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.
School of Nursing, Queensland University of Technology, Australia.
Aust Crit Care. 2019 Mar;32(2):122-130. doi: 10.1016/j.aucc.2018.02.008. Epub 2018 Apr 5.
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.
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).
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.
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.
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.
在重症监护环境中，皮肤完整性管理通常是临床次要问题，这可能导致高压力性损伤（PI）发生率。本文报告了多阶段项目“将基于证据的压力性损伤预防策略转化为重症监护环境（SUSTAIN 研究）”第一阶段的结果。SUSTAIN 研究使用研究转化框架来指导评估研究采用、制定和监测减少 PI 的转化策略。
本研究旨在评估澳大利亚一家三级转诊重症监护病房（ICU）中基于证据的皮肤完整性管理研究转化的促进因素和障碍。
本探索性研究在澳大利亚大都市区的一家三级 ICU 中对 204 名注册护士进行了一项样本研究。使用（i）对 PI 预防的障碍、促进因素和态度进行描述性横断面队列调查，（ii）对 PI 知识进行横断面调查，以及（iii）进行焦点小组讨论，了解影响注册护士 PI 预防实践的当地环境因素。
参与者报告称，在预防 PI 方面，他们有能力克服中等至高程度的障碍，对 PI 预防持积极态度，并认为这是他们护理患者的重点。患者病情严重度高是实施及时 PI 预防策略的障碍。在知识测试中，具有研究生学历的参与者回答正确的陈述更多。焦点小组数据揭示了四个主题：（i）ICU 团队，（ii）护理流程，（iii）一致性教育，以及（iv）患者。
在重症监护环境中提供基于证据的 PI 预防策略至关重要。我们的研究结果表明，尽管态度积极，知识水平较高，但患者病情严重度高是证据实施的重大障碍。
