTRUMENT: The Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZPUKT) version 2, comprising 72 statements, with 3 subscales (prevention/risk, staging, and wound description) was used to measure pressure injury knowledge. Item responses are “True,” “False,” and “Don't know.” For the purpose of analyses, correct responses were scored 1, and incorrect or “don't know” responses were scored 0. Generally accepted ranges of scoring for the original PZPUKT specify less than 70% as unsatisfactory, 70% to 79.9% as satisfactory, 80% to 89.9% as good, and 90% and greater as very good knowledge of pressure injury prevention. METHODS: The survey was advertised throughout the hospital by strategically placed posters, computer screen savers within the hospital, and e-mails. Respondents completed paper-based questionnaires and data were manually entered online. Data were collected between September 2015 and October 2016. Descriptive and nonparametric inferential statistical tests (Mann-Whitney U, Kruskal-Wallis H) were used to analyze within sample differences in scores. RESULTS: The overall mean knowledge score was 65%; approximately two-thirds of the sample (68%) scored 60% and greater, reflecting an unsatisfactory knowledge level of pressure injury prevention according to the original PZPUKT scores. The lowest mean scores were found in the “wound description” subscale. Participants who sought pressure injury information via the Internet or had read pressure injury guidelines scored significantly higher than those who did not (P = .001 and P < .001, respectively). Seventeen items were answered incorrectly by over half of participants, identifying important knowledge deficits, particularly within the wound description subscale. CONCLUSIONS: When compared with results from studies using the PZPUKT, we contend that a cutoff score of 60% and greater (instead of ≥70%) should be used to indicate an overall satisfactory score. Our results identified deficits in pressure injury knowledge related to seating support and seated individuals and wound dressings as areas where nurses would benefit from focused education strategies.
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De Meyer D, Verhaeghe S, Van Hecke A, Beeckman D. Knowledge of nurses and nursing assistants about pressure ulcer prevention: A survey in 16 Belgian hospitals using the PUKAT 2.0 tool. J Tissue Viability 2019; 28:59-69. [DOI: 10.1016/j.jtv.2019.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/12/2019] [Accepted: 03/25/2019] [Indexed: 12/31/2022]
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Knowledge and Attitudes of Nurses Toward Pressure Injury Prevention: A Cross-Sectional Multisite Study. J Wound Ostomy Continence Nurs 2018; 45:233-237. [PMID: 29722753 DOI: 10.1097/won.0000000000000430] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the study was to examine the knowledge and attitudes of nurses on pressure injury prevention and determine if there was a relationship between knowledge, attitude, and years of experience following an unexplained increase in reported hospital-acquired pressure injuries across 1 health district in Sydney, Australia. DESIGN Multisite cross-sectional study. SUBJECTS AND SETTING Registered and enrolled nurses working in acute, medical, and rehabilitation units in 4 hospitals and 5 community health centers across a local health district. METHODS Using a modified version of the Pressure Ulcer Knowledge Test and the Staff Attitude Scale, nurses were invited to complete the survey online or on paper. RESULTS A total of 3123 surveys were distributed and 998 were returned yielding a response rate of 32%. Approximately one-third of nurse respondents who participated in the survey had been practicing for 5 to 10 years. Almost 80% of participants scored 33/47 or more (70% or more correct) on the knowledge survey; the mean score was 35.21. The mean score for the attitudes test was 44.43 ± 4.77, out of 55 (80.7%), indicating a positive attitude toward pressure injury prevention. There was a significant positive correlation between nurses' years of experience and attitudes, but there was no correlation between years of experience and knowledge. Knowledge and attitudes were also significantly positively correlated. CONCLUSIONS Nurses had sound knowledge and held positive attitudes toward pressure injury prevention. Positive attitudes were associated with greater time spent in the workforce. Additional research is required to examine relationships between knowledge of and attitude toward pressure injury prevention and clinical practice. Further research is also needed to determine if improving knowledge and attitudes results in a sustained reduction of hospital-acquired pressure injuries.
