Abstract
Background: The 2014 International Pressure Ulcer Prevention (PUP) Clinical Practice Guidelines (CPG) provides the most current evidence based strategies to prevent Pressure Ulcer (PU). The evidence upon which these guidelines have been developed has predominantly been generated from research conducted in developed countries. Some of these guidelines may not be feasible in developing countries due to structural and resource issues; therefore there is a need to adapt these guidelines to the context thus making it culturally acceptable. Aim: To present a protocol detailing the tailoring of international PUPCPG into a care bundle for the Nigerian context. Methods: Guided by the Knowledge to Action (KTA) framework, a two phased study will be undertaken. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria. These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. Results: A PUP care bundle, with three to eight components is expected to be developed from Phase 1. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2. Engagement of key stakeholders and consumers in the project should promote successful implementation and translate into better patient care. Conclusion: Using KTA, a knowledge translation framework, to guide the implementation of PUPCPG will enhance the likelihood of successful adoption in clinical practice. In implementing a PUP care bundle, developing countries face a number of challenges such as the feasibility of its components and the required resources.
Highlights
International clinical practice guidelines (CPG) for pressure ulcer prevention (PUP) provide guidance to improve the uptake of prevention strategies, reduce unwarranted variation in care and improve patient outcomes [1]
This paper presents a protocol to tailor international pressure ulcer prevention clinical practice guidelines (PUPCPG) to the Nigerian context
By using the Knowledge to Action (KTA) framework [2] and developing a structured process to prepare for PUPCPG uptake, the processes detailed in this protocol may be used as a guide by others, aiming to improve a range of other clinical practices in developing countries
Summary
International clinical practice guidelines (CPG) for pressure ulcer prevention (PUP) provide guidance to improve the uptake of prevention strategies, reduce unwarranted variation in care and improve patient outcomes [1]. This paper presents a protocol to tailor international pressure ulcer prevention clinical practice guidelines (PUPCPG) to the Nigerian context. In Phase 1, the Delphi technique with stakeholder leaders will be used to review the current PUPCPG, identifying core strategies that are feasible to be adopted in Nigeria These core strategies will become components of a PUP care bundle. In Phase 2, key stakeholder interviews will be used to identify the barriers, facilitators and potential implementation strategies to promote uptake of the PUP care bundle. Implementation strategies to promote adoption of the PUP care bundle into clinical practice in selected Nigerian hospitals, is expected to result from Phase 2.
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