Nurses’ knowledge, practice, and barriers in implementing pressure Ulcer prevention care bundles in ICU of selected referral hospitals

Abstract

ABSTRACT Background: Most patients admitted to intensive care units (ICUs) still struggle with pressure ulcer prevention, especially in developing countries. Pressure ulcer prevention bundles are considered essential for lowering the incidence of pressure ulcers in patients referred to intensive care units. There is little information available in Tanzania regarding the difficulties faced by nurses in implementing the pressure ulcer treatment bundle. Aims: Examining nurses' practices, knowledge, and barriers in applying pressure ulcer prevention care bundles in intensive care units at particular referral hospitals in Dar es Salaam, Tanzania, is the study's main goal. Methodology: Analytical, cross-sectional study design was employed. The study was conducted at (MNH, JKCI, and MOI). The data was gathered via a self-administered questionnaire. A simple random sampling with a stratified approach was employed to select 112 study participants. The data was evaluated using both descriptive and inferential statistics using SPSS software version 26. A bivariate analysis was carried out with p<0.2, which was deemed fit for a multivariate analysis which set the p-value <0.05 as statistically significant. Results: The study revealed that most of the participants (65.2%) had insufficient knowledge of the pressure ulcer prevention bundle. It was noted that working institutions, level of education, and training were associated with nurses’ knowledge of pressure ulcer prevention bundles. (AOR = 10.082, 95% CI: 1.578–64.403, P = 0.015), (AOR = 33.334, 95% CI: 2.478 448.479, P = 0.008), and (AOR = 0.231, 95% CI: 0.077-0.695, p = 0.009) respectively. Moreover, only 42% of respondents had good practice in pressure ulcer prevention bundle implementation. It was found that only training was associated with nurses’ practice on pressure ulcer prevention bundles. (AOR = 2.758, 95% CI: 1.18-6.437, P = 0.019. Most barriers reported were insufficient pressure ulcer prevention bundles and the absence of courses offering specialized training on preventing pressure ulcers in the workplace. vi Conclusion: The majority of the respondents had insufficient knowledge and practice in pressure ulcer prevention care bundles, and this was associated with the presence of barriers hindering nurses in the proper implementation of this tool for patients admitted to ICUs. Due to insufficient knowledge and practice in pressure ulcer prevention bundle continuous professional training for nurses working in ICUs is important. KEY TERMS. The pressure ulcer prevention care bundle, Braden scale, Pressure Ulcer, critically ill Patients, National Referral Hospital.