The effectiveness of a pressure injury prevention program for nursing assistants in private for‐profit nursing homes: A cluster randomized controlled trial

Abstract

AimTo examine the effectiveness of a pressure injury prevention program for private for‐profit nursing homes.DesignThis study was a two‐arm cluster randomized controlled trial. Ten private for‐profit nursing homes made up the clusters.MethodsThe participants were nursing home residents who aged 60 or above regardless of whether or not having pre‐existing pressure injuries and also three types of nursing home assistants who provided direct care to the residents from 10 private for‐profit nursing homes. These 10 nursing homes were randomly assigned to either the experimental or the control group. There were 477 and 536 resident participants and 51 and 62 nursing assistant participants in the experimental and control groups, respectively. The residents were the study participants and the nursing assistant participants were the interveners. The experimental group had the pressure injury prevention program implemented while the control group received the usual care. The primary study outcome which was the pressure injury incidence was analysed by GEE. Significance was set at a p‐value of ≤.05. The data were collected between September 2017–March 2018.ResultThere were significant interactive effects of time and group on the incidence of pressure injuries (p = .0015) and on the skill performance of the nursing assistant participants (p < .0001).ConclusionsAn evidence‐based pressure injury prevention program reduced the development of the pressure injuries and improved the skill performance of the nursing assistant participants. It is highly recommended that private for‐profit nursing homes with high proportion of non‐professional nursing assistants and insufficient nurses adopt this program for improving the prevention care of pressure injuries.ImpactThis research has an impact on prevention care of pressure injury in private for‐profit nursing homes with high proportion non‐professional nursing assistants which have the similar characteristics as the nursing homes studied in various regions and countries.Trial registration: The Controlled Trial registration ID is NCT02270385.

Impact of a Pressure Ulcers Instructional Program on Nurses' Performance and Patient Outcomes

“…In terms of nurses' level of practice, the current study found that mean nurse practice scores were low in the pre-program, indicating that the studied nurses had low levels of practice in the pre-program, which could be due to insufficient training as most of them had not attended any PU training course, but there were highly statistically significant differences post-intervention, indicating that the educational program was effective. These findings are similar to those of Kwong et al, (2020), who conducted cluster randomized controlled trials to determine the effectiveness of a pressure injury prevention program for nursing assistants in private for-profit nursing homes. Khojastehfar, Ghezeljeh, & Haghani, (2020) investigated the effectiveness of a pressure injury prevention program for nursing assistants in private for-profit nursing homes.…”

Content Validity and Reliability of the Pressure Ulcer Knowledge Test and the Knowledge Level of Portuguese Nurses at Long-Term Care Units: A Cross-Sectional Survey

“…Implementing pressure injury prevention programs reduced PU development and improved skills performance of nurses and multidisciplinary teams [14,46,47]. Training programmes centred on evidence-based nursing practices proved to increase tissue tolerance and significantly reduce tissue deterioration [48].…”

Effect of Educational Training on Nurses’ Ability to Care for Patients with Pressure Injuries: A Meta-analysis

“…In total, six studies reported on the effect of educational training on nurses’ knowledge of caring for patients with PIs 13,14,18,21–23 . The pooled standardized mean difference was 1.60 (95% CI, 0.79–2.41), and this difference was statistically significant ( P < .001; Figure 2).…”

“…In addition, most of the included studies used elearning or computer-based training programs, which they found to be more effective than face-to-face lectures. 14,18,20,22 This finding is especially relevant given the current COVID-19 scenario: Implementing virtual training programs will still significantly improve nurses' PI knowledge and clinical skills. However, it is also necessary to have regular, refresher educational programs with continuous feedback and a follow-up system.…”

“…After the final stage of screening, a total of nine studies encompassing 25,723 participants met the eligibility criteria and were included in the review (Figure 1). 3,13,14,[18][19][20][21][22][23]…”