Performance and Influencing Factors of Evidence-Based Pressure Ulcer Care Among Acute Care Hospital Nurses.

Abstract

In previous studies about performance or factors affecting pressure ulcer (PU) care, old tools with nonupdated contents about the prevention and intervention of PU have been mainly used. Thus, there is little known how well evidence-based PU care is performed and what its' influencing factors are recently. This study aimed to evaluate the PU care performance, based on evidence-based practice guidelines, and identify factors affecting it while considering nurses' individual and institutional characteristics. We recruited 199 nurses involved in PU care, from August 20 to September 10, 2016, at two PU-related academic conferences in Korea. To examine PU care performance and knowledge as a related factor, we developed tools based on recent guidelines. To identify factors affecting PU care performance, we examined nurses' (individual level) and their institutions' (institutional level) characteristics, and analyzed using a hierarchical multiple regression test. Mean PU care performance of nurses was rated 3.99 out of 5. Performance level in "wound care: debridement"; "pain control"; "prevention skin care"; "incontinence management"; "supporting surface"; and "nutrition in PU prevention and treatment" was below average. Interest in PU care (β=.28, p=<.001), the main PU manager in a ward being a wound, ostomy, continence nurse (β=.22, p=.013), and an institution with a nursing practice guideline for PU care (β=.16, p=.02) were identified as significant factors affecting a good PU care performance. To improve nurses' evidence-based PU care performance, nurses must recognize PU care's importance and take responsibility for improving their own performance. At the institutional level, systematic evidence-based guidelines and support systems, such as activating wound specialists, must be implemented. The academic society can support these initiatives by updating continuously the national guideline on PU prevention and management for ease of use by nurses or institutions.