Pressure Sores: An Investigation Into the Clinical Nursing Management of the Prevention and Management of Pressure Sores Within an Acute Hospital Trust

Pressure sores are a common problem throughout all health care settings. A number of risk assessment scales have been developed in an endeavour to help carers recognise the individuals most at risk of developing pressure sores, and to identify the factors which contribute to that risk in order to guide appropriate and individualised plans of care. Waterlow (1991) suggests that a care plan relating specifically to the prevention and management of pressure sores may be beneficial. However, no study has investigated if the results of risk assessment are used to plan patient care or if a pressure sore care plan is advantageous. This two-phase correlational study was conducted to identify whether there was an association between risk assessment, as defined by the Waterlow Risk Assessment Scale, severity of sore, as defined by the Stirling Pressure Sore Severity scale, and management of care. In addition, two care plan systems were compared to determine if a care plan specifically for the prevention and treatment of pressure sores facilitated the systematic management of patient care. The study was conducted in an acute hospital trust. Thirty Registered Nurses were interviewed using a structured interview schedule and 327 patient records were reviewed. A comparison was made between two different care plan systems in use. Data were analysed using chi-squared, Spearman's correlation co-efficient, and McNemar's test. Level of significance was set at p<0.05 The relationship between Waterlow score and mobilisation (chi2=3.2,df=4,p=0.530) was not significant. Significant relationships were detected between Waterlow score and pressure relief (chi2 =32.92,df=2,p<0.001), Waterlow score and education (chi2=6.04, df =2,p<0.05), Waterlow score and severity of sore (rs=0.46, p<0.001). Also between care plan type and pressure relief (chi2=38.3,df=2,p<0.01), care plan type and mobilisation (chi2=12.1,df=2,p<0.016) and between care plan type and education (chi2 40.8, df=2,p