Critiquing Quantitative Article


Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design Werku Etafa Ebi1*, Getahun Fetensa Hirko1 and Diriba Ayala Mijena2


Background: Pressure ulcer is a preventable medical complication of immobility. It has psychological, economic and social impact on individual and family. Its cost of treatment is more than twice of cost of prevention. It is primarily the nurses’ responsibility to prevent pressure ulcer. The aim of this study was to assess the nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega.

Methods: A descriptive multicenter cross-sectional study design using quantitative method was employed to collect data from 212 randomly selected nurses. Data was collected using structured two validated self-administered instruments of pressure ulcer knowledge test evaluate nurses’ knowledge. Mean scores were compared using the Mann-Whitney U and Kruskal-Wallis tests. Means, standard deviation, and frequencies were used to describe nurses’ knowledge levels and barriers to pressure ulcer prevention.

Results: Analysis of the study displayed 91.5% had inadequate knowledge to pressure ulcer prevention. The mean of nurses’ knowledge in all theme and per item were 11.31 (SD = 5.97) and 0.43 (SD = 0.22).respectively. The study participants had the highest mean item score (2.65 ± 0.87) in nutrition theme, whereas, scored lowest on etiology and development (0.27 ± 0.18) and preventive measures to reduce duration of pressure (0.29 ± 0.18), The study also identified significant nurses read articles (0.000) and received training (p = 0.003). Shortage of pressure relieving devices, lack of staff and lack of training were the most commonly cited perceived barriers to practice pressure ulcer prevention.

Conclusions: This study highlights areas where measures can be made to facilitate pressure ulcer prevention in public hospitals in Wollega zones, such as increase regular adequate further training of nurses regarding pressure ulcer/its prevention points.

Keywords: Pressure ulcer, Prevention, Nurses, Knowledge

Background Pressure ulcers (PUs) prevention remains a significant challenge for nurses [1, 2], and its incidence is consi- dered an indicator of poor quality of care [3–5]. Patients and families know that pressure ulcers are painful and slow to heal [5]. Some risk factors for the development of pressure ulcers/injuries include advanced age, immo- bility, incontinence, inadequate nutrition and hydration, neuro-sensory deficiency, device-related skin pressure,

multiple comorbidities and circulatory abnormalities [5–7]. Ninety-five percent (95%) of pressure ulcers are avoidable [8, 9]. The incidence of pressure ulcers in adults varies from

0 to 12% in acute care settings, 24.3 to 53.4% in critical care settings and 1.9 to 59% in elderly care settings [6]. The prevalence of pressure ulcer has decreased over time in the USA (2004–2011 [10], 2006–2009 [11]). Two dif- ferent cross-sectional studies conducted at Felegehiwot and Dessie referral hospital, in Ethiopia reported 16.8 and 14.9% overall prevalence rate of PU, respectively [12, 13]. Moreover, these studies identified risk factors PU such as prolonged hospitalization, slight limit of sensory

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