Knowledge and practice of informal caregivers on pressure injury prevention and treatment among patients receiving palliative care.

BACKGROUND: Pressure injuries (PIs) are prevalent in palliative care. Lack of knowledge and skills among informal caregivers on PI prevention and management contributes significantly to the occurance or deterioration of PIs. AIM: The aims of this study were to: (1) determine the level of knowledge and practices of informal caregivers on PI prevention and treatment; (2) explore the socio-demographic characteristics of informal caregivers that influence PI prevention and treatment among patients who need palliative care. METHODS: The quantitative cross-sectional descriptive design was used to collect data from 146 informal caregivers, and a valid and reliable questionnaire was used. RESULTS: A total of 146 informal caregivers of patients with PI completed the study. Most participants had a relatively low level of PI prevention, treatment knowledge and practice. Participants who were older than 28 years, working for the government and married had significantly better knowledge and practice of PI prevention and treatment than other participants. CONCLUSION: Information for informal caregivers in different settings about PI prevention and treatment is needed. Informal caregivers need to acquire more professional practices and knowledge to improve the quality of patient care.

Pressure Injury Prevention in Adult Critically Ill Patients: A Best Practice Implementation Project.

Implementation science is the process of integrating an intervention into practice within an organization or health system and is a useful strategy to improve practice, affect patient outcomes, and promote practice sustainability. In this series, AJN and the journal JBI Evidence Implementation have partnered to deliver examples of how health care facilities from around the world have worked to solve common patient care problems. Through this partnership, we strive to create awareness and share knowledge and experiences by publishing summaries of studies that have appeared in JBI Evidence Implementation. These summaries are designed to provide nursing teams with an overview of the barriers faced and the strategies and resources needed to improve practice and drive change at the unit level. Our goal is to ensure that AJN readers have access to important evidence-based information designed to influence patient outcomes and nursing practice.-Carl A. Kirton, DNP, MBA, RN, ANP, FAAN.

Pressure ulcers: aSSKINg framework study.

Pressure ulcers (PUs) represent a burden to the health economy and patients alike. Despite national and international guidelines regarding the management of risk, the incidence and prevalence across England remains high. Detecting early the risk of PUs is paramount, and requires using a valid risk assessment tool alongside clinical judgement and management of associated risk factors. There is a need to implement prevention strategies. Introducing care bundles for pressure ulcers, for example SKIN, SSKIN and most recently aSSKINg, is designed to guide clinicians and reduce variations in care. This article presents a review of the evidence on compliance with guidelines, frameworks, pathways or care bundles within primary and secondary care settings. This article focuses on the literature review that was conducted to inform a subsequent clinical audit of compliance with the aSSKINg framework in a Community NHS Foundation Trust in the South East of England.

Skin Tears Preventable With a Gentle Approach: A Case Series.

Skin tears are a major problem for patients and the health care professionals who treat them. Although opinions on their prevalence differ, it is estimated that they are encountered more frequently than pressure sores but are overlooked. Recommendations based on strong evidence were presented for the prevention and treatment of skin tears as classified by the International Skin Tear Advisory Panel. This case series includes the clinical status of 3 patients who developed skin tears while receiving care in the hospital, and the corrective and preventive practices related to skin tears. This article will contribute to raising the awareness of health care professionals in predicting, preventing, evaluating, and treating skin tears.

Application of deep learning to pressure injury staging.

OBJECTIVE: Accurate assessment of pressure injuries (PIs) is necessary for a good outcome. Junior and non-specialist nurses have less experience with PIs and lack clinical practice, and so have difficulty staging them accurately. In this work, a deep learning-based system for PI staging and tissue classification is proposed to help improve its accuracy and efficiency in clinical practice, and save healthcare costs. METHOD: A total of 1610 cases of PI and their corresponding photographs were collected from clinical practice, and each sample was accurately staged and the tissues labelled by experts for training a Mask Region-based Convolutional Neural Network (Mask R-CNN, Facebook Artificial Intelligence Research, Meta, US) object detection and instance segmentation network. A recognition system was set up to automatically stage and classify the tissues of the remotely uploaded PI photographs. RESULTS: On a test set of 100 samples, the average precision of this model for stage recognition reached 0.603, which exceeded that of the medical personnel involved in the comparative evaluation, including an enterostomal therapist. CONCLUSION: In this study, the deep learning-based PI staging system achieved the evaluation performance of a nurse with professional training in wound care. This low-cost system could help overcome the difficulty of identifying PIs by junior and non-specialist nurses, and provide valuable auxiliary clinical information.

