Abstract:
Pressure Ulcer (PU) was shown to reduce patient’s quality of life, increase their suffering, health
care costs and their morbidity and mortality rate. Moreover, the incidence and prevalence of
PUs are reported as worldwide health problem nowadays. In Rwanda, little is known regarding
the practice of prevention of PU especially in ICU units where patients are more exposed.
Purpose of the study: The study's goal is to evaluate the nurses' preventive strategies for PU
in ICU at three Rwandan referral hospitals. Methods: The effectiveness of risk assessment and
prevention measures was evaluated using a cross-sectional descriptive design and quantitative
research. In this study, nurses from three referral hospitals in Rwanda who worked in ICU units
were included. The researcher adapted a checklist for data collection based on guidelines for
pressure ulcer risk assessment and prevention from the Canadian Registered Nurses Best
Practice Program. Using SPSS version 25 and both descriptive and inferential statistics tests,
the data were analyzed. Prior data collection, the researcher requested ethical clearance from
UR/IRB and permission from hospitals’ administration as well as the consent from the
participants of this study
. Results: Most participants (57.1%, n=40) were female; 57.1% (n=40)
had advanced diploma, 37.1% (n=26) had bachelor’s degree, masters level were 5.7% (n=4)
and the mean age was 34.5 years old with 24 years old as minimum and 47 years old as
maximum. A high proportion of participants (92.1%, n=68) had not received a training about
pressure ulcers. The average number of patients assigned to nurse was approximately 2 patients
per shift. Majority of nurses (90%, n=63) had lower practice level regarding pressure ulcers
risk assessment while only (10%, n=7) had good practice level. Majority of them (82.9%, n=58)
had lower practice level regarding pressure ulcers prevention while only (17.1%, n=12) had
good practice level. A statistically significant difference between the number of patients under
task and prevention practice level (p<0.05). No statistically difference was found between
practice level and age, gender, education level, training and working experience.
Conclusion
and recommendations: There are gaps towards PU prevention practice among nurses working
in three selected referral hospitals in Rwanda. The level of practice towards PU risk assessment
and PU prevention is low. Many patients assigned to one nurse per shift has been found to be
associated with low practice level. We might recommend measures like staff training,
increasing the number of nursing staff and researches on challenges of PU prevention among
nurses to improve that practice.
