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A multifaceted intervention for evidence-based pressure ulcer prevention: a 3 year follow-up.
Region Gävleborg; Uppsala University; Centre for Research and Development, Region Gävleborg/Uppsala University.
Centre for Research and Development, Region Gävleborg/Uppsala University.
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala University.
Uppsala University.
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2020 (English)In: International Journal of Evidence-Based Healthcare, ISSN 1744-1595, E-ISSN 1744-1609, Vol. 18, no 4, p. 391-400Article in journal (Refereed) Published
Abstract [en]

AIM: To assess sustainability of an intervention used to implement pressure ulcer prevention.

BACKGROUND: The Promoting Action on Research Implementation in Health Service, framework was used to develop an intervention aimed to implement evidence-based pressure ulcer prevention in a hospital setting. A short-term follow-up showed that significantly more patients received pressure ulcer prevention. A qualitative process evaluation gave support that the intervention and the implementation process changed the understanding and approach to working with pressure ulcer prevention from treating to preventing.

METHOD: The study had a sequential mixed method approach, combining quantitative and qualitative data. For the quantitative data, baseline and short-term follow-up (6-8 months) data reported in an initial study were compared with long-term follow-up (36-42 months) data (n = 259 patients). For the qualitative data, interviews with registered nurses (n = 20), assistant nurses (n = 7) and first-line managers (n = 5) were performed.

RESULTS: The performance of pressure ulcer prevention was sustained 3 years from its conception. The number of patients with pressure ulcers was reduced (P = 0.021). Systematic work with quality measurements, support from first-line managers, internal facilitation, collaboration and pressure ulcer prevention skills could explained the sustainability. Obstacles to achieve high-quality pressure ulcer prevention were inadequate communication, high workloads and high rates of new and substitute nurses.

CONCLUSION: Three different components for sustainability on the micro-level are described; benefits for the patients, the need for routinization and development over time. Threats to sustainability are described as factors on the macro-level. There needs to be collaboration in the healthcare organization from the micro-to-macro levels, and committed experienced nurses are needed to obtain high-quality sustainable pressure ulcer prevention.

Place, publisher, year, edition, pages
JBI Evidence Implementation , 2020. Vol. 18, no 4, p. 391-400
Keywords [en]
implementation, nursing, pressure ulcer, prevention, sustainability
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-33327DOI: 10.1097/XEB.0000000000000239ISI: 000617054400005PubMedID: 32649398Scopus ID: 2-s2.0-85101457311OAI: oai:DiVA.org:hig-33327DiVA, id: diva2:1458623
Available from: 2020-08-17 Created: 2020-08-17 Last updated: 2022-09-22Bibliographically approved

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Mamhidir, Anna-Greta

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