Effect of bundle of care guidelines on nurses' performance for prevention of pressure ulcer among the immobilized stroke patients

Abstract

Abstract Improving Pressure ulcer prevention remains an important issue for hospital patients. Pressure ulcers occur in approximately 17-20 % of hospitalized patients. Patients with stroke in intensive care units particularly at risk because they are relatively immobile. Therefore, the best treatment for pressure ulcers is to prevent their development. Prevention depends on excellent nursing care and incorporating those practices in a bundle of care are likely to lead to better outcomes. Aims: The aim of this study was to assess and evaluate the effect of bundle of care guidelines on nurses' performance for prevention of pressure ulcer among immobilized stroke patients. Subjects and Methods: Design: A quasi experimental design was used. Setting: The study was conducted in Neuro-medicine Intensive Care Unit at Ain Shams University Hospital and Neurosurgery Intensive Care Unit at El-demerdash Hospital. Sample: A convenience sample of 25 nurses and two purposive samples of immobilized stroke patients (30 patients were taken pre-guidelines and 30 patients were post- guidelines implementation).Tools for data collection: A Self administered structured Questionnaire and observational checklists and Patient assessment sheet .Results: There was a statistically significance differences between pre & post guidelines implementation regarding knowledge and practice of the studied nurses regarding the bundle of care for prevention of pressure ulcer. There was no statistically significant difference between pre & post guidelines implementation regarding pressure ulcer characteristics among the immobilized stroke patients. Conclusions: The bundle of care guidelines was helpful on the improvement of the nurses' knowledge and practices for prevention of pressure ulcer among immobilized stroke patients. Recommendations: Periodic in service – training advanced care programs regarding bundle of care for pressure ulcer based on best practice guidelines for nurses working in intensive care unit.