Assessment of Nurses’ Knowledge, Attitude, and Perceived Barriers to Expressed Pressure Ulcer Prevention Practice in Addis Ababa Government Hospitals, Addis Ababa, Ethiopia, 2015

Abstract

Background. Although pressure ulcer development is now generally considered as an indicator for quality of nursing care, questions and concerns about situations in which they are unavoidable remain. Awareness about the significance of the problem, positive attitude towards prevention, and an adequate level of knowledge are cornerstones to effectively prevent pressure ulcers. Objective. To assess nurses' knowledge, attitudes, and perceived barriers to expressed pressure ulcer prevention practice in Addis Ababa government hospitals. Methods and Materials. This is a cross-sectional study by design. A total of 217 eligible nurses participated in the study and data were collected through pretested self-administered questionnaire. Results. When queried, 61.2% of the respondents had adequate knowledge on pressure ulcer prevention practices, while 68.4% had favorable attitudes towards prevention practices. Moreover, 67.3% of participants had good pressure ulcer prevention practices. Conclusion and Recommendation. More than half of the nurses were found to have adequate knowledge about pressure ulcer prevention and their attitude towards it was overall favorable. Expressed pressure ulcer prevention practice was affected by the participant's level of knowledge, attitude, and barriers of care. To provide effective prevention of pressure ulcer, nurses' level of knowledge and attitude should be enhanced besides resolving these barriers. IntroductionPressure ulcer is defined by the National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) as "localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction." People most at risk of pressure ulcers are those with a medical condition that limits their ability to change positions, requires them to use a wheelchair, or confines them to a bed for a long time [1].Pressure ulcers result when increased pressure exceeds the local capillary pressure. Depending on patient's severity of illness, less pressure may be adequate enough to obstruct capillary blood flow and can result in decreased oxygen delivery to tissues and as a result pressure ulcers can develop within 2 to 6 hours. If patients who are at risk of pressure ulcer are identified, effective measures will be taken to prevent its occurrence [2].There are several factors contributing to the development of pressure ulcers. These included prior ulcers, peripheral vascular diseases, diabetic mellitus, smoking, prolonged immobility, poor nutritional status, incontinency, impaired sensation, and aging as intrinsic factors and pressure, shear, friction, moisture, poor moving, and handling as well as therapeutic devices as extrinsic factors. Nurses' knowledge and attitude are also viewed as extrinsic factors for pressure ulcer formation [3].

Practice on pressure ulcer prevention among nurses in selected public hospitals, Tigray, Ethiopia

“…The current findings showed that nurses who participated in the study had a good knowledge (82.75%) towards pressure ulcer prevention which is higher than the finding of the study in Alexandria Insurance Hospitals (< 70%) with similar study participants [20] as well as the finding in a study conducted in Bangladesh (57.79%) [13]. But, higher than the study conducted in among 3 public hospitals of AA Ethiopia (Black lion, St Paul's, Ras Desta Damtew) [21] and across 6 public hospitals (Black Lion, Zawuditu Memorial, Alert, Yekatit, Tirunesh Beijing, and Menilik II) which revealed that, the overall nurses knowledge towards PUP was 61.2% and 63.85% respectively [22]. The finding was also higher than the study conducted in Gondar University Teaching Hospital which was at 54.4% [7].…”

Operating room nurses' self‐reported knowledge and attitude on perioperative pressure injury

“…The sample size was calculated referencing Dilie and Mengistu . The margin of error was set as 5% based on the common formula for a single proportion with a 95% CI— p ± 1.96 , where p was the prior estimate of the proportion of operating room nurses, and n was the sample size needed for this study, where p = 0.83 was the estimate proportion available, and Z score is a standard normal distribution value at 95% confidence level.…”

“…The sample size was calculated referencing Dilie and Mengistu. 8 The margin of error was set as 5% based on the common formula for a single proportion with a 95% CI-p ± 1.96…”

“…With the knowledge gain, nurses can then apply the principles of care prevention, knowledge in PI risk assessment, prevention, and management. Literature reported varied opinions on nurses' knowledge and attitudes influencing the practice of PI prevention . Some studies reported strong, direct correlations between knowledge and attitudes in PI prevention, while others contradicted the relationship .…”

Knowledge and Practices of Student Nurses of NRI College of Nursing in Application of SSKIN towards Prevention of Pressure Ulcers in NRI Hospital, Chinakakani, Mangalagiri, Guntur (Dt). AP

“…A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing or confounding factors are also associated with pressure ulcers; the significance of these factors is yet to be elucidated [1][2][3]. Pressure ulcers are the common conditions among patients hospitalized in acute and chronic care facilities and impose significant burden on patients, their relatives and caregivers [1,2].…”