Difficulties and obstacles experienced by intensive care unit nurses during the prevention and care of pressure injuries: A qualitative study.

AIM: This study aimed to examine the difficulties and obstacles experienced by nurses working in intensive care units during the prevention and care of pressure injuries (ulcers). MATERIALS AND METHODS: A descriptive phenomenological study was designed, involving 13 nurses working in the intensive care unit of a hospital in Turkey. The data were collected through face-to-face interviews. The data were analyzed using thematic analysis. The findings were reported according to the Consolidated Criteria for Reporting Qualitative Studies criteria. RESULTS: Through the data analysis, an overall theme "Prevention and Care of Pressure Injuries" and three main themes, namely "Obstacles Encountered", "Impacts on The Nurses", and "Needs and Recommendations" were identified. CONCLUSION: This study identified institution-related issues (lack of resources, managers' attitudes, etc.), as well as lack of knowledge and training prevent the effective management of pressure injuries in intensive care units. The development of pressure injuries emotionally and professionally affects nurses. The primary needs of nurses were found to be equipment and material support, personnel training, positive attitudes of institution managers, and the establishment of a wound care unit within the hospital. The following recommendations were made based on the obtained findings: practical training should be given to all intensive care unit teams based on the latest information, modern, practical, diverse, and sufficient amount of equipment for pressure injuries should be provided, personnel shortage should be eliminated, institution managers should exhibit solution-oriented attitudes toward nurses rather than accusatory approaches, and a wound care unit should be established within the hospital. This study was limited to the nurses working in the ICU of a state hospital in Turkey. Since the study was carried out in a single hospital and due to the personal characteristics of the participants, the findings cannot be generalized to all ICU nurses and healthcare institutions.

Influences of evidence-based nursing intervention on pressure ulcers in intensive care units: A meta-analysis.

A meta-analysis was conducted comprehensively to investigate the impact of evidence-based nursing (EBN) interventions on pressure injury (PI) in the intensive care unit (ICU) patients. Computer searches were performed, from databases inception to November 2023, in Wanfang, PubMed, China National Knowledge Infrastructure, Google Scholar, Embase, and Cochrane Library for randomized controlled trials (RCTs) on the application of EBN interventions in ICU patients. Two independent researchers conducted screenings of the literature, extracted data, and carried out quality evaluations. Stata 17.0 software was employed for data analysis. Overall, 25 RCTs, involving 2494 ICU patients, were included. It was found that compared to conventional care methods, the implementation of EBN interventions in ICU patients markedly decreased the occurrence of PI (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.17-0.30, p < 0.001), delayed the onset time of pressure ulcers (standardized mean difference [SMD]: -1.61, 95% CI: -2.00 to -1.22, p < 0.001), and also improved nursing satisfaction (OR: 1.18, 95% CI: 1.14-1.23, p < 0.001). Our findings suggest the implementation of EBN interventions in the care of PI in ICU patients is highly valuable, can reduce the occurrence of PI, can delay the time of appearance, and is associated with relatively higher nursing satisfaction, making it worthy of promotion.

Barriers and facilitators of adherence to evidence-based pressure injury prevention clinical practice guideline among intensive care nurses: A cross-sectional survey.

OBJECTIVE: To explore intensive care unit (ICU) nurses' perceptions of their adherence to pressure injury prevention clinical practice guideline and identify the perceived barriers and facilitators that influence evidence-based pressure injury prevention practices in Chinese tertiary hospitals. RESEARCH METHODOLOGY/DESIGN: This was a multi-site, quantitative, cross-sectional study. Data were collected using a self-report questionnaire with three sections: participant demographic information, adherence to pressure injury prevention clinical practice guideline, and barriers to and facilitators of pressure injury prevention clinical practice guideline implementation. SETTING: Thirty-three adult ICUs in 16 tertiary general hospitals in 5 major cities in Liaoning Province, China. RESULTS: In total, 473 nurses responded to the survey. The mean score for adherence to pressure injury prevention clinical practice guideline was 159.06 ± 20.65, with 65.3 % reporting good adherence. Multiple stepwise regression analysis indicated that smaller ICU size (ß = -0.114, p = 0.012) and having participated in training on pressure injury prevention clinical practice guideline (ß = 0.149, p = 0.001) were statistically significantly associated with better adherence. ICU nurses identified the low priority given to pressure injury prevention as the top barrier. The top three facilitators were awareness of evidence-based practice, the current documentation format for pressure injury risk/nursing interventions, and leadership support. CONCLUSION: ICU nurses' adherence to pressure injury prevention clinical practice guideline was satisfactory, and they reported low-to-moderate barriers and moderate facilitators. IMPLICATIONS FOR CLINICAL PRACTICE: Participating in training on pressure injury prevention clinical practice guideline was a predictor of ICU nurses' adherence. Therefore, it is highly recommended that healthcare organisations consider providing training to nurses and address the barriers identified to improve nurses' adherence to evidence-based pressure injury prevention guidelines.

