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Adherence to evidence‐based pressure injury prevention guidelines in routine clinical practice: a longitudinal study
Authors:Wendy Chaboyer  Tracey Bucknall  Brigid Gillespie  Lukman Thalib  Elizabeth McInnes  Julie Considine  Edel Murray  Paula Duffy  Michelle Tuck  Emma Harbeck
Affiliation:1. Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia;2. Deakin University, Centre for Quality and Patient Safety, Alfred Health Partnership, School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, Australia;3. School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia;4. Gold Coast Health and Hospital Service, Gold Coast, QLD, Australia;5. Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar;6. Nursing Research Institute, Australian Catholic University, Darlinghurst, NSW, Australia;7. St Vincent's Health Australia, Sydney, NSW, Australia;8. Deakin University, Centre for Quality and Patient Safety, Eastern Health Partnership, School of Nursing and Midwifery, Faculty of Health, Geelong, VIC, Australia;9. St Vincent's Private Hospital, Sydney, NSW, Australia;10. Nursing Diagnostic, Emergency and Medical Services, Gold Coast Hospital and Health Service, Gold Coast, QLD, Australia;11. Wound Management, The Alfred Hospital, Melbourne, VIC, Australia
Abstract:The aim of this longitudinal study was to describe adherence to evidence‐based pressure injury (PI) prevention guidelines in routine clinical practice in Australian hospitals. Data were analysed from four control sites of a larger‐cluster randomised trial of a PI intervention. The sample of 799 included 220 (27·5%) Not at risk, 344 (43·1%) At risk and 110 (13·8%) At high risk patients. A total of 84 (10·5%) patients developed a PI during the study: 20 (9·0% of 220) in the Not at risk group, 45 (13·1% of 344) in the At risk group, 15 (13·6% of 110) in the At high risk group and 4 (3·2% of 125) patients who did not have a risk assessment completed. Of all patients, 165 (20·7%) received only one PI prevention strategy, and 494 (61·8%) received ≥2 strategies at some point during the study period. There was no statistical difference in the proportion of time the three risk groups received ≥1 and ≥2 strategies; on average, this was less than half the time they were in the study. Thus, patients were not receiving PI prevention strategies consistently throughout their hospital stay, although it is possible patients' risk changed over the study period.
Keywords:Adverse events  Clinical practice guidelines  Pressure ulcer  Prevention  Processes of care
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