School of Nursing, Midwifery & Paramedicine, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia.
School of Nursing, University of Wollongong, Wollongong, NSW, Australia.
Int Wound J. 2024 Oct;21(10):e70050. doi: 10.1111/iwj.70050.
Pressure injuries are a significant problem for immobile patients in acute care and can have a profound impact on patients' health and well-being, putting pressure on healthcare systems and strain on the healthcare economy. Nurses play a pivotal role in preventing pressure injuries. A study using multiple methods was conducted to explore pressure injury prevention practices in four inpatient units within a tertiary-level Australian Hospital. Quantitative and qualitative methods were used to gather data across a 9-month period. Observations, audits, surveys and interviews were used to collect data across five time points. Statistical analysis of the quantitative data was undertaken, and thematic analysis was used to analyse qualitative data. Data were integrated using a realist evaluation framework. Ethical approval for the study was granted. The quantitative results demonstrated significant reductions in pressure injury prevalence from 11.5% at commencement to 4.8% at completion of the study. Hospital-acquired pressure injuries also reduced from 4.6% to 1.9%. These results were achieved even though nursing knowledge and attitudes did not increase during the study period. Three qualitative themes were identified: Making Nursing Care Visible, Understanding the 'Why' and Engagement is Key. This study demonstrates that pressure injuries can be prevented with improvements in nursing care processes. Nurses' knowledge and attitudes towards pressure injury prevention did not change throughout this study and further research is required on how nurses' knowledge and attitudes contribute towards pressure injury prevention practices.
压力性损伤是急性护理中不动患者的一个重大问题，会对患者的健康和福祉产生深远影响，给医疗保健系统带来压力并加重医疗经济负担。护士在预防压力性损伤方面发挥着关键作用。本研究采用多种方法，探索了澳大利亚一家三级医院的四个住院病房的压力性损伤预防实践。在 9 个月的时间里，采用定量和定性方法收集数据。在五个时间点使用观察、审核、调查和访谈收集数据。对定量数据进行了统计分析，并使用主题分析对定性数据进行了分析。使用现实主义评估框架整合数据。该研究获得了伦理批准。定量结果表明，压力性损伤的患病率从研究开始时的 11.5%显著下降到研究结束时的 4.8%。医院获得性压力性损伤也从 4.6%下降到 1.9%。尽管在研究期间护理知识和态度没有增加，但仍取得了这些结果。确定了三个定性主题：使护理护理可见，理解“为什么”和参与是关键。这项研究表明，通过改善护理护理流程，可以预防压力性损伤。在整个研究过程中，护士对压力性损伤预防的知识和态度没有改变，需要进一步研究护士的知识和态度如何有助于压力性损伤预防实践。