Pressure ulcer prevention and treatment interventions in Sub-Saharan Africa: A systematic review.

BACKGROUND: The high burden of pressure ulcers (PUs) in Sub-Saharan Africa (SSA), coupled with the limited resources, underscores the need for preventive and context-specific treatment strategies. PURPOSE: Therefore, the purpose of this systematic review was to establish and elucidate PU prevention and treatment interventions tested in SSA. METHODS: This systematic review of the literature used, PRISMA to guide the search. FINDINGS: The review identified nine studies on PU prevention (three) and treatment (six). Low-cost interventions assembled from locally available materials and multifaceted policies significantly prevented and treated PUs. The interventions included wound dressing agents, simple negative pressure suction devices that significantly treated PUs, and water-based bed surfaces. DISCUSSION: There were gaps in the interventions that have been proven successful in other global settings. CONCLUSION: In SSA, there is a need for nurses to tailor, test, and disseminate findings from evidence-based projects for PU prevention that have been successful in similar settings.

Effects of predictive nursing interventions on pressure ulcer in older bedridden patients: A meta-analysis.

To evaluate the effect of predictive nursing interventions on pressure ulcers in elderly bedridden patients by meta-analysis. Applied computer searches of PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomised controlled trials (RCTs) on the effect of predictive nursing in preventing pressure ulcers in elderly bedridden patients from the database inception to November 2023. Two researchers independently screened the literature, extracted data and performed quality assessment based on inclusion and exclusion criteria. Stata 17.0 software was utilised for data analysis. Eighteen RCTs involving 6504 patients were finally included. The analysis revealed the implementation of predictive nursing interventions had a significant advantage in reducing the incidence of pressure ulcers in elderly bedridden patients compared with conventional nursing (odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.15-0.28, p < 0.001), while the patients' satisfaction with nursing care was higher (OR = 3.70, 95% CI: 2.99-4.57, p < 0.001). This study shows that the implementation of a predictive nursing interventions for elderly bedridden patients can effectively reduce the occurrence of pressure ulcers and significantly improve patients' satisfaction with nursing care, which is worthy of clinical promotion and application.

Assessment of pressure injury knowledge using PZ-PUKT questionnaire among Indian nurses and the evaluation of impact of an educational intervention on the knowledge scores: A quasi-experimental study.

AIM: To determine the knowledge of pressure injury among Indian nurses using PZ-PUKT questionnaire and to evaluate the effect of an educational intervention on knowledge scores. MATERIALS AND METHODS: A Quasi-experimental study design was used to test the Pressure injury knowledge of 273 nurses in a tertiary care teaching hospital. The Pieper Zulkowski Pressure Ulcer Knowledge Test questionnaire was given as a pre-test prior to education session and re-administered after the activity was completed. RESULTS: The mean score of the pre-test was 48.58 ± 6.75 (C·I 47.8-49.4) and post-test 54.14 ± 7.69 (C·I 53.3-55.1), which showed a statistically significant improvement. In the pre-test, nurses had highest score in the prevention subset while wound subset had the greatest improvement in the post-test. Female participants had a better understanding about Pressure injuries when compared to males. Also, the Assistant Nursing Superintendents and ward in Charge nurses had better knowledge as compared with other nurses. CONCLUSIONS: The knowledge of pressure injury among nurses is limited. Knowledge deficits should be identified and targeted educational interventions should be administered to all the nurses irrespective of their educational level and work experience. Wound certification courses should be instituted so that it gives the nurses a better opportunity to learn about pressure injuries at a certified level. All nurses should undergo periodic training in this ever-evolving field so as to provide the best care to their patients.

Assessment of pressure injury risk in intensive care using the COMHON index: An interrater reliability study.