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Coyer F, Cook JL, Doubrovsky A, Campbell J, Vann A, McNamara G. Understanding contextual barriers and enablers to pressure injury prevention practice in an Australian intensive care unit: An exploratory study. Aust Crit Care 2018; 32:122-130. [PMID: 29627314 DOI: 10.1016/j.aucc.2018.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 01/31/2018] [Accepted: 02/05/2018] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Skin integrity management is often a low clinical priority in the intensive care environment, possibly resulting in high pressure injury (PI) prevalence. This article reports the results of the first phase of a multiphased project, "Translating evidence-based pressure injury prevention strategies to the intensive care environment (SUSTAIN study)". The SUSTAIN study used a research translation framework to guide the assessment of research uptake, development, and monitoring of translational strategies to reduce PIs. OBJECTIVE The objective was to assess the enablers and barriers to research translation of evidence-based skin integrity management in one Australian tertiary referral intensive care unit (ICU). METHODS This exploratory study was conducted in an Australian metropolitan tertiary ICU on a sample of 204 registered nurses. Data were collected using (i) a descriptive cross-sectional cohort survey of barriers, enablers, and attitudes to PI prevention, (ii) a cross-sectional survey of PI knowledge, and (iii) focus groups to understand the local contextual factors impacting registered nurses' PI prevention practice. RESULTS Participants reported a moderate to high ability to rise above barriers in PI prevention, a positive attitude towards PI prevention, and considered this a priority in their care of patients. High patient acuity emerged as a barrier to implementing timely PI prevention strategies. In the knowledge, test participants with postgraduate qualifications answered more statements correctly. Focus group data revealed four themes: (i) team ICU, (ii) processes of care, (iii) education for consistency, and (iv) the patient. CONCLUSIONS It is essential that evidence-based PI prevention strategies are provided in the intensive care environment. Our findings indicate that despite positive attitudes and sound knowledge levels, high patient acuity is a significant barrier to evidence implementation.
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Affiliation(s)
- Fiona Coyer
- Joint Appointment Intensive Care Services, Royal Brisbane and Women's Hospital, Australia; School of Nursing, Queensland University of Technology, Australia; Institute of Skin Integrity and Infection Prevention, University of Huddersfield, UK.
| | - Jane-Louise Cook
- School of Nursing, Queensland University of Technology, Australia.
| | - Anna Doubrovsky
- School of Nursing, Queensland University of Technology, Australia.
| | - Jill Campbell
- School of Nursing, Queensland University of Technology, Australia; Skin Integrity Services, Royal Brisbane and Women's Hospital, Australia.
| | - Amanda Vann
- Intensive Care Services, Royal Brisbane and Women's Hospital, Australia.
| | - Greg McNamara
- Intensive Care Services, Royal Brisbane and Women's Hospital, Australia.
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Gabison S, Mathur S, Nussbaum EL, Popovic MR, Verrier MC. Trunk Function and Ischial Pressure Offloading in Individuals with Spinal Cord Injury. J Spinal Cord Med 2017; 40:723-732. [PMID: 28610474 PMCID: PMC5778936 DOI: 10.1080/10790268.2017.1328345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To determine if there is a relationship between trunk function and offloading of the ischial tuberosities in individuals with Spinal Cord Injury (SCI). DESIGN Prospective cross-sectional evaluation. SETTING Sub-acute rehabilitation hospital. PARTICIPANTS Fifteen non-ambulatory participants with complete or incomplete traumatic and non-traumatic SCI, American Spinal Injury Association Impairment Scale (AIS), Classification A-D. OUTCOME MEASURES Isometric trunk strength using a hand held dynamometer, the ability to reach using the multidirectional reach test and offloading times of the ischial tuberosities using a customized pressure mat. RESULTS Participants who were able to engage in the multidirectional reach test were defined as "Reachers", whereas individuals who were unable to engage in the multidirectional reach test were defined as "Non-Reachers". Trunk strength was significantly higher in Reachers compared with Non-Reachers (P < 0.05). Offloading times over the left and right ischial tuberosities were lower in Non-Reachers when compared with Reachers, however the results were statistically significant only for offloading over the right ischial tuberosity (P < 0.05). There was no correlation between trunk strength and pressure offloading times for both groups. CONCLUSIONS Regardless of an individual's ability to engage in a reaching task, participants with spinal cord injury spent more time offloading the left ischial tuberosity compared with the right ischial tuberosity. The study highlights the need to identify factors that may contribute to offloading behavior in individuals with spinal cord injury who lack sufficient trunk strength.
