Nurses’ perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study

Abstract

BackgroundPressure ulcer prevention is a critical patient safety indicator for acute care hospitals. An innovative pressure ulcer prevention care bundle targeting patient participation in their care was recently tested in a cluster randomised trial in eight Australian hospitals. Understanding nurses’ perspectives of such an intervention is imperative when interpreting results and translating evidence into practice. As part of a process evaluation for the main trial, this study assessed nurses’ perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice.MethodsThis qualitative descriptive study involved semi-structured interviews with nursing staff at four Australian hospitals that were intervention sites for a cluster randomised trial testing a pressure ulcer prevention care bundle. Four to five participants were purposively sampled at each site. A trained interviewer used a semi-structured interview guide to question participants about their perceptions of the care bundle. Interviews were digitally recorded, transcribed and analysed using thematic analysis.ResultsEighteen nurses from four hospitals participated in the study. Nurses’ perceptions of the intervention are described in five themes: 1) Awareness of the pressure ulcer prevention care bundle and its similarity to current practice; 2) Improving awareness, communication and participation with the pressure ulcer prevention care bundle; 3) Appreciating the positive aspects of patient participation in care; 4) Perceived barriers to engaging patients in the pressure ulcer prevention care bundle; and 5) Partnering with nursing staff to facilitate pressure ulcer prevention care bundle implementation.ConclusionsOverall, nurses found the care bundle feasible and acceptable. They identified a number of benefits from the bundle, including improved communication, awareness and participation in pressure ulcer prevention care among patients and staff. However, nurses thought the care bundle was not appropriate or effective for all patients, such as those who were cognitively impaired. Perceived enablers to implementation of the bundle included facilitation through effective communication and dissemination of evidence about the care bundle; strong leadership and ability to influence staff behaviour; and simplicity of the care bundle.

Healthy Skin Wins: A Glowing Pressure Ulcer Prevention Program That Can Guide Evidence‐Based Practice

“…The qualitative component of the study provided rich data about hospital staff's perceptions of the PUPP and identified what was working and what was missing. In particular, participants in the qualitative interviews identified two recommendations to strengthen the PUPP: (a) education programs targeting health care aides and (b) active patient participation (Chaboyer et al, , ; Gillespie, Chaboyer, Sykes, O'Brien, & Brandis, ; Latimer, Chaboyer, & Gillespie, ; Murray, ; Roberts et al, ).…”

“…Evidence‐based practice guidelines about PU prevention and treatment have been developed and promoted locally and globally (British Columbia Provincial Nursing Skin and Wound Committee, ; National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, & Pan Pacific Pressure Injury Alliance, ; Registered Nurses' Association of Ontario, ; Winnipeg Regional Health Authority, ). Changing material resources and interventions may be challenging for some healthcare providers, but educational opportunities about evidence‐based practice have enhanced adoption of best practices (Baldelli & Paciella, ; Chaboyer et al, ; Chaboyer & Gillespie, ; Hunter, Kelly, Stanley, Stilley, & Anderson, ; Murray, ; Roberts et al, ; Schmidt & Brown, ).…”

Patient education materials on pressure injury prevention in hospitals and health services in Victoria, Australia: Availability and content analysis

“…37 The role of education tools is an important consideration in efforts to improve health literacy. Educating and involving patients in prevention and management of PIs has been identified as being important in clinical settings in Australia, 33,38,39 the United Kingdom, 40 the United States, 41,42 and other countries. 43,44 In Australia, the content and frequency of consumer education for sustained knowledge and best practices in prevention and management of PIs were included in a list of priority issues 45 with patients themselves expressing the need for ongoing education on PI prevention.…”

“…The role of education tools is an important consideration in efforts to improve health literacy. Educating and involving patients in prevention and management of PIs has been identified as being important in clinical settings in Australia, the United Kingdom, the United States, and other countries …”

Current practice in dialysis central venous catheter management: Multi‐disciplinary renal team perspectives

“…Practice interviews with methodological experts (MW and AC) and renal clinicians (NAG) were undertaken. A semi‐structured interview guide was used to elicit information on local practices and staff attitudes to practice and to promote flexibility and responsiveness to the experiences and the roles of participants . Only data collected from the a priori domains of current processes around dialysis CVC use, insertion, maintenance and removal, were included in this substudy analysis.…”