Assessment of prevention practices towards pressure ulcers in ICU by nurses at selected Referral Hospitals in Rwanda

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.