Evaluation of Nurses’ Knowledge and Attitudes to Prevent Pressure Injuries
Yıl 2023,
Cilt: 6 Sayı: 2, 340 - 353, 01.09.2023
Pakize Özyürek
,
Öznur Gürlek Kısacık
Öz
Objective: It was aimed to evaluate the knowledge level and attitudes of nurses to prevent pressure ulcers (PUs) in this study.
Methods: This descriptive and cross-sectional study was conducted by 140 nurses, who worked in a hospital between 01.04.2020-01.09.2020. "Nurse Information Form", the Turkish version of “Pressure Ulcer Prevention Knowledge Assessment Instrument "(PUPKAI-T) and "Attitude Towards Pressure Ulcer Prevention Instrument (APuP)" were used as data collection tools.
Results: The mean age of the participants was 26.71±5.55, and the mean of professional year 6.48±5.09. The total PUPKAI-T score of the participants was 10.82 out of 26 and only 8.5% (n=12) and correct answer percentage had an acceptable knowledge score (≥%60; ≥16). The average score on APuP was 37.10 out of 52 points (41.6%). Also, 42.8% (n=60) of the nurses had an attitude mean score of ≥%75 (satisfactory level of attitude). A positive weak relationship was observed between age and attitude scores of the nurses (rs=0.198; p=0.019), while a weak negative relationship between the duration of working in the clinic and the attitude scores of the nurses (rs=-0.199; p=0.018).
Conclusion: It was determined that the nurses' knowledge about preventing pressure injuries was at an acceptable level and their attitudes were not at a satisfactory level. Training strategies and intervention’s purpose to increase the knowledge of nurses and develop positive attitudes should be developed to improve practices to prevent PUs.
Keywords: Nurse, pressure ulcer, information, prevention, attitude
Proje Numarası
19.KARİYER.019
Kaynakça
- Aslan A, Van Giersbergen YM. (2016). Nurses’ attitudes towards pressure ulcer prevention in Turkey. Journal of Tissue Viability, 25, 66-73.
- Avsar P, Patton D, O’Connor T, Moore Z. (2019). Do we still need to assess nurses' attitudes towards pressure ulcer prevention? A systematic review. Journal of Wound Care, 28(12), 12795-12806.
- Beeckman D, Defloor T, Demarre L, Van Hecke A, Vanderwee K. (2010). Pressure ulcers: development and psychometric evaluation of the attitude towards pressure ulcer prevention instrument (APuP). International Journal of Nursing Studies, 47(11),1432-1438.
- Charalambous C, Koulouri A, Roupa Z, Vasilopoulos A, Kyriakou M, Vasiliou M. (2019). Knowledge and attitudes of nurses in a major public hospital in Cyprus towards pressure ulcer prevention. Journal of Tissue Viability, 28(1),40-45.
- Clark M, Semple MJ, Ivins N, Mahoney K, Harding K. (2017). National audit of pressure ulcers and incontinence-associated dermatitis in hospitals across Wales: a cross-sectional study. BMJ Open, 7(8), e015616.
- Cowan LJ, Ahn H, Flores M, Yarrow, J, Barks, L, Garvan, C, Weaver, M, Stechmiller, J. (2019). Pressure ulcer prevalence by level of paralysis in patients with spinal cord ınjury in long-term care. Advances Skin Wound Care, 32(3),122-130.
- Çelik S, Dirimeşe E, Taşdemir N, Aşık Ş, Demircan S, Eyican S, Güven B. (2017). Hemşirelerin bası yarasını önleme ve yönetme bilgisi. Bakırköy Tıp Dergisi, 13(3),133-139.
- Dilie A, Mengistu D. (2015). Assessment of nurses’ knowledge, attitude, and perceived barriers to expressed pressure ulcer prevention practice in addis ababa government hospitals, Addis Ababa, Ethiopia, 2015. Hindawi Publishing Corporation Advances in Nursing, 1-11.
- DiVita MA, Granger CV, Goldstein R, Niewczyk PM, Freudenheim JL. (2018). Mandated quality of care metrics for medicare patients: examining new or worsened pressure ulcers and rehabilitation outcomes in United States inpatient rehabilitation facilities. Archives Physical Medicine Rehabilitation, 99(8),1514-1524.
- Domingues EA, Cavalcanti MC, Costa PC, Lopes MH, Monteiro I, Alexandre NM. (2016). Pain prevalence, socio-demographic and clinical features in patients with chronic ulcers. Journal of Tissue Viability, 25(3),180-184.
