Pressure injury prevention strategies in acute medical inpatients: an observational study

Abstract

Background: Pressure injuries are a patient safety issue. Despite the suite of prevention strategies, sustained reductions in pressure injury prevalence rates have not been achieved. Generally, nurses are usually responsible for assessing patients’ pressure injury risk, and then implementing appropriate prevention strategies. The study aim was to describe five planned and implemented pressure injury prevention strategies (risk assessment, management plan, support surface, repositioning, and education), and determine if a relationship existed between the planning and implementation of support surfaces and regular repositioning. Method: An observational study collecting data using chart audits and semi-structured observations. Data were analysed using descriptive and inferential statistics. This study was set in four medical units across two Australian metropolitan hospitals. The sample comprised adult medical inpatients with reduced mobility. A subsample of participants assessed at pressure injury risk on admission was drawn from this sample. Participants were aged ≥18 years, had a hospital length of stay of ≥3 days prior to recruitment, provided an informed consent, and had reduced mobility. Results: There was suboptimal planning and implementation of pressure injury prevention strategies for the sample and subsample. There was a significant relationship between planned and implemented support surfaces at both hospitals; however, no relationship existed between the planned and implemented of regular repositioning at either site. Conclusion: The planning and implementation of pressure injury strategies is haphazard. Patients received support surfaces; however, gaps exist in pressure injury risk assessment, management planning, regular repositioning, and patient education.

Keywords:

• clinical practice guidelines
• nursing care
• pressure ulcer
• prevention
• planned
• implemented
• patient safety

Acknowledgements

S.L., W.C., and B.G. were included in data collection and analysis, manuscript preparation and in study design.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Sharon Latimer http://orcid.org/0000-0003-2704-150X

Additional information

Funding

This study was supported by a Griffith University Area of Strategic Investment Chronic Diseases grant and a Griffith University Vice Chancellor Scholarship.