Critical Care Physicians: knowledge, attitudes and beliefs regarding pressure ulcers

 

Purpose: To determine critical care physicians’ knowledge, attitudes and beliefs towards pressure ulcer prevention and treatment in critically ill patients.

Background: ICU prevalence rates of acquired pressure ulcers are cited as the highest among hospitalized patients. CMS guidelines require the physician or mid-level practitioner to document pressure ulcers that are present on admission. Lack of accurate documentation of an existing Stage III/IV pressure ulcer can result in a loss of reimbursement. The paradox however is that physicians report a lack of education in pressure ulcer staging, prevention and management.

Methods: A descriptive, correlational design was utilized to describe the factors associated with critical care physicians’ knowledge, attitudes and beliefs regarding pressure ulcers (n= 56). A survey tool was developed to measure physicians’ attitudes and beliefs. The knowledge portion of the tool was modified based on the Pressure Ulcer Knowledge Tool (Pieper & Mott, 1995).

Results: Preliminary findings place the physicians’ knowledge level at 79% (C range). The majority of physicians (69%) reported poor to adequate basic medical education training on pressure ulcer prevention and treatment and 60% of the sample reported that they had never attended a lecture on pressure ulcers. Advanced practice nurses and wound care nurses were identified by 65% of the sample as the health care practitioner utilized most frequently by critical care physicians to manage pressure ulcers.

Conclusions: Despite advances in medical technology and the use of formalized prevention programs, the numbers of pressure ulcers acquired during hospitalizations continue to grow. Management of a critically ill patient requires a multidisciplinary approach, including prevention and/or management of an impending pressure ulcer. The critical care physician, as an integral member of this team may benefit from formalized pressure ulcer education in an effort to heighten awareness of this phenomenon in critical care patients.