Pressure Injury Prevention and the Role of the Patient: A Mixed Methods Study

Abstract

Pressure injuries are acknowledged worldwide as a quality care indicator and a patient safety issue. Pressure injuries have negative impacts for patients, nurses and healthcare organisations in terms of physical and emotional distress, increased workloads and economic burden. Additionally, pressure injuries result in reduced community confidence in the healthcare system. Internationally and in Australia, pressure injury prevalence rates are concerning, with sustained reductions difficult to achieve despite the availability of prevention resources. International clinical practice guidelines recommend pressure injury prevention strategies that are widely adopted by clinicians. There is agreement these strategies may help prevent the development of pressure injuries, however, nurses’ planning and implementation of these strategies often does not reflect best practice standards, possibly placing patients at risk. This mixed methods, multicentre study had two aims: first, to describe the pressure injury prevention clinical practices in hospitalised adult medical patients with reduced mobility; and second, to describe patients’ perceptions of their current and future role in pressure injury prevention care. Utilising a sequential, explanatory research design, this study used a priority-sequence model whereby the quantitative data was collected first, followed by the qualitative data. A consecutive sample of 241 participants with reduced mobility was recruited to the study. Chart audits and semi-structured observations were used to collect the quantitative data; with the observations conducted at 30-minute intervals over a continuous 24-hour period.