Dellefield Mary Ellen, Magnabosco Jennifer L
Department of Veterans Affairs, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
Department of Veterans Affairs, Center for Implementation Practice & Research Support (CIPRS), VA Greater Los Angeles Healthcare System, Sepulveda, CA, USA; Yo San University of Traditional Chinese Medicine, Los Angeles, CA, USA.
Geriatr Nurs. 2014 Mar-Apr;35(2):97-104. doi: 10.1016/j.gerinurse.2013.10.010. Epub 2013 Oct 14.
Sustaining pressure ulcer prevention (PUP) in nursing homes has been difficult to achieve. Implementation science researchers suggest that identification of individual staff and organizational factors influencing current practices is essential to the development of an effective and customized plan to implement practice changes in a specific setting. A mixed methods approach was used to describe nurses' perceptions of individual and organization-level factors influencing performance of PUP in two Veterans Health Administration (VHA) nursing homes prior to implementation of a national VHA initiative on Hospital Acquired Pressure Ulcers (HAPUs). Individual interviews of 16 nursing staff were conducted. Individual factors influencing practice were a personal sense of responsibility to Veterans and belief in the effectiveness and importance of preventive measures. Organizational factors were existence of cooperative practices between nursing assistants and licensed nurses in assessing risk; teamwork, communication, and a commitment to Veterans' well-being. Integration and reinforcement of such factors in the development and maintenance of customized plans of PUP initiatives is recommended.
在养老院维持压疮预防（PUP）一直难以实现。实施科学研究人员表明，识别影响当前做法的个体工作人员和组织因素对于制定有效且定制化的计划以在特定环境中实施实践变革至关重要。在退伍军人健康管理局（VHA）针对医院获得性压疮（HAPUs）开展全国性倡议之前，采用了混合方法来描述护士对影响两家VHA养老院中PUP绩效的个体和组织层面因素的看法。对16名护理人员进行了个体访谈。影响实践的个体因素包括对退伍军人的个人责任感以及对预防措施有效性和重要性的信念。组织因素包括护理助理和有执照护士在评估风险方面的合作做法；团队合作、沟通以及对退伍军人福祉的承诺。建议在制定和维持PUP倡议的定制计划时整合并强化这些因素。