- Ekim CE, Sabuncu N. (2018). Hemşirelerin basınç ülserlerini önlemeye yönelik tutumlarının incelenmesi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, 9,890-90.
- Etafa W, Argaw Z, Gemechu E, Melese B. (2018). Nurses’ attitude and perceived barriers to pressure ulcer prevention. BMC Nursing, 17(14), 2-8.
- Gedamu H, Abate T, Ayalew E, Tegenaw A, Birhanu M, Tafere Y. (2021). Level of nurses’ knowledge on pressure ulcer prevention: A systematic review and meta-analysis study in Ethiopia. Heliyon, 7(7), e07648.
- Gunningberg L, Mårtensson G, Mamhidir AG, Florin J, Athlin AM, Baath C. (2015). Ulcer knowledge of registered nurses, assistant nurses and student nurses: adescriptive, comparative multicentre study in Sweden. International Wound Journal, 12(4),462-468.
- Halász GB, Bérešová A, Tkáˇcová L, Magurová D, Lizáková. (2021). Nurses’ knowledge and attitudes towards prevention of pressure ulcers. International Journal of Environmental Research and Public Health, 18(1705),1-9
- Hu L, Sae-Sia W, Kitrungrote L. (2021). Intensive care nurses’ knowledge, attitude, and practice of pressure injury prevention in China: a cross-sectional study. Risk Management and Healthcare Policy, 14,4257–4267.
- Inan DG, Oztunç G. (2012). Pressure ulcer prevalence in Turkey: a sample from a university hospital. Journal of
Wound, Ostomy and Continence Nursing, 39(4),409-413.
- Kaddourah B, Abu-Shaheen AK, Al-Tannir M. (2016). Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: a cross-sectional study. BMC Nursing, 15(17),1-7.
- Kaşıkçı M, Aksoy M, Ay E. (2018). Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: A cross-sectional study. Journal of Tissue Viability, 27(3),135-140.
- Keser E, Yüksel S. (2020). Cerrahi hemşirelerinin basınç yaralarını önlemeye yönelik bilgi durumları ve tutumları. Selçuk Medical Journal, 36(3),216-225.
- Kim JY, Lee YJ. (2019). A study on the nursing knowledge, attitude, and performance towards pressure ulcer prevention among nurses in Korea longterm care facilities. International Wound Journal, 16, 29-35.
- Kopuz E, Karaca A. (2019). Evaluation of nurses’ knowledge about risk monitoring and risk prevention for pressure ulcers. Clinical and Experimental Health Sciences, 9,157-165.
- Mallah Z, Nassar N, Kurdahi Badr L. (2015). The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: controlled before and after study. Applied Nursing Research, 28(2),106-13.
- Mamishi N, Behroozishad F, Mohagheghi M, Eftekhar Z, Shahabi Z. (2006). The study of nurses’knowledge and attitudes regarding cancer pain management. Hayat, 12,23-32.
- Moya-Suárez AB, Canca-Sánchez JC, Enríquez de Luna-Rodríguez M, Aranda-Gallardo M, Morales-Asencio JM. (2018). Factors associated with variability in the prevention of pressure ulcers. Journal of Tissue Viability, 27(4),211-216.
- Nuru N, Zewdu F, Amsalu S, Mehretie Y. (2015). Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC Nursing,14(34),2-8.
- Sari SP, Everink IHJ, Amir Y, Lohrmann C, Halfens R, Moore Z, Beeckman D, Schols JM. (2021). Knowledge and attitude of community nurses on pressure injury prevention: a cross-sectional study in an indonesian city. International Wound Journal, 18(4),422-431.
- Sebba Tosta de Souza DM, Veiga DF, Santos ID, Abla LE, Juliano Y, Ferreira LM. (2015). Health-Related quality of life in elderly patients with pressure ulcers in different care settings. Journal of Wound, Ostomy and Continence Nursing, 42(4),352-359.
- Sengul T, Karadag A. (2020). Determination of nurses’ level of knowledge on the prevention of pressure ulcers: The case of Turkey. Journal of Tissue Viability, 29,337–341.
- Strand T, Lindgren M. (2010). Knowledge, attitudes and barriers toward prevention of pressure injuries in intensive care units: a descriptive cross-sectional study. Intensive and Critical Care Nursing, 26,335-42.
- Sving E, Gunningberg L, Högman M, Mamhidir AG. (2012). Registered nurses' attention to and perceptions of pressure ulcer prevention in hospital settings. Journal of Clinical Nursing, 21(9-10),1293-303.