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Affiliation(s)
- Sharon Gabison
- SCI Mobility Lab, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada,Department of Physical Therapy, University of Toronto, Toronto, Canada,Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada,Correspondence to: Sharon Gabison, Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada.
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ethne L. Nussbaum
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada,MClSc program in field of Wound Healing, Western University, London, Canada
| | - Milos R. Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Mary C. Verrier
- SCI Mobility Lab, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada,Department of Physical Therapy, University of Toronto, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
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Martin D, Albensi L, Van Haute S, Froese M, Montgomery M, Lam M, Gierys K, Lajeunesse R, Guse L, Basova N. Healthy Skin Wins: A Glowing Pressure Ulcer Prevention Program That Can Guide Evidence-Based Practice. Worldviews Evid Based Nurs 2017; 14:473-483. [PMID: 28755424 DOI: 10.1111/wvn.12242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND In 2013, an observational survey was conducted among 242 in-patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence-based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled "Healthy Skin Wins" with an online tutorial about PU prevention. AIMS To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP. METHODS This was a mixed methods study. A repeat observational survey discerned if the PUPP reduced PU prevalence. A pre-test post-test design was used to determine whether hospital staff's knowledge of PU prevention was enhanced by the online tutorial. Qualitative interviews were conducted with nurses, allied health professionals, and health care aides to explore staff's perspectives of the PUPP. RESULTS A comparison of initial and repeat observational surveys (n = 239) identified a statistically significant reduction in the prevalence of PU to 7.53% (p < .001). The online tutorial enhanced staff knowledge level with a statistically significantly higher mean post-test score (n = 80). Thirty-five frontline staff shared their perspectives of the PUPP with "it's definitely a combination of everything" and "there's a disconnect between what's needed and what's available" as the main themes. CONCLUSIONS Incorporating evidence-based PU prevention into clinical practice greatly reduced the prevalence of PUs among hospital in-patients. Due to the small sample size for the pre-test post-test component, the effectiveness of the online tutorial in improving the knowledge level of PU prevention among hospital staff requires further research. LINKING EVIDENCE TO ACTION Evidence-based PU prevention strategies are facilitated by using a multidisciplinary approach. Educational tools about PU prevention must target all members of the healthcare team including healthcare aides, patients and families.
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Affiliation(s)
- Donna Martin
- Xi Lambda, Associate Professor, University of Manitoba, Rady Faculty of Health Sciences, College of Nursing, Winnipeg, Manitoba, Canada
| | - Lisa Albensi
- Xi Lambda, Director of Health Services, Southern Health Sante-Sud Regional Authority, Bethesda Regional Health Centre, Steinbach, Manitoba, Canada
| | - Stephanie Van Haute
- Program Development Officer, Manitoba HIV Program, Winnipeg Manitoba; Nursing Supervisor, St. Boniface Hospital, Winnipeg Manitoba; Facility Patient Care Manager, Seven Oaks General Hospital, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
| | - Maria Froese
- Physiotherapist, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Mary Montgomery
- Occupational Therapist, Seven Oaks Hospital, Occupational Therapy, Winnipeg, Manitoba, Canada
| | - Mavis Lam
- Registered Dietician, Seven Oaks Hospital, Clinical Nutrition, Winnipeg, Manitoba, Canada
| | - Kendra Gierys
- Continuing Education Instructor, Seven Oaks Hospital, Critical Care, Winnipeg, Manitoba, Canada
| | - Rob Lajeunesse
- Program Care Team Manager, Seven Oaks Hospital, Renal Health, Winnipeg, Manitoba, Canada
| | - Lorna Guse
- Associate Professor, University of Manitoba, Rady Faculty of Health Sciences, College of Nursing, Winnipeg, Manitoba, Canada
| | - Nataliya Basova
- Xi Lambda, Registered Nurse, Health Sciences Centre, Central Support Services, Surgical Relief Team, Winnipeg, Manitoba, Canada
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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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Abstract
