Can a patient-centred pressure injury prevention care bundle increase patient participation and reduce pressure injuries; An implementation study

Abstract

Preventing hospital-acquired pressure injuries (HAPI) in patients is a key quality of care and safety goal for healthcare organisations and clinicians. Nurses implement numerous pressure injury prevention (PIP) strategies including encouraging patients to participate in their care. However, finding ways to actively engage patients in their PIP care has proved challenging. The study aim was to implement a patient-centred pressure injury prevention care bundle (PPIPCB) intervention in collaboration with patients and nurses, and evaluate its effectiveness relative to the implementation process (feasibility, acceptability and fidelity), patient participation in their PIP care (before and after its implementation), patient satisfaction with the intervention, and changes in HAPI prevalence over an 18-month period. Our findings suggest that at hospital admission, patients wanted more PIP information from nurses. Yet, nurses perceived they were meeting the PIP education needs of patients. This demonstrates more should be done to encourage nurses to engage with patients about their PIP care, so patients have the required knowledge and understanding to participate. Patients and nurses deemed our PPIPCB intervention was feasible and acceptable in terms of its clear and simple messaging, format and ease of use. Patients and nurses described the intervention as a valuable education tool that would facilitate important PIP care conversations. Our study found a significant increase in patients PIP knowledge following their engagement with the PPIPCB intervention. Factors such as simple messaging, accessibility, and satisfaction might explain patient’s decision to engage with the intervention. Most patients and their families reported the three simple messages (keep moving, eat well, and look after your skin) within the PPIPCB intervention were easy for them to understand and incorporate into their daily PIP care. Finally, patients were very satisfied with the PPIPCB intervention quality and the ‘perceived benefits’ of the three key messages for PIP.