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Int Wound J. 2016 Oct;13(5):645-54. doi: 10.1111/iwj.12337. Epub 2014 Jul 25.

Getting evidence-based pressure ulcer prevention into practice: a multi-faceted unit-tailored intervention in a hospital setting.

Author information

1
Clinical Training Centre, County Council of Gävleborg, Gävle, Sweden. eva.sving@lg.se.
2
Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden. eva.sving@lg.se.
3
Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Gävle, Sweden. eva.sving@lg.se.
4
Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
5
Department of Medical Sciences, Lung Medicine and Allergology, Uppsala University, Gävle, Sweden.
6
Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Gävle, Sweden.
7
Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.

Abstract

The aim of the study was to evaluate whether a multi-faceted, unit-tailored intervention using evidenced-based pressure ulcer prevention affects (i) the performance of pressure ulcer prevention, (ii) the prevalence of pressure ulcers and (iii) knowledge and attitudes concerning pressure ulcer prevention among registered and assistant nurses. A quasi-experimental, clustered pre- and post-test design was used. Five units at a hospital setting were included. The intervention was based on the PARIHS framework and included a multi-professional team, training and repeated quality measurements. An established methodology was used to evaluate the prevalence and prevention of pressure ulcers. Nurses' knowledge and attitudes were evaluated using a validated questionnaire. A total of 506 patients were included, of whom 105 patients had a risk to develop pressure ulcer. More patients were provided pressure ulcer prevention care (P = 0·001) and more prevention care was given to each patient (P = 0·021) after the intervention. Corresponding results were shown in the group of patients assessed as being at risk for developing pressure ulcers. Nurses' knowledge about pressure ulcer prevention increased (P < 0·001). Positive attitudes towards pressure ulcer prevention remained high between pre- and post-test surveys. This multi-faceted unit-tailored intervention affected pressure ulcer prevention. Facilitation and repeated quality measurement together with constructed feedback of results seemed to be the most important factor for pressure ulcer prevention.

KEYWORDS:

Implementation; Nursing care; PARIHS; Pressure ulcer; Prevention

PMID:
25060416
DOI:
10.1111/iwj.12337
[Indexed for MEDLINE]

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