OBJECTIVES: To assess the interrater reliability of the COMHON (level of COnciousness, Mobility, Haemodynamics, Oxygenation, Nutrition) Index pressure injury risk assessment tool. DESIGN: Interrater reliability was tested. Twenty-five intensive care patients were each assessed by five different nurse-raters from a pool of intensive care nurses who were available on the days of assessment. In total, 25 nurses participated. SETTING: Two general and one cardiovascular surgery intensive care units in Istanbul, Turkey. MAIN OUTCOME MEASURES: Interrater reliability was analysed using intraclass correlations, and standard errors of measurement (SEM) were calculated for sum scores, risk level and item scores. Minimally detectable change (MDC) was also calculated for sum score. Consistency between paired raters was analysed using Pearson's Product Moment Correlation (r) for sum score and Spearman's rho (rs) for ordinal variables. RESULTS: All assessments were completed in ≤5 min. Interrater reliability was very high [ICC (1,1) = 0.998 (95 % CI 0.996 - 0.999)] with a SEM of 0.14 and MDC of 0.39. Consistency between paired raters was strong for sum and item scores and risk levels (coefficients >0.6). All scale items showed correlations of >.3 with the sum score. CONCLUSION: The results demonstrate near-perfect interrater reliability. Further research into the psychometric properties of the COMHON Index and its impact on preventative intervention use is warranted. IMPLICATIONS FOR CLINICAL PRACTICE: Pressure injury risk assessment within intensive care should be setting-specific due to the unique risk factors inherent to the patient population, which are not considered by general pressure injury risk assessment tools. An intensive care-specific pressure injury risk assessment tool was tested and demonstrated high reliability between intensive care nurses. Further research is needed to understand how its use in practice affects preventative intervention implementation and, in turn, how it impacts pressure injury outcomes.

Shedding new light for nurses: Enhancing pressure injury prevention across skin tones with sub-epidermal moisture assessment technology.

AIM(S): To assess the effectiveness of sub-epidermal moisture (SEM) assessment technology in the detection of early-stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital-acquired pressure injury (HAPI) incidence. DESIGN: Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change. METHODS: The study evaluated 140 adult patients admitted to the CCU over a 24-week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12-week pre-implementation period. Fifty patients were admitted through the subsequent 12-week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta ≥0.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data. RESULTS: Pre-implementation HAPI incidence was 8.9% (N = 8/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre-implementation group. CONCLUSION: Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early-stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions. IMPLICATIONS: PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes. IMPACT: Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy-specific interventions (treatment effect) and prevented PIs across all population types (prevention effect). The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. What does this paper contribute to the wider global clinical community? Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety.

The attitude towards Medical Device-Related Pressure Injuries Questionnaire: a Turkish validity and reliability study.

BACKGROUND: The attitudes of nurses should be measured using valid and reliable tools to develop effective nursing care strategies for the prevention of medical device-related pressure injuries and to organize necessary training programs. PURPOSE: This study was planned to conduct the Turkish validity and reliability study of the Attitude towards Medical Device-Related Pressure Ulcers/Injuries Questionnaire (MDRPU/I Questionnaire (the English-language version)) in nurses. METHODS: This methodological study included 134 nurses working in hospitals of different sizes and characteristics (public hospitals, training and research hospitals, and university hospitals) in Turkey. The validity and reliability of the Attitude Towards Medical Device-Related Pressure Injuries (MDRPI Questionnaire (the Turkish-language version)) Questionnaire were tested using language validity, content validity, face validity, construct validity, and reliability analyses. RESULTS: The final version of the questionnaire had a content validity index of 98.03%, sufficient construct validity, and a Cronbach α value of 0.92 for the total questionnaire. CONCLUSIONS: The Turkish version of the MDRPI Questionnaire is valid, reliable, and suitable for measuring the attitudes of nurses in Turkey toward the prevention and care of medical device-related pressure injuries.

