Nurses’ Knowledge, Practices, and Barriers in Care of Patients with Pressure Ulcers in a Ugandan Teaching Hospital

Abstract

Pressure ulcers have been identified as a major burden of hospitalization worldwide, and nurses are at the forefront of prevention. The purpose of this study was to determine the nurses' knowledge and practices regarding risk factors, prevention, and management of pressure ulcers at a teaching hospital in Uganda. The study employed a descriptive cross-sectional design. Fifty-six Ugandan registered practicing nurses were sampled. A composite self-administered questionnaire and an observation checklist were utilized. The nurses had limited knowledge about critical parameters of pressure ulcers. Prevention practices were observed to be unreliable and uncoordinated related to a significant shortage of staff and logistics for pressure ulcer prevention. Nurses had poor access to current literature on pressure ulcer prevention. Translation of nurses' knowledge into practice is possible if barriers like staff shortage, pressure relieving devices provision, and risk assessment tools are addressed at Mulago.

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

“…Consistent with the studies done in Turkey [20] and Uganda [15], participants in this research reported some of the frequently applied pressure ulcer prevention practices. These include patient repositioning (91.8%), keeping patient skins dry and moist (83.2%), balanced diet (80.1%), protecting the skin during patient transfer (85.7%), documenting prevention strategies (83.2%), and removing any tightly fitting clothes from the patient (87.8%).…”

Factors Affecting Nurses’ Compliance in Preventing Pressure Ulcer Among Hospitalized Patients at King Abdulaziz University Hospital

“…Also, according to Mwebaza et al (2014), lack of supplies for pressure ulcer management and prevention, and a shortage of human healthcare resources, particularly nurses were potential and actual barriers to implementing pressure ulcer prevention and management. Heavy workloads related to shortage of staff (94.6%) and shortage of pressure relieving devices were also mentioned in the same study.…”

“…The similarities continued to be seen with patients being also considered as a barrier when they were identified as uncooperative (62.5%). Poor access to pressure ulcer literature (37.5%) and inadequate coverage about pressure ulcers during training (23.2%) considered as barriers also [17]. Pressure ulcer prevention is an interdisciplinary issue and thus needs team work to contribute to successful care and multidisciplinary efforts.…”

“…Lack of knowledge and skills, and negative attitudes in pressure ulcer prevention contributes significantly to the occurrence or worsening of pressure ulcer [23]. Several studies revealed that shortage of supplies for pressure ulcer prevention and shortages of human resource for health, particularly nurses, were the most cited barriers to carrying out appropriate pressure ulcer management [17], [14]. Furthermore, nursing care in relation to pressure ulcers is lacking adequate pressure ulcer documentation, risk assessment, training, and prevention and treatment guidelines [30].…”

Factors influencing nurses’ knowledge acquisition of diabetes care and its management: A qualitative study

“…Lack of effective multidisciplinary collaboration, and disrespect from physicians, is clearly a disincentive to nurses to contribute to case discussions, possibly to further diabetes education (Burgess & Purkis, ). There are clearly very real workload barriers, but few nurses anywhere, worldwide, would not report this as an issue (Mwebaza, Katende, Groves, & Nankumbi, ). Inadequate diabetes education programmes, lack of institutional support and materials, heavy workloads and shortages of nursing staff have also been identified in studies from the UK, the United States, Australia, Jordan and Nigeria (Alotaibi et al., ).…”