Knowledge and practice for pressure injury prevention among care managers in a home care setting: a cross-sectional study

Abstract

Purpose: Previous studies on pressure injury prevention using questionnaire surveys have targeted physicians and nurses working in hospitals. However, few have administered surveys to social welfare professionals at home care. Thus, this study aimed to investigate the current level of knowledge and practice regarding pressure injury prevention among Japanese care managers. Patients and methods: A cross-sectional study among care managers working in a Japanese city was performed from June to July 2016. Data were collected using a questionnaire to assess the participants' knowledge of and practice for pressure injury prevention. The questionnaire included 1) measures of demographic characterization, 2) measures of knowledge, 3) measures of practice, and 4) measures of the difficulties of using pressure injury risk assessment scales. Results: A total of 48 participants were analyzed (response rate: 55%). The overall knowledge and practice scores were 78.6% and 61.8%, respectively. The percentages of participants who knew the risk assessment scales were 38%, 26%, and 13% for the Braden scale, the Ohura-Hotta scale, and the University of Kanazawa scale, respectively. We also observed that 50% of the participants in this study believed that the use of risk assessment scales in daily practice in home care may be difficult. Conclusion: Through the results of this questionnaire survey, we concluded that the current levels of knowledge and practice regarding pressure injury prevention among the care managers participating in our study were "moderate" and "low", respectively. Low scores were obtained for knowledge with respect to the question, "Using risk assessment scales". We will develop a new risk assessment scale as a bridge between both medical professionals and social welfare professionals. Practically, the authors recommend care managers should receive continuous education and practical training for pressure injury prevention in a home care setting.

Inter-Rater Reliability of a Pressure Injury Risk Assessment Scale for Home Care: A Multicenter Cross-Sectional Study

“…31 Most care managers currently believe that physician and/or nurse interventions can be initiated after the development of pressure injury, which is not ideal in real-world settings. 16 We therefore believe that pressure injury risk assessment scales, including the PPRA-Home, can serve as a bridge between medical and social welfare professionals to achieve a multidisciplinary approach in preventing pressure injuries during home care.…”

“…Our previous questionnaire survey targeting care managers, one type of professional occupation under the social welfare services of the LTCI system, revealed that less than half of the participants found it difficult to use the Braden or OH scales in daily actual clinical practice. 16 Reports have shown that the Braden scale did not have a strong enough impact for use in long-term care facilities. 17 , 18 The Japanese government had originally introduced a medical-social welfare networking model into the LTCI system with care managers as gatekeepers.…”

Convergent Validity of Three Pressure Injury Risk Assessment Scales: Comparing the PPRA-Home (Pressure Injury Primary Risk Assessment Scale for Home Care) to Two Traditional Scales

“…However, Japanese care managers generally do not consult with physicians and nurses about pressure injury prevention prior to their home-care clients actually developing pressure injuries. 19 This lack of communication likely is due to the fact that most care managers believe medical professional input and intervention is not needed until after a pressure injury has formed.…”

“…Additionally, acute care and social welfare professionals have distinct perspectives, not the least of which is their differing clinical environments. 19 …”

“…10 Despite the benefits of performing pressure injury risk assessments, care managers have reported having difficulty using the Braden and OH scales. 19 These scales may be incompatible with home care because they were designed for use by staff at acute care hospitals. Additionally, acute care and social welfare professionals have distinct perspectives, not the least of which is their differing clinical environments.…”