Lesiones cutáneas relacionadas con la dependencia en el paciente crítico pronado. Estudio de incidencia / Dependency-related skin lesions in the prone critical patient. Incidence study

Objetivo: Determinar la incidencia de las lesiones cutáneas relacionadas con la dependencia (LCRD) en los pacientes en decúbito prono (DP) e identificar los factores predisponentes. Método: Estudio descriptivo-longitudinal en 2 unidades de cuidados intensivos (UCI) polivalentes. Se incluyeron pacientes con ventilación mecánica invasiva y DP, sin lesiones al ingreso. Se registraron 3 tipos de LCRD: (lesiones por presión [LPP], lesiones cutáneas asociadas a la humedad [LESCAH] y lesiones por fricción [LF]), variables demográficas, diagnóstico, estancia, episodios en DP, cambios posturales, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbúmina al ingreso, índice de masa corporal (IMC), diabetes, hipertensión arterial, tabaquismo, enfermedad vascular periférica (EVP), fármacos vasoactivos, escala de Braden y mortalidad. Análisis bivariante: prueba de χ2, t-Student o U de Mann-Whitney. Multivariante: regresión logística. Resultados: Se incluyeron 49 pacientes. Se realizaron 170 DP. Aparecieron 41 LCRD en 22 pacientes con una incidencia acumulada del 44,9% (IC 95%: 31,6-58,7). El 63,4% LPP (73,1% faciales; 76,9% categoría II), el 12,2% LESCAH (60% inguinales; 60% categoría II) y el 24,4% LF (50% torácicas; 70% categoría III). La mediana de edad del grupo con lesiones (GCL) fue de 66,5 (61,8-71,3) frente al 64 (43-71) años del grupo sin lesiones (GSL); p=0,04. El 80% del GCL tenía EVP frente al 20% del GSL; p=0,03. La mediana de horas totales en DP del GCL fue de 96,9 (56,1-149,4) frente a 38,2 (18,8-57) del GSL; p<0,001. El análisis multivariante seleccionó horas totales DP (OR: 1,03; IC 95%: 1,01-1,05) y la EVP (OR: 8,9; IC 95%: 1,3-58,9) como factores predisponentes para desarrollar LCRD. Conclusiones: Existe una elevada incidencia de LCRD en DP, mayoritariamente lesiones por presión, aunque de baja severidad. Las horas acumuladas en DP y la enfermedad vascular periférica favorecen su desarrollo.(AU)

Objective: To determine the incidence of dependence-related skin lesions (DRSL) in patients in prone position (PP) and to identify the predisposing factors. Method: Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL:(pressure ulcers (PU), moisture-associated skin damage (MASD) and friction injuries (FI)), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index (BMI), diabetes, hypertension, smoking, peripheral vascular disease (PVD), vasoactive drugs, Braden scale and mortality. Bivariate analysis: Chi-square test, t-test or Mann-Whitney U test. Multivariate analysis: logistic regression. Results: Forty nine patients were included and 170 PP were performed. Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9% (95% CI: 31.6-58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI (50% thoracic; 70% stage III). The median age of the lesion group (LG) was 66.5 (61.8-71.3) vs 64 (43-71) years old in the non-lesion group (NLG), P=.04. Eighty percent of the LG had PVD vs 20% of the NLG, p=0.03. The median total hours on PP of the LG was 96.9 (56.1-149.4) vs 38.2 (18.8-57) of the NIG, P<.001. Multivariate analysis selected total PP hours (OR: 1.03; 95% CI: 1.01-1.05) and PVD (OR: 8.9; 95% CI: 1.3-58.9) as predisposing factors for developing DRSL. Conclusions: There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity. The accumulated hours in probe position and peripheral vascular disease favor their development.(AU)

Cuide, movimente, evite lesão por pressão no seu paciente: um relato de experiência / Care, move, avoid pressure injury in your patient: an experience report / Cuidar, mover, evitar lesiones por presión en su paciente: informe de una experiencia

Introdução: As lesões por pressão (LPP) correspondem a danos na pele ou em tecidos moles encobertos, geralmente em áreas de proeminências ósseas, ou associado ao uso de dispositivo médico ou outro tipo de artefato. Diante disso, a enfermeira deve desenvolver sua prática, baseada em evidências científicas e priorizar a prevenção da formação das lesões na pele. Objetivo: Relatar a experiência de estudantes de Enfermagem sobre o desenvolvimento de ações de promoção do cuidado seguro relacionado à prevenção de LPP em pacientes internados em um hospital público pediátrico na Bahia. Metodologia: Trata-se de um estudo de caráter descritivo, do tipo relato de experiência, realizado por seis estudantes de Enfermagem em um hospital estadual pediátrico localizado no estado da Bahia, no período de novembro 2022. Principais resultados: Percebeu-se que existem profissionais de enfermagem que possuem interesse em obter mais conhecimento sobre o assunto, porém ainda há lacunas de conhecimento por parte da equipe sobre alguns assuntos abordados, tais como a escala de Braden e a utilização do colchão caixa de ovo para todas as faixas etárias. Foi possível perceber que os passos para prevenir a lesão por pressão não são cumpridos por parte da equipe e isso pode dificultar a prevenção das lesões de forma efetiva. Conclusão: Recomenda-se, portanto, que as unidades assistenciais, juntamente com suas respectivas coordenadoras, realizem ações contínuas de educação permanente, a fim de contribuir para uma melhor qualificação profissional, promovendo, acima de tudo, a segurança do paciente.

