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Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit

Received: 17 July 2019     Accepted: 19 August 2019     Published: 25 September 2019
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Abstract

Pressure ulcers are a common and highly relevant professional care issues in pediatric intensive care units. The aim of this study was to evaluate the effect of preventive bundle guidelines on nurses’ knowledge and compliance regarding pressure ulcer among critically ill children at Pediatric intensive care unit. Research design: A quasi-experimental design was used. Settings: This study was conducted at the pediatric intensive care unit in Benha Specialized Pediatric Hospital. Sample: A Convenient sample of nurses (n=43) and purposive sample of critically ill children (n=70) were included from the above mentioned setting. Those children were divided equally into two groups (study and control). Tools of data collection: Three tools were used namely; a structured interviewing questionnaire format, pressure ulcer preventive bundle compliance checklist and Braden Q Risk Assessment Scale. Results: Most children in the study group were not at risk of pressure ulcer in the first and second week of admission as well as before discharge than children in the control group. Moreover, the results revealed that there was significant improvement in nurses’ knowledge regarding pressure ulcer as well as their compliance with preventive bundle guideline after bundle implementation. Conclusion: The implementation of preventive bundle guidelines proved to be effective in improving nurses' knowledge and their compliance, with a positive impact on the incidence of pressure ulcer among critically ill children. Recommendation: Preventive bundle guidelines should be implemented in pediatric intensive care units to reduce the harm associated with hospital-acquired pressure ulcer.

Published in American Journal of Nursing Science (Volume 8, Issue 5)
DOI 10.11648/j.ajns.20190805.17
Page(s) 243-254
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Preventive Bundle Guidelines, Pressure Ulcer, Critically Ill Children, Pediatric Intensive Care Unit

