Factors contributing to evidence-based pressure ulcer prevention : a cross-sectional study

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Factors contributing to evidence-based pressure ulcer prevention : a cross-sectional study

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Publication Article, peer reviewed scientific
Title Factors contributing to evidence-based pressure ulcer prevention : a cross-sectional study
Author(s) Sving, Eva ; Idvall, Ewa ; Högberg, Hans ; Gunningberg, Lena
Date 2013
English abstract
Background Implementation of evidence-based care for pressure ulcer prevention is lacking. As the hospital organization is complex, more knowledge is needed to understand how nursing care in this area can be improved. Objectives The present study investigated the associations between variables on different levels in the healthcare setting (patient, unit, hospital) and the documentation of (1) risk assessment and (2) skin assessment within 24 h of admission, the use of (3) pressure-reducing mattresses and (4) planned repositioning in bed. Design A cross-sectional study. Settings One university hospital and one general hospital. Participants Geriatric (n = 8), medical (n = 24) and surgical (n = 19) units. All adult patients (>17 years), in total 825, were included. Methods A one-day prevalence study was conducted using the methodology specified by the European Pressure Ulcer Advisory Panel, together with the established methods used by the Collaborative Alliance for Nursing Outcomes. Independent variables were patient characteristics, hospital type, unit type, nurse staffing and workload. Dependent variables were documented risk and skin assessment within 24 h of admission, pressure-reducing mattresses and planned repositioning in bed. The data were analysed with Logistic regression using the Generalized Estimating Equation (GEE) approach. Results Patients at risk of developing pressure ulcers (Braden < 17) had higher odds of having risk assessment documented, and of receiving pressure-reducing mattresses and planned repositioning. Patients at the general hospital were less likely to have risk and skin assessment documented and to receive pressure-reducing mattresses. On the other hand, planned repositioning was more likely to be used at the general hospital. When total hours of nursing care was lower, patients had higher odds of having pressure-reducing mattresses but were less likely to have planned repositioning. Conclusion Patient characteristics (high age and risk score) and hospital type were associated with pressure ulcer prevention. Surprisingly, nurse staffing played only a minor role. Leaders in healthcare organizations should establish routines on different levels that support evidence-based pressure ulcer prevention, and registered nurses need to assume responsibility for bedside care.
Link http://www.sciencedirect.com/science/article/pii/S002074891300268X (external link to publication)
Publisher Elsevier
Host/Issue International Journal of Nursing Studies;5
Volume 51
ISSN 0020-7489
Pages 717–725
Language swe (iso)
Subject(s) Associations
Hospital type
Nurse staffing
Patient characteristic
Pressure ulcer prevention
Unit type
Workload
Medicine
Research Subject Categories::MEDICINE
Handle http://hdl.handle.net/2043/16432 (link to this page)

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