Introduction: Pressure lesions (PPL) correspond to damage to the skin or covert soft tissue, usually in areas of bony prominence, or associated with the use of a medical device or other type of artifact. Therefore, nurses should develop their practice, based on scientific evidence and prioritize the prevention of skin lesion formation. Objective: To report the experience of nursing students on the development of actions to promote safe care related to the prevention of PPL in patients admitted to a pediatric public hospital in Bahia. Methodology: This is a descriptive study, of the type of experience report, conducted by six nursing students in a pediatric state hospital located in the state of Bahia, in the period of November 2022. Main results: It was noticed that there are nursing professionals who have an interest in obtaining more knowledge about the subject, but there are still gaps in knowledge on the part of the team on some subjects addressed, such as the Braden scale and the use of the egg box mattress for all age groups. It was possible to notice that the steps to prevent pressure injury are not met by the team and this can hinder the prevention of injuries effectively. Conclusion: It is recommended, therefore, that the care units, together with their respective coordinators, carry out continuous actions of continuing education, in order to contribute to a better professional qualification, promoting, above all, patient safety.

Introducción: Las lesiones por presión (LPP) corresponden a lesiones en la piel o tejidos blandos encubiertos, generalmente en zonas de prominencia ósea, o asociadas al uso de un dispositivo médico u otro tipo de artefacto. Por ello, el personal de enfermería debe desarrollar su práctica, basándose en la evidencia científica y priorizando la prevención de la formación de lesiones cutáneas. Objetivo: Relatar la experiencia de estudiantes de enfermería sobre el desarrollo de acciones para promover cuidados seguros relacionados a la prevención de PPL en pacientes internados en un hospital público pediátrico de Bahía. Metodología: Se trata de un estudio descriptivo, del tipo relato de experiencia, realizado por seis estudiantes de enfermería en un hospital público pediátrico localizado en el estado de Bahía, en el período de noviembre de 2022. Principales resultados: Se observó que hay profesionales de enfermería que tienen interés en obtener más conocimientos sobre el tema, pero todavía hay lagunas de conocimiento por parte del equipo en algunos temas abordados, como la escala de Braden y el uso del colchón caja de huevos para todos los grupos de edad. Se pudo notar que los pasos para prevenir lesiones por presión no son cumplidos por el equipo y esto puede dificultar la prevención de lesiones de forma efectiva. Conclusiones: Se recomienda, por lo tanto, que las unidades asistenciales, junto con sus respectivos coordinadores, realicen acciones continuas de formación continuada, con el fin de contribuir a una mejor cualificación profesional, promoviendo, sobre todo, la seguridad del paciente.

Barreras y actitudes para prevenir el efecto adverso de úlceras por presión en una unidad de traumatología / Barriers and attitudes to prevent the adverse effect of pressure ulcers in a trauma unit

Objetivo: Determinar el tipo de barreras y actitudes hacia la prevención de las úlceras por presión en una unidad hospitalaria de traumatología. Metodología: Estudio observacional descriptivo realizado en la Unidad de Traumatología General. Se aplicaron 3 cuestionarios: cuestionario de percepción de seguridad del paciente (PSP); cuestionario de actitudes hacia la prevención de las úlceras por presión (APuP) y cuestionario de barreras hacia la prevención de las úlceras por presión (BPUPP). Resultados: La muestra estuvo constituida por 35 profesionales (21 enfermeras y 14 auxiliares). Rango medio de edad, 31-50 años (57,2%); género predominante, mujer (94,3%); la media de experiencia laboral fue de < 5 años (71,4%), y como profesional titulado, < 10 años (34,3%). El 86,6% de los profesionales tenían formación en prevención de úlceras por presión. Se puntuó con un 7 a la unidad donde trabajaban en relación con la cultura de la seguridad y prevención de las úlceras por presión como evento adverso. Las enfermeras identificaron hasta 16 barreras y las auxiliares 18, de ellas 14 resultaron comunes. Conclusiones: Se observó una actitud positiva de los profesionales hacia las medidas de prevención, existiendo acuerdo en que las úlceras por presión son evitables y prevenibles. Sin embargo, prevalecen algunas barreras relacionadas con factores de tipo organizacional (excesiva rotación de personal), déficit de conocimientos (“siempre se ha hecho así”) o insuficiente colaboración y comunicación entre niveles asistenciales, resultados estos que concuerdan con lo publicado en la literatura y que urge buscarles solución (AU)

