Pressure ulcers are described as ‘localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear’(1,2,3,4).
Annually more than 2.5 million patients develop pressure ulcer in the United States of America alone (5). Management of hospital-acquired pressure ulcer costs billions of dollar each year; for a single individual with a diagnosis of pressure ulcer costs nearly 129,000$ on average (6). A pressure ulcer is largely avoidable, but in a thirteen years study, its prevalence rate increased more than 80% (7). A comparative study conducted in Norwegian and Irish site shows that PU prevalence was 54% in the Norwegian and 12% in the Irish site (8). another study done in Sweden revealed that the 21 different countries prevalence ranged from 9% to 31 % (9). A similar study conducted in Ethiopia indicates that off total patients admitted 16.8% of them had pressure ulcer (10).
Hospitals need to devote more resources to prevent and manage pressure ulcers. Professionals should also meet their responsibility to provide continuous nursing education and continuous medical education to staffs about pressure ulcers. Included and reflected in this education should be the importance of interdisciplinary collaboration (11).
Adequate application of incontinence management and measures are taken to prevent skin damage merits serious attention, including evidence-based pressure ulcer prevention and management to redistribute pressure such as preventive skin care based on principles of cleansing, enhancing the skin’s moisture barrier, and regular turning and repositioning along with protection (12). Timely and accurate assessment of pressure ulcers depends on individual nurses’ knowledge of towards pressure ulcers, with education on skin and risk assessment forming a key component (13).
Nurses have a great position to advance best practice towards prevention of PU. Therefore they are in need to be knowledgeable about the signs and symptoms of pressure ulcers, and preventive strategies to reduce its incidence (13). But according to a study conducted across the globe nurses does not have sufficient knowledge about pressure ulcer prevention, classification, and management(14). Study in Nepal revealed that only 59% of nurses had adequate knowledge about pressure ulcer prevention (15). A similar study conducted in North West Ethiopia shows nearly half 54.4 % of the nurses had good knowledge towards pressure ulcer prevention (16).
The prevalence of pressure ulcers decreased if the patient is assessed for the risk of pressure ulcer upon his/her admission and if a regular assessment is followed by appropriate action or intervention(17).
Providing sufficient education, a positive attitude and addressing barriers are all important aspects to improve knowledge and use of pressure ulcer preventive measures among nursing staff(18).
Understands nurses knowledge about pressure ulcer prevention, classification and management are important to improve their knowledge towards pressure ulcer prevention. The purpose of this study is assessing knowledge gaps, and identifying associated factors about pressure ulcer prevention among nurses working at Hawassa university comprehensive specialized hospital.
Justification of the study
PU is a major significant and complex problem in hospitals in terms of human suffering, tissue necrosis, pain, septicemia, disfigurement, loss of productivity, and financial burden. Nurses have typically expended most of their time with the patients. Therefore nurses have a pivotal position and role to prevent and manage pressure ulcer by making correction through interdisciplinary teamwork. So nurses are in need of complete knowledge to prevent and monitor all conditions associated with pressure ulcer occurrences.
To my best search, there is limited evidence on nurses’ knowledge and its associated factors towards pressure ulcer prevention in Ethiopia as general, and there has been no published data particularly in the study area. Therefore, information emanating from this study will be a valuable reason for the future in developing appropriate educational strategies and training in this area.
Objectives