BackgroundPressure injury prevention (PIP) is an important area of patient safety. Encouraging patient participation in care is a growing trend in healthcare as it can increase adherence to treatment plans and improve outcomes. Patients in acute care settings may be able to take on an active role in PIP. However, there is limited information on patients’ views of their perceived role in PIP. The aims of our study were to survey hospitalised patients’ views on a) their perceived roles in PIP and, b) factors that enable or inhibit patient participation in PIP strategies.MethodsEligible participants were 18 years of age or older, from a neurology or orthopaedic ward and had been admitted to hospital at least 24 hours prior to enrolment in the study. A questionnaire comprising of fixed and open-ended responses was administered by researchers to participants. Numerical data was analysed descriptively and free-text comments were content-analysed and grouped into themes.ResultsThe mean age of participants (n = 51) was 65 years (sd = 16.6); over half were female and three quarters were orthopaedic surgical patients. Eighty-six per cent of participants understood the concept of pressure injury and 80% agreed that patients have a role in PIP. Participants nominated the following PIP strategies that could be undertaken by patients: Keep skin healthy; Listen to your body and Looking after the inside. Strategies required for patient participation in PIP were represented by three themes: Manage pain and discomfort; Work together; Ongoing PI education.ConclusionTo ensure successful participation in PIP, patients require education throughout admission, management of pain and discomfort and a supportive and collaborative relationship with health care staff. Health professionals should identify patient ability and motivation to prevent pressure injury (PI), work in partnership with patients to adhere to PIP, and ensure that PIP actions are facilitated with appropriate pain relief.

The aim of this longitudinal study was to describe adherence to evidence-based pressure injury (PI) prevention guidelines in routine clinical practice in Australian hospitals. Data were analysed from four control sites of a larger-cluster randomised trial of a PI intervention. The sample of 799 included 220 (27·5%) Not at risk, 344 (43·1%) At risk and 110 (13·8%) At high risk patients. A total of 84 (10·5%) patients developed a PI during the study: 20 (9·0% of 220) in the Not at risk group, 45 (13·1% of 344) in the At risk group, 15 (13·6% of 110) in the At high risk group and 4 (3·2% of 125) patients who did not have a risk assessment completed. Of all patients, 165 (20·7%) received only one PI prevention strategy, and 494 (61·8%) received ≥2 strategies at some point during the study period. There was no statistical difference in the proportion of time the three risk groups received ≥1 and ≥2 strategies; on average, this was less than half the time they were in the study. Thus, patients were not receiving PI prevention strategies consistently throughout their hospital stay, although it is possible patients' risk changed over the study period.

Background Clinical registry participation is a measure of healthcare quality. Limited knowledge exists on Australian hospitals participation in clinical registries and whether this registry data informs quality improvement initiatives. Hence, our study aimed to; identify participation in clinical registries; determine if registry data inform quality improvement initiatives; identify registry participation enablers; and clinicians’ educational needs to improve use of registry data to drive practice change. Methods : A self-administered survey was distributed to staff coordinating registries in seven hospitals in New South Wales, Australia. Eligible registries were international, national and state-based clinical, condition/disease-specific and device/product registries. Results : Response rate was 70% (97/139). Sixty-two (64%) respondents contributed data to 46 eligible registries. Registry reports were most often received by nurses (61%) and infrequently by hospital executives (8.4%). Less than half used registry data ‘always’ or ‘often’ to influence practice improvement (48%) and care pathways (49%). Protected time for data collection (87%) and benchmarking (79%) were ‘very likely’ or ‘likely’ to promote continued participation. Over half ‘strongly agreed’ or ‘agreed’ that clinical practice improvement training (79%) and evidence-practice gap identification (77%) would optimise use of registry data. Conclusions : Registry data are generally only visible to local speciality units and not routinely used to inform quality improvement. Centralised on-going registry funding, accessible and transparent integrated information systems, combined with data informed improvement science education could be first steps to promote quality data-driven clinical improvement initiatives.

No abstract

Purpose There has been an increase in swimming in natural bodies of water as reported in personal qualitative accounts. However, limited academic research has explored the meaning of this occupation. Engaging with nature, exercising and being part of a community contribute to better mental and physical health. The purpose of this research was to explore the meaning that adults attribute to open-water swimming in natural bodies of water. Design/methodology/approach This study used phenomenological interviews to explore the meaning that five adults attribute to open-water swimming. Findings Open-water swimming contributes to meaning-making in many ways. Participants reported swimming as necessary for maintaining mental and emotional well-being and forming meaningful connections with the social environment, nature and their true selves. Research limitations/implications This study contributes to the understanding of the meaning of open-water swimming for adults in Ireland. Understanding the meaning of this occupation may add to the body of evidence exploring blue-space to promote health. Originality/value Open-water swimming is an occupation growing in popularity. This is the first paper to explore open-water swimming from an occupational perspective. This may provide an alternative perspective for viewing blue-space engagement and understanding the relationship between health, blue-space occupations and our oceans.