University of South Alabama, Mobile, Alabama, USA.
J Nurs Scholarsh. 2024 Mar;56(2):291-313. doi: 10.1111/jnu.12940. Epub 2023 Nov 20.
Hospital-acquired pressure injuries (HAPIs) are a global high-stakes patient safety issue. Key stakeholder perspectives regarding their role and experiences with pressure injuries is critical as part of the solution to minimizing HAPI occurrence and attain sustainability.
A qualitative, descriptive approach provided multiple perspectives of key stakeholders to support the complexity of HAPI care. The qualitative data are a part of a mixed method convergent research study examining pressure injury prevention and management practices.
Nursing system theory, mixed method convergent design, and participatory action research methodologies were chosen to address both the gap analysis development and results, achieve collaborative comprehensiveness, and enable key stakeholder involvement throughout this HAPI prevention and management initiative. Participants were recruited and enrolled from a large Level I trauma hospital and the key stakeholders. Demographic information were collected prior to the individual interview. Focused interviews were conducted virtually using zoom technology. Qualitative data were analyzed using NVivo software and thematic analysis was confirmed across the co-investigators for congruence and applicability to the research questions.
Qualitative interviews with 26 key stakeholders provided data to support and integrate a link with gap analysis results on the complex health issue of HAPIs. Specific barrier and recommendation themes identified interventions that could be prioritized. The 52 barrier and 52 recommendation themes/sub-theme(s) respectively were organized by Donabedian (structure, process, and outcome) with structure elements the majority. The top three structure barrier themes involved equipment and standards for use, staff prevention education, and specialized health professionals. The top three structure recommendation themes involved specialized health professionals, equipment and standards for use, and an educational plan for those at risk or with HAPIs.
The article provides findings from the qualitative portion of a mixed method study related to HAPIs. The qualitative findings associated with the gap analysis quantitative results, achieved the goal of the participatory action research key stakeholders' input into HAPI care and can be replicated internationally.
The benefit of key stakeholder's involvement in solving a clinical problem is sustainability. A quantitative approach and integrating qualitative stakeholders' perspectives provide an in-depth solution that will advance nursing capacity toward health care delivery and HAPI nursing science and policy development on a global level.
医院获得性压疮（HAPI）是一个全球性的高风险患者安全问题。关键利益相关者对其在压疮方面的角色和经验的看法至关重要，因为这是减少 HAPI 发生并实现可持续性的解决方案的一部分。
定性、描述性方法为关键利益相关者提供了多种视角，以支持 HAPI 护理的复杂性。这些定性数据是混合方法收敛研究的一部分，该研究检查了压疮预防和管理实践。
选择护理系统理论、混合方法收敛设计和参与式行动研究方法来解决差距分析的发展和结果，实现协作的全面性，并使关键利益相关者在整个 HAPI 预防和管理计划中参与。参与者是从一家大型一级创伤医院和关键利益相关者中招募和注册的。在进行个人访谈之前收集了人口统计信息。使用 zoom 技术进行了虚拟焦点访谈。使用 NVivo 软件分析定性数据，并由共同研究者对主题分析进行确认，以确保一致性和对研究问题的适用性。
对 26 名关键利益相关者的定性访谈提供了数据，以支持和整合与 HAPI 这一复杂健康问题的差距分析结果的联系。确定了具体的障碍和建议主题，这些主题可以优先考虑干预措施。52 个障碍和 52 个建议主题/子主题（s）分别由 Donabedian（结构、过程和结果）组织，结构元素占多数。结构障碍主题的前三个涉及设备和使用标准、员工预防教育以及专业卫生专业人员。结构建议主题的前三个涉及专业卫生专业人员、设备和使用标准以及有 HAPI 风险或已患有 HAPI 的人的教育计划。
本文提供了混合方法研究中与 HAPI 相关的定性部分的结果。与差距分析定量结果相关的定性发现实现了参与式行动研究关键利益相关者对 HAPI 护理投入的目标，并且可以在国际上复制。
关键利益相关者参与解决临床问题的好处是可持续性。定量方法和整合定性利益相关者的观点提供了深入的解决方案，将提高护理能力，促进全球医疗保健服务和 HAPI 护理科学和政策的发展。
