Authors (including presenting author) :
LO WC(1), HUI WM(1), SIN ML(1), HO HY(1), WANG KF(1), CHOY YM(1), TSANG KK(2), CHAN SK(1), PI SS(1)
Affiliation :
(1)Department of Nursing, Hong Kong Buddhist Hospital, (2)Department of Orthopaedic and Traumatology, Queen Elizabeth Hospital
Introduction :
Pressure injuries are painful and debilitating and, if left untreated, can lead to serious harm and death. It is also a major nursing performance index. Therefore, it is of utmost importance to have a systematic pressure injury prevention and management.
Objectives :
In order to improve the compliance, accuracy and practice of nursing care in Buddhist Hospital (BH), a systematic review of the pressure injury prevention and management is conducted in this study.
Methodology :
A preliminary audit on pressure injury management was conducted in all wards in BH in 2016. 20 patients who have pressure injury were selected as target samples. In addition, we used PUSH (Pressure Ulcer Score for Healing) tool as a way to evaluate the effectiveness of pressure injury management as the practice outcome. Once the result of preliminary audit and PUSH scores was obtained, we designed our intervention based on any findings. Post-intervention audit and PUSH scores were then computed again in 2017 to evaluate the effectiveness of the intervention.
Result & Outcome :
Preliminary audit: The overall compliance rate was 83%. 5 items had compliance rate < 80%: weekly risk screening, accurate risk screening, weekly nutrition & hydration assessment, appropriate wound management strategy & accurate wound data documentation. PUSH: 42% had improved wound, 29% had same condition wound, and 29% had worsen wound. Intervention: The intervention consisted of: 1) sharing of preliminary audit result to ward staff, 2) a Norton Score Risk Assessment Guide to help improving pressure injury risk assessment accuracy, 3) a Body Weight Form to help facilitating the reassessment of patient nutrition and hydration status, and 4) training sessions on wound documentation, wound assessment and management, organized by wound management team. Post-intervention audit: The overall compliance rate was 91.01%. Improvement had been observed in all items which had compliance rates < 80%. PUSH: 71% had improved wound, and 25% had the same condition wound. Only 4% had worsen wound. (p = 0.05)