Improving pressure ulcer prevention in a nursing home: action research

Kennedy, Margaret

doi:10.12968/bjcn.2005.10.sup4.20144

Cited by 11 publications

(20 citation statements)

References 10 publications

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“…Nurse performance improved in 11 of the 21 research projects. These improvements ranged from better screening of patients (Booth et al 2007) to the use of preventive measures (Cooper 2005; Kennedy 2005) and better discharge planning (Atwal & Caldwell 2002). Two articles reported no improvement in performance.…”

Section: Type Of Action Researchmentioning

confidence: 99%

“…The most frequently reported patient outcome ( N = 5) was an increased knowledge of those patients involved in the research (Koch & Kelly 1999; Koch et al 2000, 2001; Kralik & Koch 2005; Glasson et al 2006). An increase in patient satisfaction was also reported (Glasson et al 2006), a health benefit in the form of a lower incidence of decubitus (Kennedy 2005) or reduced functional problems after discharge (Ross et al 2005).…”

mentioning

confidence: 99%

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Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review

Munten¹,

Bogaard²,

Cox³

et al. 2010

Worldviews on Evidence-Based Nursing

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A B S T R A C T Background:As is often reported in the literature exploring the research-practice gap, applying the principles of evidence-based practice is easier said than done. Action research is a methodology with an explicit intent of linking the worlds of research and practice. This review attempts to answer the question: What is known about implementing evidence-based practice in nursing through action research?Approach: A total of 21 action research studies have been used to answer this question. To prevent possible confusion over terminology, we used a conceptual framework that distinguishes various influencing factors in terms of four target groups (ranging from the individual end user to society as a whole) at whom the strategy is aimed and various strategies (ranging from individual feedback to contracting care providers) related to the same four target groups.Findings: Studies often failed to name the implementation strategies applied, necessitating deduction from the text by the reader. In most of the studies the implementation strategy was directed at a combination of target groups. Many of the projects reviewed reported positive contextual outcomes, "knowledge improvement" among nurses, and to a lesser degree, improved "performance." Patient outcomes were the least reported outcome measure.Conclusion: With an element of caution, this review concludes that the implementation of evidencebased practice using action research is a promising approach. Caution is needed because of the lack of detailed descriptions of implementation strategies, and their intensity and frequency prevents us from drawing firm conclusions. These are important considerations for any action researcher intending to implement EBP using this approach.

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Section: Type Of Action Researchmentioning

confidence: 99%

mentioning

confidence: 99%

Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review

Munten¹,

Bogaard²,

Cox³

et al. 2010

Worldviews on Evidence-Based Nursing

View full text Add to dashboard Cite

show abstract

“…All these care issues increased the risk of PU development [38]. Some of the issues that were identified in this study are same as those that were reported as barriers to PU prevention care in Kennedy’s action research study [29]. In the focus group interviews conducted after the completion of the second and third cycle, the care staff members responded that they were paying more attention to those care practices and were making improvements in those areas.…”

Section: Discussionmentioning

confidence: 77%

“…This implies that the change has not been effective enough for all incontinent residents. The inadequate manpower is a barrier to improving the quality of PU prevention care [29] in the two areas that are long sitting-out time and use of inner and outer napkins in night shift. Finally, the issue of the location of beds is one that is difficult to change so some strategies e.g., availability of a set of lifting belt and transfer slide to be placed in each room should be further considered to engage staff members who stand in one bedside in performing lifting and transferring procedures.…”

Section: Discussionmentioning

confidence: 99%

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Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study

2016

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BackgroundA need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes.MethodsA total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning), changing (action), and refreezing (results) were carried out. During each cycle, focus group interviews, field observations of the care staff’s practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results.ResultsThe following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the revised risk assessment method, the timely and appropriate use of PU prevention materials, the empowering of staff to improve the quality of PU care, and improved home management.ConclusionThrough the action research approach, the care staff were empowered and their PU prevention care practices had improved, which contributed to the decreased incidence of pressure ulcers. A PU prevention protocol that was accepted by the staff was finally developed as the standard of care for such homes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0361-8) contains supplementary material, which is available to authorized users.

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Consistent pressure ulcer prevention practice: The effect on PU prevalence and PU stages, and impact on PU prevention—A quasi‐experimental intervention study

Mäki-Turja-Rostedt

Leino‐Kilpi

Koivunen

et al. 2022

International Wound Journal

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This study evaluates the effect of nursing staff's renewed consistent pressure ulcer (PU) prevention practice on PU prevalence and the PU prevention implemented for residents. A quasi‐experimental intervention study was conducted. The data were collected from 232 residents (n = 115 in intervention and 117 in comparison group) in two public long‐term older people care (LOPC) facilities in Finland using the Pressure Ulcer Patient instrument (PUP‐Instrument). The facilities were chosen with convenience sampling, after which they were randomly allocated as either intervention or comparison facility. Based on international guidelines for PU prevention, the renewed, consistent PU prevention practice with six areas was developed and implemented using the operational model for evidence‐based practices (OMEBP). After the intervention, a significant difference between the intervention and the comparison facility was seen in the prevalence of PUs and in the residents’ highest stage of PUs in the sacrum, buttock and hip areas, and heels. Between the facilities, a significant difference was seen in the use of PU and nutrition risk assessment instruments and nutritional supplements, time used for repositioning in the daytime and at night‐time, lifting belt use, and avoiding shearing or stretching residents’ skin. The successful intervention improved skin integrity in LOPC facilities.

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Improving pressure ulcer prevention in a nursing home: action research

Cited by 11 publications

References 10 publications

Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review

Implementation of Evidence-Based Practice in Nursing Using Action Research: A Review

Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study

Consistent pressure ulcer prevention practice: The effect on PU prevalence and PU stages, and impact on PU prevention—A quasi‐experimental intervention study

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