References
[1] Simsic J., Kevin D., Sarah H., Stephanie P. &Robert G., (2019): Prevention of pressure ulcers in a pediatric cardiac intensive care unit, Pediatric Quality & Safety, 2 April, 2019 - Volume 4 Latest Articles - Issue 2– p, Wolters Kluwer.
[2] Uysal G., Duzkaya D. S., Yakut T. & Bozkurt G., (2019): Effect of pressure injury prevention guides used in a pediatric intensive care, Clinical Nursing Research, PP: 1-14.
[3] Kiss E. & Heilar M. (2014): Pediatric skin integrity practice guideline for institutional use: A quality improvement project Journal of Pediatric Nursing 29, 362-367.
[4] Özgen R., & Eti Aslan F., (2015): Evaluation of pressure wound prevalence and risk factors in children (master thesis). Acibadem University, İstanbul.
[5] Sterken D. J., Mooney J., Ropele D., Kett A., &Vander Laan K. J., (2015): Mastering pressure ulcer risk assessment with the pediatric pressure ulcer prediction and evaluation tool (PPUPET), Journal of Pediatric Nursing, 30, 598-610.
[6] Goodman L., Khemani E., Cacao F., Yoon J., Burkoski V., Jarrett S., Collins B. & Hall T., (2018): A comparison of hospital-acquired pressure injuries in intensive care and non-intensive care units: a multifaceted quality improvement initiative, PMJ, Volume 7, Issue 4.
[7] Singh C. D., Anderson C., White E. & Shoqirat, N. (2018): The impact of pediatric pressure injury prevention bundle on pediatric pressure injury rates, Journal of Wound, Ostomy and Continence Nursing, 45, 209-212.
[8] Schlüer A. B., (2017): Pressure ulcers in maturing skin-A clinical perspective. Journal of Tissue Viability.; 26 (1): 2-5. Doi: 10.1016/j.jtv.2016. 10.001
[9] Courtwright S. E., Mastro K. A., Preuster C., Dardashti N., McGill S. & Madelon M., (2017): Reducing hospital-acquired pressure ulcers using bundle methodology in pediatric and neonatal patients receiving extracorporeal mem brane oxygenation therapy: An integrative review and call to action. Journal for Specialists in Pediatric Nursing. 22 (4). Doi: 10.1111/jspn.12188.
[10] Al-Otaibi Y. K., Al-Nowaiser N. & Rahman A., (2019): Reducing hospital-acquired pressure injuries, BMJ Open Quality, 26 April, 2019.
[11] Padula W. V., Pronovost P., Makic M. B., Wald H., Moran D., Mishra M. K. & Meltzer D. O., (2019): Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis, BMJ, Volume 28, Issue 2.
[12] Zuo X. & Meng F. A., (2015): A care bundle for pressure injury treatment in intensive care units. International Journal of Nursing Sciences, 2; (4): 340-347. December 2015, Doi: 10.1016/j.ijnss.10.008.
[13] Vasconcelos B. D. J. & Caliri L. H. M., (2017): Nursing actions before and after a protocol for preventing pressure injury in intensive care, Escola Anna Nery; 21 (1). Doi: 10.5935/1414-8145.20170001.
[14] Frank G., Walsh K. E., Wooton S., Bost J., Dong W., Keller L., Miller M., Zieker K. & Brilli B. J., (2017): Impact of a pressure injury prevention bundle in the solutions for patient safety network, Pediatric Quality& Safety. April 2017, Volume 2, Issue 2.
[15] Quigley S. M. & Curley M. A., (1996): Skin integrity in the pediatric population: Preventing and managing pressure ulcers. Journal of the Society of Pediatric Nurses. 1996; 1 (1): 7-18.
[16] Curley M. A., Hasbani N. R., Quigley S. M., Stellar J. J., Pasek T. A. & Shelley S. S., (2018): Predicting pressure injury risk in pediatric patients: The Braden QD Scale, The journal of pediatric, 192: 189-95.
[17] Santos V. L., Serpa L. F., Cordero G. M. & Gamboa S. G., (2018): Risk assessment in pressure ulcers, science and practice of pressure ulcer management, Springer publisher, pp 57-77.
[18] Reyna R., (2015): Preventing pressure ulcers in pediatric patients, Practical Issues in Wound, Skin and Ostomy Management, available at https://woundcareadvisor.com/preventing-pressure-ulcers-in-pediatric-patients_vol4-no4.
[19] Hassan E. A., (2018): Impact of educational guidelines about prevention of pressure injuries among infants in intensive care unit, Symbiosis Journal Nursing health care, semantic scholar, available at https://www.semanticscholar.org/faq.
[20] Zhang Y., Liu L., Hu J., Wang Z. & Haung Q., (2016): Assessing nursing quality in paediatric intensive care units: a cross-sectional study in China, Nursing in critical care, Volume 22, Issue 6, 355-361.
[21] Al-Shidi A. S., (2016): Pressure ulcer management in Oman: Nurses’ knowledge and views, Dissertation submitted in partial fulfillment of the requirements for the degree of doctorate of philosophy in nursing and Health care, School of medicine, Collage of medical, veterinary & life sciences, Glasgow University.
[22] Abou- El Enein N. Y., & Zaghloul A. A., (2011): Nurses' knowledge of prevention and management of pressure ulcer at a Health Insurance Hospital in Alexandria, International Journal of Nursing Practice 2011; 17 (3): 262–268.
[23] Hashad R., E. & Hassan R. E., (2018): The effect of implementing a designed skin care bundle protocol on modifying nurses' practices toward pediatric intensive care units patients. International Journal of Nursing Didactics. 2018; 8 (2): 33-40.
[24] Tayyib N., Coyer F. & Lewis P. A., (2016): Implementing a pressure ulcer prevention bundle in an adult intensive care. Intensive and Critical Care Nursing. 2016b; (37): 27-36.
[25] Visscher M., King A., Nie A., Schaffer P., Taylor T., Pruitt D., Giaccone M., Ashby M. &Keswani S. A., (2013): Quality-improvement collaborative project to reduce pressure ulcers in PICUs, Official Journal of The American Academy of Pediatrics. 2013; 131 (6): 1950–1960.
[26] Horner D., L., & Bellamy M., C., (2012): Care bundles in intensive care. Continuing Education in Anesthesia Critical Care & Pain. 2012; 12 (4), 199-202.
[27] Beeckman D., Defloor T., Schoonhoven L., &Vanderwee K., (2011): Knowledge and attitudes of nurses on pressure ulcer prevention: a cross-sectional multicenter study in Belgian hospitals. Worldviews Evidence Based Nursing. 2011; 8 (3): 166–176. doi: 10.1111/j.17416787.2011.00217.x.
[28] Konstantin A. T., (2017): Pediatric intensive care unit skin-care team. Master s' projects and Capstone. 2017, University of San Francisco, available at https://respiratory.usfca.edu/capstone/508.
[29] Sabaq A. G. & Amer S. A., (2018): Effect of preventive bundle guidelines on reducing iatrogenic pressure injuries among critically ill neonates, International Journal of Nursing Didactics, 8: (08) 22-36, August (2018).
[30] Riccioni R., Berlanga R., Hagan J., Schier R. &Gordon M., (2019): Interrater reliability of the Braden and Braden Q by skin champion nurses, Journal of Pediatric Nursing, Volume 44, January–February 2019, Pages 9-15.
[31] Liao Y., Gao G. & Mo L., (2018): Predictive accuracy of the Braden Q Scale in risk assessment for pediatric pressure ulcer: A meta-analysis, International journal of nursing science, Volume 5, Issue 4, 10 October 2018, Pages 419-426.
[32] Penoyer D., Britt C., Arwood L., Wilkinson L. & Sole M., (2019): A critical care-specific pup bundle reduces hospital-acquired pressure ulcers in the ICU, Critical Care Medicine: January 2019 - Volume 47 - Issue 1 - p 324.
[33] Crane N., Pool N., Chang I. & Rogan S., (2019): A dedicated pediatric logistic organ dysfunction score - adjusted pressure injury risk assessment scale is required for tertiary pediatric ICUs, cardiology in the young, volume 29, Issue 3 March 2019, pp. 455-456.
Cite This Article
  • APA Style

