Abstract
BackgroundPatients are at risk of developing pressure injuries in the peri-operative setting. Studies evaluating the impact of educational interventions on peri-operative nurses’ knowledge and reported practice are scarce. The purpose of this study was to evaluate the effect of a multifaceted intervention on peri-operative nurses’ (a) knowledge of pressure injury risks, risk assessment and prevention strategies for patients in the operating suite; and (b) reported practice relating to risk assessment practices and implementation of prevention strategies for patients in the operating suite.MethodsA before-after research design was used. A convenience sample of all registered and enrolled nurses employed in two hospitals’ operating suites was recruited. A multifaceted intervention was delivered which comprised a short presentation, educational materials and reminder posters. A 48-item survey tool was completed pre-and post-intervention to measure self-reported knowledge and practice.Results70 eligible peri-operative nurses completed both surveys. Post-intervention, statistically significant improvements were seen in knowledge of correct descriptions of pressure injury stages (p=0.001); appropriate reassessment for patients with a new pressure injury (p=0.05); appropriate actions for patients with an existing stage 1 (p=0.02) and stage 2 pressure injury (p=0.04). Statistical improvements were also seen in reported practice relating to an increase in the use of a risk assessment tool in conjunction with clinical judgement (p=0.0008); verbal handover of patients’ pressure injury risk status from the operating room nurse to the recovery room (p=0.023) and from the recovery room nurse to the postoperative ward nurse (p=0.045). The number of participants reporting use of non-recommended and recommended pressure-relieving strategies was unchanged.ConclusionA multi-faceted educational intervention can improve some aspects of perioperative nurses’ knowledge and reported practice such as risk assessment practices but not others such as use of recommended pressure-relieving devices. Further research is required to ascertain effective interventions which improve all areas of practice and knowledge, particularly in the use of appropriate pressure-relieving devices in order to prevent pressure injuries in surgical patients.
Highlights
Patients are at risk of developing pressure injuries in the peri-operative setting
We report here the effects of a multifaceted intervention aimed at improving (a) perioperative nurses’ knowledge and reported practice with pressure injury risk assessment and initiation of pressure prevention strategies for peri-operative patients
Questionnaires were distributed to all eligible nurses at both operating suites and we received a total of 90 surveys back from the pre-intervention mail out and 90 surveys from the post-intervention mail out
Summary
Patients are at risk of developing pressure injuries in the peri-operative setting. Studies evaluating the impact of educational interventions on peri-operative nurses’ knowledge and reported practice are scarce. A Belgian study of 22 hospitals found only 17.5% of at-risk patients were appropriately allocated a dynamic mattress system [27]; a Swedish study conducted in a large teaching hospital found that the majority of those at risk for pressure injuries did not get evidence-based care [28]; while only half of eligible patients across 89 Dutch institutions were allocated a pressure-relieving support surface and less than one-third were regularly repositioned [29] These studies and others have found inadequacies and gaps in nurses’ documentation of pressure injury risk assessment, and prevention measures used [19,30,31,32,33]
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