Mukantwari Sophie, Bikorimana Emmanuel, Rumagihwa Liberatha, Akaninyene Ime U, Ntakirutimana Christian, Mucumbitsi Joseph, Uhawenimana Thierry Claudien, Ikwuka David
Department of Intensive Care Unit, Kigali University Teaching Hospital, Kigali, Rwanda.
College of Medicine and Health Sciences, School of Nursing and Midwifery, University of Rwanda, Po. Box: 3286, Kigali, Rwanda.
BMC Nurs. 2025 Jan 28;24(1):104. doi: 10.1186/s12912-025-02754-1.
Pressure injuries are costly and can lead to mortality and psychosocial consequences if not managed effectively. Proper management of pressure injuries is crucial for quality nursing care. However, there is limited research on nurses' knowledge and practices in preventing and managing pressure injuries among critically ill patients in Rwanda. In addition, barriers affecting nurses' practices in this area also need further investigation in order to inform the interventions to improve nursing care of patients with pressure injuries in Rwandan hospitals.
A cross-sectional study involving 129 health nurses was conducted to determine their knowledge and practice levels regarding the prevention of pressure injuries in critically ill patients, and barriers impeding practice in this area. The research modified the Pieper-Zulkowski Pressure Ulcer Knowledge Test to evaluate the knowledge of nurses concerning the prevention of pressure injuries. A 33-item instrument drawn from pressure ulcer risk assessment and prevention toolkits established by the Agency for Healthcare Research and Quality was used to assess nurses' practices. Additionally, barriers influencing nurses' knowledge and practices related to the prevention of pressure injuries were evaluated through questions derived from a comparable study conducted in Ethiopia. Descriptive statistics were computed for each variable. Mean scores were computed to categorize nurses' level of knowledge and practice. Logistic regression analysis was employed to examine the influence of sociodemographic factors and training on the nurses' knowledge and practice, with a statistical significance set at a p-value less than 0.05.
The study found that 40.0% of nurses had inadequate knowledge towards pressure injury prevention, and 60.0% reported that they inadequately practiced pressure injury prevention among critically ill patients. Nurses who have not been trained in pressure injury prevention have a 52.4% reduction in the odd of having adequate practice compared to those who have been trained (OR 0.476; 95% CI 0.211-0.996). Heavy workload, inadequate staff, shortage of equipments, presence of other priorities than pressure injury prevention, inadequate training coverage of pressure injury prevention were the most prevalent barriers reported.
The evaluation of nurses' knowledge and practices on pressure injury prevention in critically ill patients at the study setting found that while nurses have satisfactory knowledge, their practical application is lacking due to factors like high workloads and insufficient staffing. The study recommends caution in interpreting the results due to a limited sample size, suggesting further research to guide improvements in nursing practices.
压疮成本高昂，如果管理不当，可能导致死亡和心理社会后果。正确管理压疮对于优质护理至关重要。然而，卢旺达针对重症患者预防和管理压疮方面护士的知识和实践的研究有限。此外，影响护士在该领域实践的障碍也需要进一步调查，以便为改善卢旺达医院压疮患者护理的干预措施提供依据。
开展了一项涉及129名护士的横断面研究，以确定他们在重症患者压疮预防方面的知识和实践水平，以及阻碍该领域实践的障碍。该研究修改了皮珀 - 祖尔科夫斯基压疮知识测试，以评估护士关于预防压疮的知识。使用从医疗保健研究与质量局制定的压疮风险评估和预防工具包中提取的一份33项指标的工具来评估护士的实践。此外，通过借鉴在埃塞俄比亚进行的一项类似研究中的问题，评估了影响护士预防压疮知识和实践的障碍。对每个变量进行描述性统计。计算平均得分以对护士的知识和实践水平进行分类。采用逻辑回归分析来检验社会人口学因素和培训对护士知识和实践的影响，设定统计学显著性为p值小于0.05。
研究发现，40.0%的护士对压疮预防知识掌握不足，60.0%的护士报告称他们在重症患者中预防压疮的实践不足。未接受过压疮预防培训的护士与接受过培训的护士相比，有充分实践的几率降低了52.4%（比值比0.476；95%置信区间0.211 - 0.996）。报告的最普遍障碍包括工作量大、人员不足、设备短缺、存在比压疮预防更优先的事项以及压疮预防培训覆盖不足。
在研究环境中对护士在重症患者压疮预防方面的知识和实践进行评估发现，虽然护士有足够的知识，但由于工作量大、人员配备不足等因素，其实际应用存在欠缺。由于样本量有限，该研究建议在解释结果时谨慎，建议进一步开展研究以指导护理实践的改进。