Objective: To determine the type of barriers and attitudes towards the prevention of pressure ulcers in a traumatology hospital unit. Methodology: Descriptive observational study conducted in the General Traumatology Unit. Three questionnaires were applied: Patient Perception of Safety Questionnaire (PSP); Attitudes towards PPU Prevention Questionnaire (APuP) and Barriers to PPU Prevention Questionnaire (BPUPP). Results: The sample consisted of 35 professionals (21 nurses and 14 assistants). Mean age range, 31-50 years (57.2%); predominantly female gender (94.3%), mean work experience was < 5 years (71.4%), and as a qualified professional < 10 years (34.3%). A total of 86.6% of the professionals were trained in PU prevention. The unit where they worked was scored with a seven in relation to the culture of safety and prevention of PUs as an adverse event. Nurses identified up to 16 barriers and assistants 18, of which 14 were common. Conclusions: A positive attitude of the professionals towards prevention measures was observed, with agreement that PUs are avoidable and preventable. However, some barriers related to organizational factors prevail (excessive staff turnover), knowledge deficit (“it has always been done this way”) or insufficient collaboration and communication between care levels, results that agree with those published in the literature and that it is urgent to seek solution (AU)

Análise do conhecimento de profissionais de enfermagem sobre prevenção de lesão por pressão: estudo transversal / Análisis del conocimiento de profesionales de enfermería sobre prevención de úlcera por presión: estudio transversal / Analysis of nursing professionals' knowledge about pressure ulcer prevention: a cross-sectional study

RESUMO Objetivos analisar e comparar o nível de conhecimento sobre prevenção de lesão por pressão entre enfermeiros e técnicos de enfermagem que atuam em Unidades de Terapia Intensiva e graduandos em enfermagem no último ano do curso. Método estudo transversal, de caráter descritivo-exploratório e de abordagem quantitativa, utilizando o Pieper's Pressure Ulcer Knowledge Test. Os dados foram analisados através do Statistical Package for Social Science, mediante estatística descritiva e inferencial (ANOVA-One Way, teste de normalidade de Shapiro-Wilk e pressuposto de homogeneidade através do teste de Levene). Resultados a amostra da pesquisa abarcou 70 participantes, sendo 22 enfermeiros, 14 técnicos de enfermagem e 34 graduandos em enfermagem. Foi visto que apenas 22,7% dos enfermeiros, 7,1% dos técnicos e 0,0% dos graduandos em enfermagem atingiram o percentual de acertos ≥ 90% recomendado pelo teste de conhecimento. Conclusão e implicações para a prática os resultados encontrados neste estudo permitiram identificar um nível insuficiente de conhecimento e uma percepção de aptidão equivocada, relacionados à prevenção de lesão por pressão, entre os participantes do estudo, com ênfase para os técnicos e para os graduandos em enfermagem. Logo, esta pesquisa aponta para a necessidade de ações educativas que visem a capacitação do público supramencionado.

RESUMEN Objetivos analizar y comparar el nivel de conocimiento sobre prevención de úlceras por presión entre enfermeros y técnicos de enfermería que actúan en Unidades de Cuidados Intensivos y estudiantes de enfermería en el último año del curso. Método estudio transversal, descriptivo-exploratorio y de abordaje cuantitativo, utilizando el Pieper's Pressure Ulcer Knowledge Test. Los datos fueron analizados mediante el Statistical Package for Social Science, utilizando estadística descriptiva e inferencial (ANOVA-One Way, prueba de normalidad de Shapiro-Wilk y suposición de homogeneidad mediante la prueba de Levene). Resultados la muestra contó con 70 participantes, siendo 22 enfermeros, 14 técnicos de enfermería y 34 estudiantes de graduación en enfermería. Se observó que sólo el 22,7% de los enfermeros, el 7,1% de los técnicos y el 0,0% de los estudiantes alcanzaron el porcentaje de aciertos ≥ 90% recomendado por la prueba de conocimiento. Conclusión e implicaciones para la práctica los resultados encontrados permitieron identificar un nivel de conocimiento insuficiente y una percepción de aptitud errónea, relacionada con la prevención de úlceras por presión, entre los participantes del estudio, con énfasis en los técnicos y estudiantes de enfermería. Por lo tanto, esta investigación apunta la necesidad de acciones educativas dirigidas a la formación de dicho público.

