Preventing Pressure Ulcers in Hospitals: A Systematic Review of Nurse-Focused Quality Improvement Interventions
| Autor: | Lynn M. Soban, Susanne Hempel, Lisa V. Rubenstein, Brett Munjas, Jeremy N. V. Miles |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Pressure Ulcer
medicine.medical_specialty Quality management Leadership and Management business.industry Psychological intervention MEDLINE Alternative medicine Absolute risk reduction Skin Care Quality Improvement Hospitalization Outcome and Process Assessment Health Care Nursing Intervention (counseling) Health care Humans Medicine business Nursing Process Nursing process |
| Zdroj: | The Joint Commission Journal on Quality and Patient Safety. 37:245-AP16 |
| ISSN: | 1553-7250 |
| DOI: | 10.1016/s1553-7250(11)37032-8 |
| Popis: | Article-at-a-Glance Background A systematic review of the literature on nurse-focused interventions conducted in the hospital setting informs the evidence base for implementation of pressure ulcer (PU) prevention programs. Despite the availability of published guidelines, there is little evidence about which interventions can be successfully integrated into routine care through quality improvement (QI). The two previous literature syntheses on PU prevention have included articles from multiple settings but have not focused specifically on QI. Methods A search of six electronic databases for publications from January 1990 to September 2009 was conducted. Trial registries and bibliographies of retrieved studies and reviews, and Internet sites of funding agencies were also searched. Using standardized forms, two independent reviewers screened publications for eligibility into the sample; data were abstracted and study quality was assessed for those that passed screening. Findings Thirty-nine studies met the inclusion criteria. Most of them used a before-and-after study design in a single site. Intervention strategies included PU-specific changes in combination with educational and/or QI strategies. Most studies reported patient outcome measures, while fewer reported nursing process of care measures. For nearly all the studies, the authors concluded that the intervention had a positive effect. The pooled risk difference for developing PUs was –.07 (95% confidence interval [CI]: –0.0976, –0.0418) comparing the pre- and postintervention status. Conclusion Future research can build the evidence base for implementation through an increased emphasis on understanding the mechanisms by which improved outcomes are achieved and describing the conditions under which specific intervention strategies are likely to succeed or fail. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|