A multifaceted intervention for evidence-based pressure ulcer prevention: a 3 year follow-up.

Autor:	Sving E; Department of Patient Safety, Region Gävleborg, Gävle, Sweden.; Department of Public Care and Caring Sciences Uppsala University, Uppsala, Sweden.; Centre for Research and Development, Region Gävleborg/Uppsala University, Sweden., Fredriksson L; Centre for Research and Development, Region Gävleborg/Uppsala University, Sweden., Mamhidir AG; Department of Public Care and Caring Sciences Uppsala University, Uppsala, Sweden.; Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle., Högman M; Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden., Gunningberg L; Department of Public Care and Caring Sciences Uppsala University, Uppsala, Sweden.
Jazyk:	angličtina
Zdroj:	JBI evidence implementation [JBI Evid Implement] 2020 Dec; Vol. 18 (4), pp. 391-400.
DOI:	10.1097/XEB.0000000000000239
Abstrakt:	Aim: To assess sustainability of an intervention used to implement pressure ulcer prevention. Background: The Promoting Action on Research Implementation in Health Service, framework was used to develop an intervention aimed to implement evidence-based pressure ulcer prevention in a hospital setting. A short-term follow-up showed that significantly more patients received pressure ulcer prevention. A qualitative process evaluation gave support that the intervention and the implementation process changed the understanding and approach to working with pressure ulcer prevention from treating to preventing. Method: The study had a sequential mixed method approach, combining quantitative and qualitative data. For the quantitative data, baseline and short-term follow-up (6-8 months) data reported in an initial study were compared with long-term follow-up (36-42 months) data (n = 259 patients). For the qualitative data, interviews with registered nurses (n = 20), assistant nurses (n = 7) and first-line managers (n = 5) were performed. Results: The performance of pressure ulcer prevention was sustained 3 years from its conception. The number of patients with pressure ulcers was reduced (P = 0.021). Systematic work with quality measurements, support from first-line managers, internal facilitation, collaboration and pressure ulcer prevention skills could explained the sustainability. Obstacles to achieve high-quality pressure ulcer prevention were inadequate communication, high workloads and high rates of new and substitute nurses. Conclusion: Three different components for sustainability on the micro-level are described; benefits for the patients, the need for routinization and development over time. Threats to sustainability are described as factors on the macro-level. There needs to be collaboration in the healthcare organization from the micro-to-macro levels, and committed experienced nurses are needed to obtain high-quality sustainable pressure ulcer prevention.
Databáze:	MEDLINE
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