Martin Donna, Albensi Lisa, Van Haute Stephanie, Froese Maria, Montgomery Mary, Lam Mavis, Gierys Kendra, Lajeunesse Rob, Guse Lorna, Basova Nataliya
Xi Lambda, Associate Professor, University of Manitoba, Rady Faculty of Health Sciences, College of Nursing, Winnipeg, Manitoba, Canada.
Xi Lambda, Director of Health Services, Southern Health Sante-Sud Regional Authority, Bethesda Regional Health Centre, Steinbach, Manitoba, Canada.
Worldviews Evid Based Nurs. 2017 Dec;14(6):473-483. doi: 10.1111/wvn.12242. Epub 2017 Jul 29.
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.
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.
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.
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.
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.
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.
2013年,对一家社区医院的242名住院患者进行了一项观察性调查,压力性溃疡(PU)患病率为34.3%。随后实施了一项基于证据的压力性溃疡预防计划(PUPP),其中包括一项名为“健康皮肤必胜”的员工宣传活动以及一个关于PU预防的在线教程。
确定PUPP在降低PU患病率方面的有效性,确定在线教程在提高医院工作人员对PU预防知识水平方面的有效性,并探讨一线工作人员对PUPP的看法。
这是一项混合方法研究。通过重复观察性调查来判断PUPP是否降低了PU患病率。采用前后测试设计来确定在线教程是否提高了医院工作人员对PU预防的知识水平。对护士、专职医疗人员和医护助理进行定性访谈,以探讨工作人员对PUPP的看法。
对初始和重复观察性调查(n = 239)进行比较,发现PU患病率在统计学上显著降低至7.53%(p < .001)。在线教程提高了工作人员的知识水平,测试后平均得分在统计学上显著更高(n = 80)。35名一线工作人员分享了他们对PUPP的看法,主要主题为“这绝对是所有因素的结合”以及“所需与可得之间存在脱节”。
将基于证据的PU预防纳入临床实践大大降低了医院住院患者中PU的患病率。由于前后测试部分的样本量较小,在线教程在提高医院工作人员PU预防知识水平方面的有效性需要进一步研究。
采用多学科方法有助于实施基于证据的PU预防策略。关于PU预防的教育工具必须针对医疗团队的所有成员,包括医护助理、患者及其家属。