Description of Medical-Surgical Nurses Care of Patients at Risk for Pressure Ulcers

Aim: The purpose of this qualitative study was to explore and describe the level of understanding of PU development and prevention and perceptions of implementing PU prevention measures in nurses caring for patients in medical-surgical units. Method: The study was conducted in three (3) community hospitals within the same healthcare system using an Interpretive Description approach. Six (6) focus groups were conducted including thirty (30) participants. Findings: Participants described their knowledge of PU development and prevention as good and perceived continuing education as important in maintaining knowledge levels. Two (2) methods of identifying patients at risk for PU development were described: the Braden Scale and common patient diagnoses and conditions known to be associated with patients at risk for PU. Factors perceived to facilitate nurses\u27 implementation of PU prevention measures included personal motivation, use of evidence-based treatment protocols, availability of expert consultants, and leadership support. Barriers to nurses\u27 implementation of PU prevention measures perceived by study participants included the need to prioritize competing patient needs; lack of equipment and supplies; inadequate numbers and competency of staff; patient\u27s lack of or inability to cooperate; and family involvement. Finally, regulatory mandates limiting payment for hospital acquired PU were perceived by participants as a necessary measure and positive motivator in their implementation of PU prevention measures. Implications: Additional studies are needed to further describe differences between medical versus surgical patients and settings, the influence of patient families on nurses\u27 ability to provide care, and the influence of nurse leader and organizational culture on nurse motivation and performance. Organizations should implement evidence-based practice protocols, continue to provide ongoing education regarding PU prevention measures, and seriously consider adoption of the Wound Care Nurse role