Prevention Practices and Nursing Attitudes Towards Pressure Ulcer Protocols

Shandra Averett, RN, BSN and Katie Schmidt, BSN, RN,, Simmons College, Boston, MA
Nosocomial pressure ulcer incidence continues to be a significant problem in acute and long-term care facilities, and many studies have tested interventions to reduce the incidence of facility acquired pressure injury with mixed success. The Theory of Planned Behavior may provide some insight to nursing attitudes and barriers to discover why individualized pressure ulcer prevention interventions are not completed despite having evidence based, facility provided, pressure ulcer prevention protocols that nurses are expected to follow. However, no American studies have been completed asking bedside nurses the reasons they believe that pressure injury occurs and prevention practices are not consistently maintained.  In a cross-sectional study, a survey was given to long-term care facility bedside nurses and certified nursing assistants. Their reasons for incomplete pressure ulcer prevention assessment were time, other patient care priorities, and staffing insufficiency. Nurses stated that time, patient noncompliance, and staffing issues lead to interventions being incomplete. Time, other patient priorities, and staffing issues were the staff’s barriers to documentation of prevention practices.  Nurses who had formal training on pressure ulcer prevention protocols and practices felt comfortable performing the preventative interventions.  Lack of trust or will to perform the prevention protocols were not reasons pressure ulcer prevention interventions were not followed.