    Rawia Abd Elghany Mohamed, Seham Mohamed Abd Elaziz, Hanan Nabawy Elaasar. (2019). Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit. American Journal of Nursing Science, 8(5), 243-254. https://doi.org/10.11648/j.ajns.20190805.17

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    ACS Style

    Rawia Abd Elghany Mohamed; Seham Mohamed Abd Elaziz; Hanan Nabawy Elaasar. Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit. Am. J. Nurs. Sci. 2019, 8(5), 243-254. doi: 10.11648/j.ajns.20190805.17

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    AMA Style

    Rawia Abd Elghany Mohamed, Seham Mohamed Abd Elaziz, Hanan Nabawy Elaasar. Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit. Am J Nurs Sci. 2019;8(5):243-254. doi: 10.11648/j.ajns.20190805.17

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  • @article{10.11648/j.ajns.20190805.17,
      author = {Rawia Abd Elghany Mohamed and Seham Mohamed Abd Elaziz and Hanan Nabawy Elaasar},
      title = {Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit},
      journal = {American Journal of Nursing Science},
      volume = {8},
      number = {5},
      pages = {243-254},
      doi = {10.11648/j.ajns.20190805.17},
      url = {https://doi.org/10.11648/j.ajns.20190805.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20190805.17},
      abstract = {Pressure ulcers are a common and highly relevant professional care issues in pediatric intensive care units. The aim of this study was to evaluate the effect of preventive bundle guidelines on nurses’ knowledge and compliance regarding pressure ulcer among critically ill children at Pediatric intensive care unit. Research design: A quasi-experimental design was used. Settings: This study was conducted at the pediatric intensive care unit in Benha Specialized Pediatric Hospital. Sample: A Convenient sample of nurses (n=43) and purposive sample of critically ill children (n=70) were included from the above mentioned setting. Those children were divided equally into two groups (study and control). Tools of data collection: Three tools were used namely; a structured interviewing questionnaire format, pressure ulcer preventive bundle compliance checklist and Braden Q Risk Assessment Scale. Results: Most children in the study group were not at risk of pressure ulcer in the first and second week of admission as well as before discharge than children in the control group. Moreover, the results revealed that there was significant improvement in nurses’ knowledge regarding pressure ulcer as well as their compliance with preventive bundle guideline after bundle implementation. Conclusion: The implementation of preventive bundle guidelines proved to be effective in improving nurses' knowledge and their compliance, with a positive impact on the incidence of pressure ulcer among critically ill children. Recommendation: Preventive bundle guidelines should be implemented in pediatric intensive care units to reduce the harm associated with hospital-acquired pressure ulcer.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit
    AU  - Rawia Abd Elghany Mohamed
    AU  - Seham Mohamed Abd Elaziz
    AU  - Hanan Nabawy Elaasar
    Y1  - 2019/09/25
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ajns.20190805.17
    DO  - 10.11648/j.ajns.20190805.17
    T2  - American Journal of Nursing Science
    JF  - American Journal of Nursing Science
    JO  - American Journal of Nursing Science
    SP  - 243
    EP  - 254
    PB  - Science Publishing Group
    SN  - 2328-5753
    UR  - https://doi.org/10.11648/j.ajns.20190805.17
    AB  - Pressure ulcers are a common and highly relevant professional care issues in pediatric intensive care units. The aim of this study was to evaluate the effect of preventive bundle guidelines on nurses’ knowledge and compliance regarding pressure ulcer among critically ill children at Pediatric intensive care unit. Research design: A quasi-experimental design was used. Settings: This study was conducted at the pediatric intensive care unit in Benha Specialized Pediatric Hospital. Sample: A Convenient sample of nurses (n=43) and purposive sample of critically ill children (n=70) were included from the above mentioned setting. Those children were divided equally into two groups (study and control). Tools of data collection: Three tools were used namely; a structured interviewing questionnaire format, pressure ulcer preventive bundle compliance checklist and Braden Q Risk Assessment Scale. Results: Most children in the study group were not at risk of pressure ulcer in the first and second week of admission as well as before discharge than children in the control group. Moreover, the results revealed that there was significant improvement in nurses’ knowledge regarding pressure ulcer as well as their compliance with preventive bundle guideline after bundle implementation. Conclusion: The implementation of preventive bundle guidelines proved to be effective in improving nurses' knowledge and their compliance, with a positive impact on the incidence of pressure ulcer among critically ill children. Recommendation: Preventive bundle guidelines should be implemented in pediatric intensive care units to reduce the harm associated with hospital-acquired pressure ulcer.
    VL  - 8
    IS  - 5
    ER  - 

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Author Information
  • Faculty of Nursing, Benha University, Benha, Egypt

  • Faculty of Nursing, Benha University, Benha, Egypt

  • Faculty of Nursing, Benha University, Benha, Egypt

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