- Tayyib N, Coyer F, Lewis PA. (2016). Implementing a pressure ulcer prevention bundle in an adult intensive care. Intensive and Critical Care Nursing, 37,27-36.
- Tirgari B, Mirshekari L, Forouzi MA. (2018). Pressure injury prevention: knowledge and attitudes of Iranian intensive care nurses. Advances In Skin & Wound Care, 31(4),1-8.
- Tulek Z, Polat C, Ozkan I, Theofanidis D, Togrol RE. (2016). Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument. Journal of Tissue Viability, 25(4),201-208.
- Uba MN, Alih FI, Kever RT, Lola N. (2015). Knowledge, attitude and practice of nurses toward pressure ulcer prevention in University of Maiduguri Teaching Hospital, Borno State, North Eastern, Nigeria. International Journal of Nursing and Midwifery, 7(4),54-60.
- Usher K, Woods C, Brown J, Power T, Lea J, Hutchinson M, Mather C, Miller A, Saunders A, Mills J, Zhao L, Yates K, Bodak M, Southern J, Jakson D. (2018). Australian nursing students' knowledge and attitudes towards pressure injury prevention: A cross-sectional study. International Journal of Nursing Studies, 81,14-20.
- Üstün Y. Adapting the ''attitude towards pressure ulcer prevention instrument'' into Turkish and studying its validity and reliability. Yüksek Lisans Tezi. İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü, 2013, İzmir.
- Yilmazer T, Tüzer H, Erciyas A. (2019). Knowledge and attitudes towards prevention of pressure ulcer: intensive care units sample in Turkey. Turkiye Klinikleri Journal of Nursing Sciences,11(2),140-147.
Hemşirelerin Basınç Yaralanmalarını Önlemeye Yönelik Bilgi ve Tutumlarının Değerlendirilmesi
Yıl 2023,
Cilt: 6 Sayı: 2, 340 - 353, 01.09.2023
Pakize Özyürek
,
Öznur Gürlek Kısacık
Öz
Amaç: Bu araştırmada hemşirelerin basınç yaralanmalarını önlemeye yönelik bilgi düzeyi ve tutumlarının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırma 01.04.2020-01.09.2020 tarih aralığında bir hastanede çalışan toplam 140 hemşire ile yürütülmüştür. Veriler, "Hemşire Bilgi Formu", ''Basınç Ülseri Önlemede Bilgi Değerlendirme Ölçeği Türkçe versiyonu'' (BÜÖBDÖ) ve "Basınç Ülserlerini Önlemeye Yönelik Tutum Ölçeği (BÜÖYTÖ)" ile toplanmıştır.
Bulgular: Katılımcıların yaş ortalaması 26.71±5.55 olup mesleki çalışma süresi ise 6.48±5.09 olarak saptanmıştır. Hemşirelerin, BÜÖBDÖ toplam puanı 26 üzerinden 10.82 puan aldıkları ve sadece %8.5'inin (n=12) doğru cevap yüzdesi ve kabul edilebilir bilgi puanına (≥%60; ≥16) sahip olduğu bulunmuştur. Hemşirelerin BÜÖYTÖ toplam tutum puanı 52 üzerinden 37.10 olarak saptanırken, tutum yüzdesinin %41.6 olduğu belirlenmiştir. Hemşirelerin %42.8'inin (n=60) ortalama tutum puanının ≥%75 (tatmin edici tutum düzeyi) olduğu bulunmuştur. Hemşirelerin yaşları ile tutum puanları arasında pozitif yönde (rs= 0.198; p= 0.019), klinikte çalışma süreleri ile tutum puanları arasında ise negatif yönde zayıf düzeyde bir ilişki olduğu bulunuştur (rs= -0.199; p= 0.018).
Sonuç: Hemşirelerin basınç yaralanmalarını önlemeye yönelik bilgileri kabul edilebilir puan düzeyinde ve tutumlarının ise tatmin edici düzeyde olmadığı belirlenmiştir. Basınç yaralanmalarını önlemeye yönelik uygulamaları iyileştirmek için hemşirelerin bilgilerini arttırmaya ve olumlu tutumlar geliştirmelerine yönelik eğitimsel stratejiler ve müdahaleler geliştirilmelidir.
Destekleyen Kurum
Afyonkarahisar Sağlık Bilimleri Üniversitesi BAP koordinatörlüğü
Proje Numarası
19.KARİYER.019
Teşekkür
Çalışmaya katılan hemşirelere ve finansman sağlyan Afyonkarahisar Sağlık Bilimleri Üniversitesi Rektörlüğüne teşşekkür ederiz.
