5.00
Hdl Handle:
http://hdl.handle.net/10755/211571
Type:
Research Study
Title:
FACILITATORS/BARRIERS TO PRESSURE ULCER PREVENTION:VA COMMUNITY LIVING CENTERS
Abstract:
Purposes/Aims: This study aims to describe nursing assistant (NA), licensed vocational nurse (LVN), and registered nurse (RN) perceptions of facilitators/barriers to implementing pressure ulcer prevention (PrUP) in 2 VA Community Living Centers. Knowledge, beliefs, values, attitudes, and work practices were examined. Background: Implementation of best practices is used as a strategy to promote quality of care. Maintaining PrUP practices is difficult. Knowledge, beliefs, values, attitudes, and work practices may facilitate and/or impede their implementation. Methods: Cross-sectional qualitative audio recorded 45-60 minute structured individual interviews were conducted using a purposeful and convenience sample in two CLCs in southern California. VA CLC nursing staff provide PrUP as part of usual care. Results: 16 subjects participated. Data were analyzed using content analysis and descriptive statistics. The sample was mostly female (88%); middle-age (average age 50 years); ethnically diverse (white/non-white); experienced (average 16 years/nursing); stably employed at VA (average 7 years). Aggregate analyses are noted; exploration of potential differences among nursing types is in progress. Factors related to facilitation included a centralized wound care program (work practices/knowledge) that included CLC-level team members; intrinsic motivation (attitudes) by staff and beliefs that PrUs were preventable (beliefs); early detection of PrUs by NAs during performance of daily activities of living (work practices); belief that prevention enhanced a Veteran's quality of life (beliefs); strong staff personal responsibility for PrUP (attitudes/values) and provision of care despite positive or negative feedback about performance (work practices); commitment to Veterans' well-being (values, beliefs, attitudes); and teamwork/communication with wound team(work practices). Factors related to barriers included limited performance feedback by nurse managers (work practices/values); difficulty in articulating components of common best practices (work practices/knowledge); difficulty in distinguishing how usual care differed from high-risk care for PrUP (work practices/knowledge); lack of knowledge of Veteran chart information such as written individualized care plans (work practices), and Braden Scale scores (knowledge). Implications: The effective functioning of a centralized and CLC-level wound team was important to successful PrUP. Staff valued PrUP and Veteran well-being, was self-motivated, and felt personally responsible to prevent PrUs. Teamwork and communication were seemingly important for learning and implementing aspects of PrUP care versus formal understanding of components of evidence-based PrUP practices.
Keywords:
Nursing perception; Pressure ulcer prevention
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5499
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleFACILITATORS/BARRIERS TO PRESSURE ULCER PREVENTION:VA COMMUNITY LIVING CENTERSen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211571-
dc.description.abstractPurposes/Aims: This study aims to describe nursing assistant (NA), licensed vocational nurse (LVN), and registered nurse (RN) perceptions of facilitators/barriers to implementing pressure ulcer prevention (PrUP) in 2 VA Community Living Centers. Knowledge, beliefs, values, attitudes, and work practices were examined. Background: Implementation of best practices is used as a strategy to promote quality of care. Maintaining PrUP practices is difficult. Knowledge, beliefs, values, attitudes, and work practices may facilitate and/or impede their implementation. Methods: Cross-sectional qualitative audio recorded 45-60 minute structured individual interviews were conducted using a purposeful and convenience sample in two CLCs in southern California. VA CLC nursing staff provide PrUP as part of usual care. Results: 16 subjects participated. Data were analyzed using content analysis and descriptive statistics. The sample was mostly female (88%); middle-age (average age 50 years); ethnically diverse (white/non-white); experienced (average 16 years/nursing); stably employed at VA (average 7 years). Aggregate analyses are noted; exploration of potential differences among nursing types is in progress. Factors related to facilitation included a centralized wound care program (work practices/knowledge) that included CLC-level team members; intrinsic motivation (attitudes) by staff and beliefs that PrUs were preventable (beliefs); early detection of PrUs by NAs during performance of daily activities of living (work practices); belief that prevention enhanced a Veteran's quality of life (beliefs); strong staff personal responsibility for PrUP (attitudes/values) and provision of care despite positive or negative feedback about performance (work practices); commitment to Veterans' well-being (values, beliefs, attitudes); and teamwork/communication with wound team(work practices). Factors related to barriers included limited performance feedback by nurse managers (work practices/values); difficulty in articulating components of common best practices (work practices/knowledge); difficulty in distinguishing how usual care differed from high-risk care for PrUP (work practices/knowledge); lack of knowledge of Veteran chart information such as written individualized care plans (work practices), and Braden Scale scores (knowledge). Implications: The effective functioning of a centralized and CLC-level wound team was important to successful PrUP. Staff valued PrUP and Veteran well-being, was self-motivated, and felt personally responsible to prevent PrUs. Teamwork and communication were seemingly important for learning and implementing aspects of PrUP care versus formal understanding of components of evidence-based PrUP practices.en_GB
dc.subjectNursing perceptionen_GB
dc.subjectPressure ulcer preventionen_GB
dc.date.available2012-02-20T12:02:57Z-
dc.date.issued2012-02-20T12:02:57Z-
dc.date.accessioned2012-02-20T12:02:57Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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