ABSTRACT Objectives to analyze and compare the level of knowledge about pressure ulcer prevention among nurses and nursing technicians who work in Intensive Care Units and nursing students in the last year of the course. Method a cross-sectional, descriptive-exploratory study with a quantitative approach, using the Pieper's Pressure Ulcer Knowledge Test. Data were analyzed using the Statistical Package for Social Science, using descriptive and inferential statistics (ANOVA-One Way, Shapiro-Wilk normality test and assumption of homogeneity using Levene's test). Results the research sample included 70 participants, being 22 nurses, 14 nursing technicians and 34 undergraduate nursing students. It was observed that only 22.7% of nurses, 7.1% of technicians and 0.0% of students reached the percentage of correct answers ≥ 90% recommended by the knowledge test. Conclusion and implications for practice the results found in this study made it possible to identify an insufficient level of knowledge and a mistaken perception of aptitude, related to the pressure ulcer prevention, among the study participants, with emphasis on technicians and undergraduates in nursing. Therefore, this research points to the need for educational actions aimed at training the aforementioned public.

The need for integration nursing theories into pressure ulcer care in the community.

Pressure ulcers are injuries to the skin requiring integrated care, particularly when patients are at home. Pressure ulcers have been a nursing concern for years, and several strategies have been proposed for its prevention and management. Nursing theory, which is essential for nursing practice, recommends plausible approaches to health problems. However, literature describing steps to integrate nursing theory into pressure ulcer care has not yet been explored. For this reason, this article discusses the six steps on how to apply nursing theory in community practice. A case study is also discussed to help gain a better understanding of these steps.

Conocimientos del equipo de enfermería en prevención de lesiones por presión en un hospital de Bogotá / Knowledge of the nursing team in the prevention of pressure injuries in a hospital in Bogotá

Objetivo: Determinar el nivel de conocimientos del equipo de enfermería sobre la prevención de lesiones por presión en un hospital universitario. Metodología: Estudio descriptivo con abordaje cuantitativo de corte transversal. Se aplicó el cuestionario sobre conocimientos en prevención de lesiones por presión CPUPP-31. El análisis se realizó con el paquete estadístico SPSS24. Resultados:Participaron 97 enfermeros(as) y 98 auxiliares de enfermería, de los cuales el 77,4% correspondieron al género femenino y el 22,6% al masculino. Los rangos de edad oscilaron entre los 20 y los 60 años, y el grupo de los 31-40 años (38,4%) fue el más característico. Con relación a la experiencia laboral, el 71,3% contó con una experiencia inferior a los 10 años. El nivel de conocimiento global fue del 80,6% con una diferencia estadísticamente significativa, con p = 0,001, siendo representativo el nivel de conocimientos de los enfermeros(as). Conclusiones: Existe un adecuado nivel de conocimientos en prevención de lesiones por presión en el equipo de enfermería, sin embargo, otro aspecto evaluado fue el índice global de desconocimiento con un valor del 4,5%, bajo, pero que representa un indicador importante para determinar la aparición de lesiones de piel en personas sometidas a un proceso de hospitalización y el establecimiento de estrategias preventivas oportunas (AU)

Objectives: To determine the level of knowledge of the nursing team on the prevention of pressure ulcers in a university hospital. Methodology: Descriptive study with a cross-sectional quantitative approach. The questionnaire on knowledge in prevention of pressure ulcers PIPK-31 was applied. The analysis was performed with the SPSS24 statistical package. Results: 97 nurses and 98 nursing assistants participated, of which 77.4% were female and 22.6% male. The age ranges ranged between 20 and 60 years, with the group of 31-40 years being the most characteristic (38.4%). In relation to work experience, 71.3% had less than 10 years of experience. The level of global knowledge was 80.6% with a statistically significant difference with a value of p = 0.001, the level of knowledge of the nurses being representative. Conclusions: there is an adequate level of knowledge in the prevention of pressure injuries in the nursing team, however, another aspect evaluated was the global index of ignorance with a value of 4.5%, low, but which represents an important indicator to determine the appearance of skin lesions in people subjected to a hospitalization process and the establishment of timely preventive strategies (AU)