Registered nurses’ approach to pressure injury prevention: A descriptive qualitative study

Abstract

Aims To explore Registered Nurses' approaches to pressure injury prevention, including how they perceive their roles, how they prioritize pressure injury prevention and factors influencing prevention in the Chinese context. Design A qualitative descriptive study. Methods Audio‐recorded, face‐to‐face, semi‐structured individual interviews were conducted with Registered Nurses in a large tertiary hospital in China from August to December 2020. Using the System Engineering Initiative for Patient Safety Model, the interview guide was developed to describe the work system, processes and outcomes (three domains) associated with nurses' pressure injury prevention practices. Deductive and inductive content analyses were used. Findings Twenty‐seven nurses participated in the interviews. Four themes related to two domains of the model emerged: Work system: (i) Nurses lead and coordinate pressure injury prevention; Work processes: (ii) Individualized pressure injury prevention is founded on comprehensive patient assessment; (iii) Collaborating ensures patients receive appropriate pressure injury prevention; and (iv) Competing factors influence the delivery of appropriate pressure injury prevention. One category emerged about work outcome: Nurses strive to do their best in pressure injury prevention but hold major concerns when pressure injuries occur. Conclusions Nurses play a leading role in pressure injury prevention delivery but require appropriate resources and assistance and support from other healthcare personnel, patients and carers. Understaffing, lack of resources, complex reporting and poor patient compliance challenge nurses in their delivery of pressure injury prevention. Impact Pressure injury prevention is primarily a nursing responsibility therefore nurses' approaches to prevention were explored. Nurses rely on collaboration with others and access to various resources to provide pressure injury prevention. They recognize the patients' and carers' roles and acknowledge the importance of accessing guidance and support from nursing leaders and wound experts. Acknowledging nurses leading role in prevention and ensuring they have adequate resources are important for quality care.

Medical and surgical nurses' approach to patient pressure injury prevention education: An integrative review

“…Each study was evaluated for methodological quality using the MMAT (Hong et al, 2018), encompassing qualitative and quantitative descriptive criteria. Across the six studies (Hoviattalab et al, 2014; Latimer et al, 2016, 2021; Li et al, 2021, 2022; McInnes et al, 2013), methodological quality was high; however, all presented with limitations (Table 4). Three quantitative studies identified a risk of bias (Hoviattalab et al, 2014; Li et al, 2021; McInnes et al, 2013), whilst the trustworthiness of the qualitative studies was well reported (Latimer et al, 2021; Li et al, 2022).…”

“…Nurses approach to PIP education delivery is guided by a self‐perceived sense of responsibility to prioritise (Latimer et al, 2021; Li et al, 2022), guide, raise awareness and implement PIP strategies for patients in their care (Latimer et al, 2021). Whilst nurses rely on hospital policy and clinical practice guidelines to support PIP practice (Li et al, 2022), up‐to‐date knowledge is required by nurses to facilitate delivery (Li et al, 2022).…”

“…Well‐designed patient education delivered by nurses helps bridge the health literacy gap, increasing patient satisfaction, promoting autonomy and reducing HAPI burden in hospitalised patients (Latimer et al, 2014; Marcus, 2014; Oyetunde & Akinmeye, 2015). An abundance of literature highlights insufficient patient PIP education is provided by nurses, with patient education commonly reported as the least implemented PIP strategy (Li et al, 2022; Moore et al, 2015). Greater research is needed to understand inhibiting factors for education delivery (European Pressure Ulcer Advisory Panel (EPUAP), 2019; Barakat‐Johnson et al, 2018), as 61.54% of European and up to 76.92% of Australian PI experts stated ‘content and frequency’ of staff and consumer education in PIP knowledge is a research priority (European Pressure Ulcer Advisory Panel (EPUAP), 2019).…”

Effect of a prophylactic dressing for sacral pressure injuries in non‐critically ill patients after general surgery: A randomized controlled trial

“…Therefore, clinical nurses play an important role in preventing and managing pressure injuries. They should be able to use evidence‐based practices and accepted risk assessment tools to assess a patient's risk of exacerbated injuries (Huang et al, 2021; Li et al, 2022; Mitchell, 2018).…”

“…In conclusion, pressure injury risk assessment and prevention interventions should be promoted through continuing education regarding pressure injuries for health professionals including nurses (Li et al, 2022; Porter‐Armstrong et al, 2018). Above all, pressure injuries of patients admitted to wards after general anesthesia occur immediately after surgery rather than progressing over time.…”