INTroducing A Care bundle To prevent pressure injury (INTACT) in at-risk patients: A protocol for a cluster randomised trial

Chaboyer, Wendy; Bucknall, Tracey; Webster, Joan; McInnes, Elizabeth; Banks, Merrilyn; Wallis, Marianne; Gillespie, Brigid M.; Whitty, Jennifer A.; Thalib, Lukman; Roberts, Shelley; Cullum, Nicky

doi:10.1016/j.ijnurstu.2015.04.018

Cited by 26 publications

(37 citation statements)

References 37 publications

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“…The INTACT trial measured the effectiveness of a patient education care bundle on the prevention of HAPIs. The education care bundle comprised three simple messages, delivered to patients via a video, poster and brochure: keep moving; look after your skin; eat a healthy diet (Chaboyer et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…Limited mobility was a screening criterion because it is a major PI risk factor (European Pressure Ulcer Advisory Panel et al, ). We defined “limited mobility” as the patient's use of human or equipment resources (e.g., staff, wheelchair) to mobilise or reposition (Chaboyer et al, ). Following initial screening, eligible participants received a verbal and written study overview, and if willing, provided a written consent.…”

Section: Methodsmentioning

confidence: 99%

“…Before data collection, all Research Assistants (RA), who were nurses or nursing students, undertook a one‐day skin inspection training workshop, with a summative assessment undertaken to measure their competency (Stankiewicz, Webster, Wallis, Tallot, & Chaboyer, ). The site investigator and RA assigned to each recruited hospital were responsible for participant recruitment, which occurred between 0800–1600 Monday to Friday during the data collection period (June 2014 to May 2015) (Chaboyer et al, ). It is recommended that skin inspection is undertaken within the first 8 hr of admission (European Pressure Ulcer Advisory Panel et al, ; Wounds Australia, ).…”

Section: Methodsmentioning

confidence: 99%

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Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Latimer

Chaboyer

Thalib

et al. 2019

Journal of Clinical Nursing

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Aims and objective To describe the prevalence and predictors of pressure injuries among older adults with limited mobility, within the first 36 hr of their hospital admission in Australia. Background Pressure injuries are significant health, safety and quality of care issues for patients and healthcare organisations. The early implementation of the recommended pressure injury prevention international clinical practice guidelines is a way to reduce hospital‐acquired pressure injuries. There is a paucity of evidence on the number of older persons who are admitted hospital with a pre‐existing pressure injury. Design Prospective correlational study conducted in eight tertiary referral hospitals across Australia. Our sample comprised of 1,047 participants aged ≥65 years with limited mobility, drawn from a larger Australian pragmatic cluster randomised trial. Methods Using the STROBE statement, observational data were collected on participants’ age, gender, presence of a pressure injury, Body Mass Index score, number of comorbidities and place of residence. These variables were analysed as potential predictors for pressure injuries within the first 36 hr of hospitalisation. Results From our sample, 113/1047 (10.8%) participants were observed to have a pressure injury within the first 36 hr of hospital admission. Age, multiple comorbidities and living in an aged care facility predicted the prevalence of pressure injury among older people within the first 36 hr of hospitalisation. Conclusions Our findings confirm that older adults, those with multiple comorbidities and individuals living in aged care facilities are more likely to come to hospital with a pre‐existing pressure injury or develop one soon after admission. Relevance to clinical practice Many older patients come to hospital with a community‐acquired pressure injury or develop a pressure injury soon after admission. This highlights the importance of the early detection of pressure injuries among older persons so that timely management strategies can be implemented along with the potential to reduce unnecessary financial penalties.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Latimer

Chaboyer

Thalib

et al. 2019

Journal of Clinical Nursing

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“…Our team developed a pressure ulcer prevention care bundle (PUPCB) targeted at both patients and nurses, encouraging patient participation in PUP care with three simple evidence-based messages: 1) Keep moving; 2) Look after your skin; and 3) Eat a healthy diet [12]. These messages were delivered to patients with a poster, brochure and DVD.…”

Section: Introductionmentioning

confidence: 99%

Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

et al. 2016

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BackgroundPressure ulcer prevention is a critical patient safety indicator for acute care hospitals. An innovative pressure ulcer prevention care bundle targeting patient participation in their care was recently tested in a cluster randomised trial in eight Australian hospitals. Understanding nurses’ perspectives of such an intervention is imperative when interpreting results and translating evidence into practice. As part of a process evaluation for the main trial, this study assessed nurses’ perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice.MethodsThis qualitative descriptive study involved semi-structured interviews with nursing staff at four Australian hospitals that were intervention sites for a cluster randomised trial testing a pressure ulcer prevention care bundle. Four to five participants were purposively sampled at each site. A trained interviewer used a semi-structured interview guide to question participants about their perceptions of the care bundle. Interviews were digitally recorded, transcribed and analysed using thematic analysis.ResultsEighteen nurses from four hospitals participated in the study. Nurses’ perceptions of the intervention are described in five themes: 1) Awareness of the pressure ulcer prevention care bundle and its similarity to current practice; 2) Improving awareness, communication and participation with the pressure ulcer prevention care bundle; 3) Appreciating the positive aspects of patient participation in care; 4) Perceived barriers to engaging patients in the pressure ulcer prevention care bundle; and 5) Partnering with nursing staff to facilitate pressure ulcer prevention care bundle implementation.ConclusionsOverall, nurses found the care bundle feasible and acceptable. They identified a number of benefits from the bundle, including improved communication, awareness and participation in pressure ulcer prevention care among patients and staff. However, nurses thought the care bundle was not appropriate or effective for all patients, such as those who were cognitively impaired. Perceived enablers to implementation of the bundle included facilitation through effective communication and dissemination of evidence about the care bundle; strong leadership and ability to influence staff behaviour; and simplicity of the care bundle.

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“…15 Finally, and most fundamentally, the growing rejection of implementation as a linear model of knowledge transfer from one community to another, in favour of complex model of knowledge mobilisation has brought knowledge production and its use much closer together. 16 Often referred to as coproduction, there is an emphasis on recognising the value of knowledge in all its forms that exist across all stakeholder groups, and the importance of collaboration in surfacing this knowledge through research and other strategies, and then transforming and mobilising it to where it has the potential for greatest impact.…”

mentioning

confidence: 99%

An Untapped Resource: Patient and Public Involvement in Implementation Comment on "Knowledge Mobilization in Healthcare Organizations: A View From the Resource-Based View of the Firm"

Burton

2015

Int J Health Policy Manag

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INTroducing A Care bundle To prevent pressure injury (INTACT) in at-risk patients: A protocol for a cluster randomised trial

Abstract: A Care bundle To prevent pressure injury (INTACT) in at-risk patients: a protocol for a cluster randomised trial.

Cited by 26 publications

References 37 publications

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation

Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

An Untapped Resource: Patient and Public Involvement in Implementation Comment on "Knowledge Mobilization in Healthcare Organizations: A View From the Resource-Based View of the Firm"

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