Conocimiento y uso de las directrices de prevención y tratamiento de las úlceras por presión en un hospital de agudos Knowledge and use of the guidelines for prevention and treatment of pressure ulcers in acute-care hospital

Introducción: Las úlceras por presión (UPP) siguen constituyendo hoy día un importante problema de salud y son un indicador de calidad con una relación directa con los cuidados de enfermería. Se plantea un estudio descriptivo con el objetivo de evaluar el grado de conocimiento y aplicación en su práctica asistencial de las recomendaciones que aparecen en las principales guías de práctica clínica para la prevención y cuidado de las UPP, en los profesionales de enfermería de un hospital de agudos. Material y métodos: Se diseñó un estudio transversal mediante cuestionario autocumplimentado, entre marzo y abril de 2005. La población de estudio es el personal de enfermería (diplomados y auxiliares de enfermería) de las unidades de hospitalización y UCI de un hospital de agudos. Resultados: Se obtuvo una tasa de respuesta del 37,5% (75 cuestionarios, 80% enfermeras y 20% auxiliares). En general, el grado de conocimiento de las recomendaciones sobre prevención y tratamiento de las UPP, del GNEAUPP, EPUAP y AHCPR entre los profesionales de enfermería de hospitalización y UCI está en torno al 70%, aunque destaca el bajo conocimiento de las intervenciones desaconsejadas por las guías de práctica clínica citadas, tanto en prevención como en tratamiento (aproximadamenacte, el 40%), Una cuarta parte de la muestra indica no haber recibido formación específica en UPP, ni tan sólo durante la titulación profesional. Aparecen diferencias significativas según los años de experiencia profesional: el 80,77% del grupo Introduction: Pressure ulcers continue to present a significant health problem and serve as a quality indicator that is directly related to nursing care. We propose a descriptive study with the following objective: to evaluate the level of knowledge and the application of the recommendations appearing in the main guides for the prevention of and care for pressure ulcers among nursing professionals in acute-care hospitals. Material and methods: A crosscut study was designed using a self-administered questionnaire between March and April of 2005. The study’s sampling consisted of nursing personnel (registered nurses and nurse assistants) in the hospital units and ICUs of an acute-care hospital. Results: The response rate in the survey was 37.5% (75 questionnaires: 80% nurses and 20% nurse assistants). In general terms, the level of knowledge regarding the recommendations for prevention and treatment of pressure ulcers (GNEAUPP, EPUAP and AHCPR) among hospital and ICU nursing professionals is around 70%, although there is a clearly low level of knowledge about procedures to be avoided according to the quoted clinical practice guides, both in prevention as in treatment (approximately 40%). One-fourth of the sampling reports not having received specific training in pressure ulcers, not even during professional studies. Significant differences appear as a function of the number of years of professional experience: 80.77% of the group having less than 10 years of experience has received specific training on pressure ulcers, as opposed to 61.90% of the group with more than 10 years’ experience. Conclusions: The research bibliography is not among the primary sources of information used by nursing professionals for medical decision-making; rather, others are used. This may contribute to the low level of knowledge on practices advised against by the clinical practice guides, given that such treatments are influenced by pre-existing, accepted methods of treatment and the evidence resulting from said research has not made its way into practice as much as is desired. Of note also is the fact that about 40% of known procedures are actually carried out, owing a lack of knowledge. This could be attributable to different factors, such as those of an organizational nature (i.e. lack of material resources, large work load, etc.) as well as the professionals’ possible lack of motivation. The survey has proven to be a useful tool in the detection of the need to tailor training programs according to the real necessities of the professionals. This way, we would bring about improvements, despite being the result of addressing possible deficiencies