When the focus has been on knowledge and practice variables with pressure ulcer prevention, management of this problem has been found to be directly connected to the level of nurses’ knowledge regarding the subject. A study conducted by Pieper and Mott (Thiele, Allen, & Stucky, 1999) examined registered nurses’ (RNs) knowledge of pressure ulcer prevention, pressure ulcer staging, and ulcer description. They found that the nurses had significantly more knowledge according to how recently they had heard a lecture or read an article about pressure ulcers.
Pieper & Matt (1995) found that pressure ulcer prevention strategies and methods were lacking in clinical practice and that the percentage of patients placed on a pressure ulcer prevention care plan was low amongst those at risk as well as those not at risk. This is a very important finding, concluding that number of nurses have demonstrated high knowledge and skills by keeping up-to-date on new information.
Furthermore, Hulsenboom , Bours, & Halfensl (2007) argued that the success of pressure ulcer prevention in hospitalized patients significantly depends on the edification of healthcare professionals, patients, and their relatives for the adoption of improved preventative measures. Another important area of knowledge is the ability of nurses to distinguish pressure ulcers risk factors and plan acceptable prevention plan. A study took place in Sweden to appraise nurses’ knowledge of pressure ulcer prevention, risk and the management of patients suffering from hip fractures (Gunningberg et al. , 2001).
In the general, nurses used repositioning, lotion, and pressure diminishing surfaces. However, nutritional maintenance, the diminution of shear and friction, and patient education were only used to a small extent in the clinical practice. The researchers concluded that nursing knowledge and practice could be enhanced to a much higher level (Gunningberg et al. , 2001). In terms of nurses’ knowledge and pressure and ulcer risk assessment, a study was performed in the United Kingdom, by Hill (1992), where researchers observed a number of nurses in their work place while they were giving care to their patients.
Eventually, the researcher examined them on the prevention of pressure ulcers. Nurses illustrated a good level of knowledge about dressings and nutritional needs. However, they were unable to implement their knowledge of pressure ulcer risk assessment. The outcomes of the former study were in line with the findings from a study conducted in Greece, which explored the Greek nurses’ knowledge of risk factors, at risk areas and recommended preventive strategies in relation to pressure area care (Panagiotopoulou & Kerr, 2002).
Four hundred and thirty-eight nurses working in a military hospital were included in this study. It revealed that the nurses had adequate knowledge in relation to risk factors and areas at risk. However, a significant proportion of participants were unaware that methods such as “massage” and “donuts” are no longer recommended. This lack of knowledge influenced practice, especially since there were a high proportion of nurses who could not access, read or understand research findings (Panagiotopoulou & Kerr, 2002).
This lack in knowledge obviously has implications for the implementation of evidence-based practice. In this study, the researchers followed some measures to increase the validity and generalizability of the study (response rate 71%). For example, nurses with special knowledge or little or no experience of pressure area care were excluded. In addition, senior nurses with little or no direct patient contact were excluded too. Furthermore, the inclusion criteria include registered nurses and enrolled nurses with roles and responsibilities connected with direct patient care.
Whereas the exclusion criteria included any registered nurses or enrolled nurses working in intensive care unties, emergency department, theatre or psychiatric ward. However, the main weakeness of this study lies in the using self-report questionnaire, where some data were missing. Another point was the exclusion of nurses with special knowledge about pressure ulcer. They might have had added important information that can be utilized in nursing practice. Yet, these findings seem to be the problem among vast majority of nursers in their clinical area.
Improving knowledge of risk assessment, sound prevention, management, and good education system can, with no doubt, help to reduce pressure ulcer costs. Finally, since the educational institutions are the primarily sources of knowledge for many nurses, it is important to mention that a small number of studies could be found concerning nursing students, their knowledge and attitudes. Rangel &MHL (1999) interviewed thirty-three nursing students from a Brazilian university about their knowledge and practice concerning pressure ulcers.
The study showed that less than half of the students (48%) had practiced prevention or treatment on patients at risk or with pressure ulcers, whereas 33 percent had never offered this care and 18 percent had only observed the care. The students who performed pressure ulcer prevention and treatment care cited a standard of 10. 2 pressure ulcer care measures for these patients, whereas those who had never provided the care or only observed procedures cited an average of one measure.
Among the measures utilized for treatment, 21% were considered to be inadequate according to standardization in scientific literature” (Rangel &MHL, 1999). The researchers believed that nursing practice influenced students’ knowledge of pressure ulcer prevention and management (Rangel &MHL, 1999). It can be argued that good education systems in nursing schools in particular can help many future nurses to hand and control pressure ulcer more professionally.