How Greek nurses perceive and overcome the barriers in implementing treatment for pressure ulcers: 'against the odds'.

OBJECTIVE: Although the occurrence of pressure ulcers (PUs) is now considered as an indicator of poor quality nursing care, questions and concerns remain regarding situations where PUs were unavoidable, irrespective of the care provided. The aim of this study was to explore Greek nurses' perceptions about the barriers involved and to identify the factors that influence care planning in PU treatment. METHOD: A grounded theory approach was used and semi-structured interviews were conducted with nurses who provided pressure care to clients in a rehabilitation centre in Greece. Data were analysed using the constant comparative method. RESULTS: We interviewed seven nurses. Findings revealed one main category entitled 'anarchy' in delivery of care consisted of the following three subcategories: interdisciplinary conflicts; total trust in traditional knowledge; and devaluation of other's work/role and a core category 'Against the odds': the perceived value of prevention and treatment can overcome the barriers in treating PUs. CONCLUSION: This study gives an overview of the views and beliefs of nurses about the problems and barriers involved in PU prevention and treatment. The study reveals that although some barriers to good practice may exist, nurses can hold a positive attitude toward PU prevention and treatment, and their perceived value of prevention and treatment may help nurses to overcome the barriers in managing PUs.

Private duty nurses in Greek hospitals: a literature review.

AIM: The study aims to provide an overview of the practice of private duty nurses in Greek hospitals. BACKGROUND: For several decades, it has been a necessity for some hospital patients to hire private duty nurses (PDNs) to counterbalance the inadequacies of hospital infrastructures. In the current economic crisis in Greece, the majority of patients will not be able to afford to pay for private nursing care. METHODS: Databases such as PubMed, CINAHL, ScienceDirect, Wiley Online Library, Google Scholar and national sources were searched for relevant literature through a range of keywords. Information gathered was evaluated for relevance and grouped on a thematic basis. FINDINGS: Five articles met the inclusion criteria. Nearly 90% of PDNs have secondary levels of education or below. Approximately 15% of patients use PDNs at night due to nurse shortages and inability of their families to stay with them. Fifty per cent of the relatives reported being very unsatisfied with PDN services, while the cost for the use of a PDN is rather high. CONCLUSION: The existence of private duty nursing has been largely responsible for protecting healthcare authorities from the need to develop effective care infrastructures. In the current economic climate, nursing and healthcare authorities must staff wards appropriately for safe, free and efficient care for all patients. Effective utilization of the national nursing and healthcare workforce--including PDNs with appropriate qualifications--and matching demand with the necessary skills is essential.