Nurses’ knowledge on pressure injury prevention: a systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool

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Abstract

Introduction

Inadequate knowledge on pressure injury (PI) can have a detrimental effect on preventive care strategies. The aim of this study was to assess the overall knowledge of nurses on PI prevention based on their scores on the Pressure Ulcer Knowledge Assessment Tool (PUKAT) and its subscales in different settings.

Methods

In this systematic review and meta-analysis, databases including Web of Science, Science Direct, Google Scholar, PubMed, and Scopus were searched, using the following keywords: Pressure Ulcer, Pressure injury, Bedsore, Pressure Sore, Decubitus Ulcer, knowledge, and their possible combinations. Based on heterogeneity between the studies, the data were analyzed using a random effects model. All of the analyses were performed using STATA v.12 software.

Results

In all three groups (nurses, assistant nurses, and nursing students), the lowest knowledge scores were for prevention measures to reduce the amount of pressure/shear. Nurses’ knowledge (55.4%, 95% CI: 42.4–68.4) was higher than that of nursing students (52.7%, 95% CI: 3–49.56) and assistant nurses (42.2%, 95% CI: 16.4–68).

Conclusion

The overall knowledge of nurses on PI prevention was lower than the recommended level (60%). Regular training courses and review of PI prevention guidelines can be useful in updating the knowledge of nurses, especially assistant nurses and nursing students on PI prevention.

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Most cited references 29

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Impact of pressure ulcers on quality of life in older patients: a systematic review.

Claudia Gorecki, Julia Brown, E Nelson … (2009)

To identify the impact of pressure ulcers (PUs) and PU interventions on health-related quality of life (HRQL). Systematic review and metasynthesis of primary research reporting the impact of PU and PU interventions on HRQL according to direct patient reports. Quality assessment criteria were developed and applied. Data extraction identified findings in the form of direct quotes from patients or questionnaire items and domain results. Combined synthesis of qualitative and quantitative research was performed using content analysis to generate categories and themes from findings. Thirteen electronic databases were searched, and hand searching, cross-referencing, contact with experts, and an online search was undertaken. No language restrictions were applied. Adults with PUs in acute, community, and long-term care settings across Europe, the United States, Asia, and Australia. Thirty-one studies including 2,463 participants with PUs were included in the review. Ages ranged from 17 to 96. The review included 10 qualitative and 21 quantitative studies; 293 findings, 46 categories, and 11 themes emerged. The 11 HRQL themes were physical impact, social impact, psychological effect, PU symptoms, general health, and other impacts of PUs: healthcare professional-client relationships, need for versus effect of interventions, impact on others, financial impact, perceived etiology, and need for knowledge. There is evidence that PUs and PU interventions have a significant impact on HRQL and cause substantial burden to patients.

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Preventing pressure ulcers: a systematic review.

M. Reddy, Steven S. Gill, Paula Rochon (2006)

Pressure ulcers are common in a variety of patient settings and are associated with adverse health outcomes and high treatment costs. To systematically review the evidence examining interventions to prevent pressure ulcers. MEDLINE, EMBASE, and CINAHL (from inception through June 2006) and Cochrane databases (through issue 1, 2006) were searched to identify relevant randomized controlled trials (RCTs). UMI Proquest Digital Dissertations, ISI Web of Science, and Cambridge Scientific Abstracts were also searched. All searches used the terms pressure ulcer, pressure sore, decubitus, bedsore, prevention, prophylactic, reduction, randomized, and clinical trials. Bibliographies of identified articles were further reviewed. Fifty-nine RCTs were selected. Interventions assessed in these studies were grouped into 3 categories, ie, those addressing impairments in mobility, nutrition, or skin health. Methodological quality for the RCTs was variable and generally suboptimal. Effective strategies that addressed impaired mobility included the use of support surfaces, mattress overlays on operating tables, and specialized foam and specialized sheepskin overlays. While repositioning is a mainstay in most pressure ulcer prevention protocols, there is insufficient evidence to recommend specific turning regimens for patients with impaired mobility. In patients with nutritional impairments, dietary supplements may be beneficial. The incremental benefit of specific topical agents over simple moisturizers for patients with impaired skin health is unclear. Given current evidence, using support surfaces, repositioning the patient, optimizing nutritional status, and moisturizing sacral skin are appropriate strategies to prevent pressure ulcers. Although a number of RCTs have evaluated preventive strategies for pressure ulcers, many of them had important methodological limitations. There is a need for well-designed RCTs that follow standard criteria for reporting nonpharmacological interventions and that provide data on cost-effectiveness for these interventions.

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Pressure ulcer prevalence in Europe: a pilot study.

Tom Defloor, Lena Gunningberg, Michael Clark … (2007)

Numerous prevalence studies have been conducted. The problem with these studies is that prevalence proportions cannot be compared with each other, because of differences in performance of each survey. There is no agreed standardized method for determining prevalence proportions. This study aimed to develop and pilot a uniform data collection instrument and methodology to measure the pressure ulcer prevalence and to get some insight into pressure ulcer prevalence across different patient groups in Europe. Pressure ulcer experts from different European countries developed a data collection instrument, which included five categories of data: general data, patient data, risk assessment, skin observation and prevention. A convenience sample of university and general hospitals of Belgium, Italy, Portugal, UK and Sweden participated in the study. In each participating hospital, teams of two trained nurses who collected the data on the wards were established. All patients admitted before midnight on the day of the survey and older than 18 years were included. The data collection instrument and study procedure of the survey were found to be effective by all participants. 5947 patients were surveyed in 25 hospitals in five European countries. The pressure ulcer prevalence (grade 1-4) was 18.1% and if grade 1 ulcers were excluded, it was 10.5%. The sacrum and heels were the most affected locations. Only 9.7% of the patients in need of prevention received fully adequate preventive care. The methodology is sufficiently robust to measure and compare pressure ulcer prevalence in different countries. The pressure ulcer prevalence was higher than expected and relatively few patients received adequate prevention. This indicates that more attention to prevention is needed in Europe.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Cosmet Investig Dermatol

Journal ID (iso-abbrev): Clin Cosmet Investig Dermatol

Journal ID (publisher-id): Clinical, Cosmetic and Investigational Dermatology

Title: Clinical, Cosmetic and Investigational Dermatology

Publisher: Dove Medical Press

ISSN (Electronic): 1178-7015

Publication date Collection: 2018

Publication date (Electronic): 23 November 2018

Volume: 11

Pages: 613-620

Affiliations

[1 ]Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

[2 ]Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

[3 ]Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran, rezaghanei30@ 123456yahoo.com

[4 ]Clinical Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran, rezaghanei30@ 123456yahoo.com

Author notes

Correspondence: Reza Ghanei Gheshlagh, Department of Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Pasdaran Street, 66177–13446 Sanandaj, Kurdistan, Iran, Email rezaghanei30@ 123456yahoo.com

Article

Publisher ID: ccid-11-613

DOI: 10.2147/CCID.S186381

PMC ID: 6257136

PubMed ID: 30538522

SO-VID: 10c0c86d-e95c-4188-b2f2-a9d6552f8cfe

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Nurses’ knowledge on pressure injury prevention: a systematic review and meta-analysis based on the Pressure Ulcer Knowledge Assessment Tool

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Abstract

Introduction

Methods

Results

Conclusion

Related collections

Karger: Dermatology

Most cited references 29

Impact of pressure ulcers on quality of life in older patients: a systematic review.

Preventing pressure ulcers: a systematic review.

Pressure ulcer prevalence in Europe: a pilot study.

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