Development of Nursing Practice Guideline for Prevention of Pressure Sores in Intensive Care Unit, Loei Hospital

Abstract

Background: Pressure ulcers were a crucial complication in patients with limited mobility that affected patients who became infected and had to stay in the hospital longer.  In the intensive care unit, the incidence rate of pressure sores in 2018-2020 were 1.9, 2.6, and 5.8 per thousand sleep days, respectively which tend to increase.

Objective: To develop a nursing practice guideline for the prevention of pressure sores in the intensive care unit.

Method: The study was research and development. The study was conducted from June - December 2021. The participants were 17 registered nurses and 260 patients with a Braden score ≤18 were admitted to the intensive care unit. Measurements were: 1) in-depth interviews/group discussions/semi-structured brainstorming and reflection sessions; 2) an evaluation form for nursing practice guidelines to prevent pressure sores. Data analysis, qualitative data used content analysis, and quantitative data were used to compare differences in mean scores by using Fisher's exact test, McNamar’s test, Independence t-test/ Mann Whitney U test, and Wilcoxon signed rank test.

Result: After using the guideline, it found that the nursing behavior of taking care of patients increased with statistical significance according to the guidelines in terms of risk assessment (p=0.004), pressure distribution (p=0.016), and prevention of pressure sores from medical devices (p=0.004). Clinical Outcomes after the development and using the guideline, there were pressure sores of 8 participants decreased from 6.11 percent to 0.8 percent (p=0.036).

Conclusion: Nursing practice guidelines to prevent pressure sores and gel-latex mattress innovations can reduce the incidence of pressure sores.