PURPOSE This study examined the effectiveness of a universal pressure ulcer prevention bundle (UPUPB) applied to intensive care unit (ICU) patients combined with proactive, semiweekly WOC nurse rounds. The UPUBP was compared to a standard guideline with referral-based WOC nurse involvement measuring adherence to 5 evidence-based prevention interventions and incidence of pressure ulcers. DESIGN The study used a quasi-experimental, pre-, and postintervention design in which each phase included different subjects. Descriptive methods assisted in exploring the content of WOC nurse rounds. SUBJECT AND SETTING One hundred eighty-one pre- and 146 postintervention subjects who met inclusion criteria and were admitted to ICU for more than 24 hours participated in the study. The research setting was 3 ICUs located at North Memorial Medical Center in Minneapolis, Minnesota. METHODS Data collection included admission/discharge skin assessments, chart reviews for 5 evidence-based interventions and patient characteristics, and WOC nurse rounding logs. Study subjects with intact skin on admission identified with an initial skin assessment were enrolled in which prephase subjects received standard care and postphase subjects received the UPUPB. Skin assessments on ICU discharge and chart reviews throughout the stay determined the presence of unit-acquired pressure ulcers and skin care received. Analysis included description of WOC nurse rounds, t-tests for guideline adherence, and multivariate analysis for intervention effect on pressure ulcer incidence. Unit assignment, Braden Scale score, and ICU length of stay were covariates for a multivariate model based on bivariate logistic regression screening. RESULTS The incidence of unit-acquired pressure ulcers decreased from 15.5% to 2.1%. WOC nurses logged 204 rounds over 6 months, focusing primarily on early detection of pressure sources. Data analysis revealed significantly increased adherence to heel elevation (t = -3.905, df = 325, P < .001) and repositioning (t = -2.441, df = 325, P < .015). Multivariate logistic regression modeling showed a significant reduction in unit-acquired pressure ulcers (P < .001). The intervention increased the Nagelkerke R-Square value by 0.099 (P < .001) more than 0.297 (P < .001) when including only covariates, for a final model value of 0.396 (P < .001). CONCLUSION The UPUPB with WOC nurse rounds resulted in a statistically significant and clinically relevant reduction in the incidence of pressure ulcers.
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Balzer K, Kottner J. Evidence-based practices in pressure ulcer prevention: Lost in implementation? Int J Nurs Stud 2015; 52:1655-8. [DOI: 10.1016/j.ijnurstu.2015.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 08/10/2015] [Indexed: 11/17/2022]
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A Survey of Australian Nurses' Knowledge of Pressure Injury/Pressure Ulcer Management. J Wound Ostomy Continence Nurs 2015; 42:450-60. [DOI: 10.1097/won.0000000000000141] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Knowledge about pressure ulcer prevention, classification and management: A survey of registered nurses working with trauma patients in the emergency department. Int J Orthop Trauma Nurs 2014. [DOI: 10.1016/j.ijotn.2014.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Balzer K, Kremer L, Junghans A, Halfens R, Dassen T, Kottner J. What patient characteristics guide nurses’ clinical judgement on pressure ulcer risk? A mixed methods study. Int J Nurs Stud 2014; 51:703-16. [DOI: 10.1016/j.ijnurstu.2013.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 08/27/2013] [Accepted: 09/13/2013] [Indexed: 11/26/2022]
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30
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Hsu MY, Tsao WY, Sung HC. The effectiveness of educational programs in promoting nursesʼ knowledge of pressure ulcers: a systematic review protocol. ACTA ACUST UNITED AC 2013. [DOI: 10.11124/01938924-201311050-00006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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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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Kay K, Glass N. Debunking the manual handling myth: An investigation of manual handling knowledge and practices in the Australian private health sector. Int J Nurs Pract 2011; 17:231-7. [DOI: 10.1111/j.1440-172x.2011.01930.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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