Kaynakça
- Aslan A, Van Giersbergen YM. (2016). Nurses’ attitudes towards pressure ulcer prevention in Turkey. Journal of Tissue Viability, 25, 66-73.
- Avsar P, Patton D, O’Connor T, Moore Z. (2019). Do we still need to assess nurses' attitudes towards pressure ulcer prevention? A systematic review. Journal of Wound Care, 28(12), 12795-12806.
- Beeckman D, Defloor T, Demarre L, Van Hecke A, Vanderwee K. (2010). Pressure ulcers: development and psychometric evaluation of the attitude towards pressure ulcer prevention instrument (APuP). International Journal of Nursing Studies, 47(11),1432-1438.
- Charalambous C, Koulouri A, Roupa Z, Vasilopoulos A, Kyriakou M, Vasiliou M. (2019). Knowledge and attitudes of nurses in a major public hospital in Cyprus towards pressure ulcer prevention. Journal of Tissue Viability, 28(1),40-45.
- Clark M, Semple MJ, Ivins N, Mahoney K, Harding K. (2017). National audit of pressure ulcers and incontinence-associated dermatitis in hospitals across Wales: a cross-sectional study. BMJ Open, 7(8), e015616.
- Cowan LJ, Ahn H, Flores M, Yarrow, J, Barks, L, Garvan, C, Weaver, M, Stechmiller, J. (2019). Pressure ulcer prevalence by level of paralysis in patients with spinal cord ınjury in long-term care. Advances Skin Wound Care, 32(3),122-130.
- Çelik S, Dirimeşe E, Taşdemir N, Aşık Ş, Demircan S, Eyican S, Güven B. (2017). Hemşirelerin bası yarasını önleme ve yönetme bilgisi. Bakırköy Tıp Dergisi, 13(3),133-139.
- Dilie A, Mengistu D. (2015). Assessment of nurses’ knowledge, attitude, and perceived barriers to expressed pressure ulcer prevention practice in addis ababa government hospitals, Addis Ababa, Ethiopia, 2015. Hindawi Publishing Corporation Advances in Nursing, 1-11.
- DiVita MA, Granger CV, Goldstein R, Niewczyk PM, Freudenheim JL. (2018). Mandated quality of care metrics for medicare patients: examining new or worsened pressure ulcers and rehabilitation outcomes in United States inpatient rehabilitation facilities. Archives Physical Medicine Rehabilitation, 99(8),1514-1524.
- Domingues EA, Cavalcanti MC, Costa PC, Lopes MH, Monteiro I, Alexandre NM. (2016). Pain prevalence, socio-demographic and clinical features in patients with chronic ulcers. Journal of Tissue Viability, 25(3),180-184.
- Ekim CE, Sabuncu N. (2018). Hemşirelerin basınç ülserlerini önlemeye yönelik tutumlarının incelenmesi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, 9,890-90.
- Etafa W, Argaw Z, Gemechu E, Melese B. (2018). Nurses’ attitude and perceived barriers to pressure ulcer prevention. BMC Nursing, 17(14), 2-8.
- Gedamu H, Abate T, Ayalew E, Tegenaw A, Birhanu M, Tafere Y. (2021). Level of nurses’ knowledge on pressure ulcer prevention: A systematic review and meta-analysis study in Ethiopia. Heliyon, 7(7), e07648.
- Gunningberg L, Mårtensson G, Mamhidir AG, Florin J, Athlin AM, Baath C. (2015). Ulcer knowledge of registered nurses, assistant nurses and student nurses: adescriptive, comparative multicentre study in Sweden. International Wound Journal, 12(4),462-468.
- Halász GB, Bérešová A, Tkáˇcová L, Magurová D, Lizáková. (2021). Nurses’ knowledge and attitudes towards prevention of pressure ulcers. International Journal of Environmental Research and Public Health, 18(1705),1-9
- Hu L, Sae-Sia W, Kitrungrote L. (2021). Intensive care nurses’ knowledge, attitude, and practice of pressure injury prevention in China: a cross-sectional study. Risk Management and Healthcare Policy, 14,4257–4267.
- Inan DG, Oztunç G. (2012). Pressure ulcer prevalence in Turkey: a sample from a university hospital. Journal of
Wound, Ostomy and Continence Nursing, 39(4),409-413.
- Kaddourah B, Abu-Shaheen AK, Al-Tannir M. (2016). Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: a cross-sectional study. BMC Nursing, 15(17),1-7.
