The level of nurses' education appears to play an important role in developing both an awareness and an integration of professional values into practice. More research is needed to discover methods that may be used to promote nurses' professional values among nurses already practising clinically.

Each year, more than 2.5 million people in the United States develop pressure ulcers. These skin lesions bring pain, associated risk for serious infection, and increased health care utilization. Moreover, the Centers for Medicare & Medicaid (CMS) no longer provides additional reimbursement to hospitals to care for a patient who has acquired a pressure ulcer while under the hospital's care. Thus, pressure ulcer prevention presents an important challenge in acute care hospitals. A number of best practices have been shown to be effective in reducing the occurrence of pressure ulcers, but these practices are not used systematically in all hospitals. The Challenges of Pressure Ulcer Prevention Pressure ulcer prevention requires an interdisciplinary approach to care. Some parts of pressure ulcer prevention care are highly routinized, but care must also be tailored to the specific risk profile of each patient. No individual clinician working alone, regardless of how talented, can prevent all pressure ulcers from developing. Rather, pressure ulcer prevention requires activities among many individuals, including the multiple disciplines and multiple teams involved in developing and implementing the care plan. To accomplish this coordination, high-quality prevention requires an organizational culture and operational practices that promote teamwork and communication, as well as individual expertise. Therefore, improvement in pressure ulcer prevention calls for a system focus to make needed changes. Toolkit Designed for Multiple Audiences The aim of this toolkit is to assist hospital staff in implementing effective pressure ulcer prevention practices. The toolkit was developed under a contract with the Agency for Healthcare Research and Quality through the ACTION program (Accelerating Change and Transformation in Organizations and Networks), with additional support from the Health Services Research and Development Service of the Department of Veterans Affairs. It was created by a core team with expertise in pressure ulcers and organizational change at the Boston University School of Public Health. An expert advisory panel and quality improvement teams at six participating medical centers provided input. The toolkit's content draws on literature on best practices in pressure ulcer prevention and includes both validated and newly developed tools. The toolkit was tested in the six participating medical centers. Their feedback influenced this final version and their experiences are reflected in many of the examples provided.

Background: Self-efficacy and family social support are significantly associated with hypertension self-care behaviours. However, little is known about their mechanism in Saudi Arabia. This cross-sectional study aimed to examine the relationships among family social support, self-efficacy, and self-care behaviours among men with hypertension in Saudi Arabia.Methods: Data were collected from May to August of 2018. The Hypertension Self-Care Profile and the Perceived Social Support from Friends and Family scales were used to measure the study variables. Multiple linear regression was used to analyse the relationships between the variables, and the Baron and Kenny test was used to assess if self-efficacy mediated the relationship between family social support and hypertension self-care behaviours. Results: Respondents (N = 158) from the Jizan and Al-Sharqia regions of SaudiArabia completed the survey. Family social support and self-efficacy were significantly associated with hypertension self-care behaviours. In regression, self-efficacy was the only variable significantly associated with hypertension self-care behaviours.Self-efficacy fully mediated the relationship between family social support and hypertension self-care behaviours. Conclusions: Interventions to enhance hypertension self-care behaviours amongSaudi men could focus on increasing individual's self-confidence to perform specific healthy behaviours. Family support can also contribute to the performance of hypertension self-care behaviours.