重症监护病房护士采用集束化方案预防医院获得性压疮的知识与实践：乌干达的一项教育干预研究

Knowledge and practices of intensive care unit nurses on the prevention of nosocomial pressure ulcers using a bundle protocol: an educational intervention study in Uganda.

作者信息

Katasi Kalanzi Phiona, Emma Nyakuri, Martha Imujasi, Lameck Ssemogerere, Catherine Atuhaire

机构信息

Faculty of Medicine, Department of Nursing Sciences, Mbarara University of Sciences and Technology, Mbarara, Uganda.

Department of Cardiac Critical Care and Anesthesia, Uganda Heart Institute, Kampala, Uganda.

出版信息

BMC Nurs. 2025 Aug 11;24(1):1053. doi: 10.1186/s12912-025-03731-4.

DOI:10.1186/s12912-025-03731-4

PMID:40790480

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12337400/

Abstract

INTRODUCTION

Nosocomial pressure ulcers are wounds acquired within the hospital setting, pausing a burden to the patient families and the care teams due to patient discomfort and increased costs to treat and hospital resources. Globally, patients in intensive care units (ICUs) are most impacted, and the incidents go up to 33%, while a study done in Mbarara Regional Referral Hospital stated it at 19.3%. These incidents are preventable with the use of pressure ulcer prevention guidelines. This study aimed to investigate the effect of an educational intervention with a care bundle protocol on the knowledge and practices of intensive care unit nurses of Mulago National Referral Hospital in the prevention of nosocomial pressure ulcers.

METHODS

This was a single-group quasi-experimental pre-test and post-test study that purposively selected 26 ICU nurses of Mulago National Referral Hospital. Their baseline knowledge and practice were assessed with a knowledge assessment questionnaire and an observation checklist, respectively. The nurses were then trained on the pressure ulcer prevention bundle protocol, and the training lasted two weeks. ICU nurses’ knowledge and practices were assessed two weeks after the training. Data was collected between May and July 2024 and was analyzed using STATA version 17. Independent sample t-test, Wilcoxon-rank sum test and ANOVA were used to compare variables.

RESULTS

The median (IQR) age of the study participants was 37.5 (32, 49). A biggest number of the participants were females [18] 69.2% and just above a third had attained a diploma [10] 38.5% or a Bachelor’s degree [10] 38.5%. About two thirds of the participants [17] 65.4% had never received refresher training on prevention of pressure ulcers and just above a third of them had practiced for 3–5 years in critical care. The participants reported to care for about the median (IQR) of 3 [2, 4] pressure ulcers weekly. The critical care nurses’ knowledge of pressure ulcer prevention increased to (SD) 63.2% (11.8) from (SD) 40.5 (10.6), yet practice increased to 62.6% from 37.6% with a P value of 0.001, which was statistically significant.

CONCLUSION

An educational intervention with a pressure ulcer prevention protocol brought about a significant change in participants’ knowledge and practice. More in-service training sessions on pressure ulcer prevention protocols and their availability to staff are recommended.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12912-025-03731-4.

摘要

引言

医院获得性压疮是在医院环境中发生的伤口，由于患者不适以及治疗成本增加和占用医院资源，给患者家属和护理团队带来了负担。在全球范围内，重症监护病房（ICU）的患者受影响最大，发生率高达33%，而在姆巴拉拉地区转诊医院进行的一项研究表明该发生率为19.3%。通过使用压疮预防指南，这些发生率是可以预防的。本研究旨在调查采用护理包方案的教育干预对穆拉戈国家转诊医院重症监护病房护士预防医院获得性压疮的知识和实践的影响。

方法

这是一项单组准实验性前后测研究，目的是选取穆拉戈国家转诊医院的26名ICU护士。分别使用知识评估问卷和观察检查表对他们的基线知识和实践进行评估。然后对护士进行压疮预防护理包方案培训，培训持续两周。培训两周后对ICU护士的知识和实践进行评估。数据于2024年5月至7月收集，并使用STATA 17版进行分析。采用独立样本t检验、Wilcoxon秩和检验和方差分析来比较变量。

结果

研究参与者的年龄中位数（四分位间距）为37.5（32，49）。参与者中女性占比最大[18名]，为69.2%，略高于三分之一的人获得了文凭[10名]，占38.5%，或学士学位[10名]，占38.5%。约三分之二的参与者[17名]，即65.4%，从未接受过压疮预防的进修培训，略高于三分之一的人在重症监护领域工作了3至5年。参与者报告每周护理的压疮中位数（四分位间距）为3[2，4]例。重症监护护士对压疮预防的知识从（标准差）40.5（10.6）提高到了（标准差）63.2%（11.8），而实践从37.6%提高到了62.6%，P值为0.001，具有统计学意义。