- Kaşıkçı M, Aksoy M, Ay E. (2018). Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: A cross-sectional study. Journal of Tissue Viability, 27(3),135-140.
- Keser E, Yüksel S. (2020). Cerrahi hemşirelerinin basınç yaralarını önlemeye yönelik bilgi durumları ve tutumları. Selçuk Medical Journal, 36(3),216-225.
- Kim JY, Lee YJ. (2019). A study on the nursing knowledge, attitude, and performance towards pressure ulcer prevention among nurses in Korea longterm care facilities. International Wound Journal, 16, 29-35.
- Kopuz E, Karaca A. (2019). Evaluation of nurses’ knowledge about risk monitoring and risk prevention for pressure ulcers. Clinical and Experimental Health Sciences, 9,157-165.
- Mallah Z, Nassar N, Kurdahi Badr L. (2015). The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: controlled before and after study. Applied Nursing Research, 28(2),106-13.
- Mamishi N, Behroozishad F, Mohagheghi M, Eftekhar Z, Shahabi Z. (2006). The study of nurses’knowledge and attitudes regarding cancer pain management. Hayat, 12,23-32.
- Moya-Suárez AB, Canca-Sánchez JC, Enríquez de Luna-Rodríguez M, Aranda-Gallardo M, Morales-Asencio JM. (2018). Factors associated with variability in the prevention of pressure ulcers. Journal of Tissue Viability, 27(4),211-216.
- Nuru N, Zewdu F, Amsalu S, Mehretie Y. (2015). Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC Nursing,14(34),2-8.
- Sari SP, Everink IHJ, Amir Y, Lohrmann C, Halfens R, Moore Z, Beeckman D, Schols JM. (2021). Knowledge and attitude of community nurses on pressure injury prevention: a cross-sectional study in an indonesian city. International Wound Journal, 18(4),422-431.
- Sebba Tosta de Souza DM, Veiga DF, Santos ID, Abla LE, Juliano Y, Ferreira LM. (2015). Health-Related quality of life in elderly patients with pressure ulcers in different care settings. Journal of Wound, Ostomy and Continence Nursing, 42(4),352-359.
- Sengul T, Karadag A. (2020). Determination of nurses’ level of knowledge on the prevention of pressure ulcers: The case of Turkey. Journal of Tissue Viability, 29,337–341.
- Strand T, Lindgren M. (2010). Knowledge, attitudes and barriers toward prevention of pressure injuries in intensive care units: a descriptive cross-sectional study. Intensive and Critical Care Nursing, 26,335-42.
- Sving E, Gunningberg L, Högman M, Mamhidir AG. (2012). Registered nurses' attention to and perceptions of pressure ulcer prevention in hospital settings. Journal of Clinical Nursing, 21(9-10),1293-303.
- Tayyib N, Coyer F, Lewis PA. (2016). Implementing a pressure ulcer prevention bundle in an adult intensive care. Intensive and Critical Care Nursing, 37,27-36.
- Tirgari B, Mirshekari L, Forouzi MA. (2018). Pressure injury prevention: knowledge and attitudes of Iranian intensive care nurses. Advances In Skin & Wound Care, 31(4),1-8.
- Tulek Z, Polat C, Ozkan I, Theofanidis D, Togrol RE. (2016). Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument. Journal of Tissue Viability, 25(4),201-208.
- Uba MN, Alih FI, Kever RT, Lola N. (2015). Knowledge, attitude and practice of nurses toward pressure ulcer prevention in University of Maiduguri Teaching Hospital, Borno State, North Eastern, Nigeria. International Journal of Nursing and Midwifery, 7(4),54-60.
- Usher K, Woods C, Brown J, Power T, Lea J, Hutchinson M, Mather C, Miller A, Saunders A, Mills J, Zhao L, Yates K, Bodak M, Southern J, Jakson D. (2018). Australian nursing students' knowledge and attitudes towards pressure injury prevention: A cross-sectional study. International Journal of Nursing Studies, 81,14-20.
- Üstün Y. Adapting the ''attitude towards pressure ulcer prevention instrument'' into Turkish and studying its validity and reliability. Yüksek Lisans Tezi. İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü, 2013, İzmir.
- Yilmazer T, Tüzer H, Erciyas A. (2019). Knowledge and attitudes towards prevention of pressure ulcer: intensive care units sample in Turkey. Turkiye Klinikleri Journal of Nursing Sciences,11(2),140-147.