Current practices to prevent pressure sores in elderly patients in an orthopaedic ward : an observational study

Abstract

This research study explored the current practices to prevent pressure sores in elderly patients situated in one of the orthopaedic wards of the local general hospital in Malta. Pressure sores, constitute a health problem of utmost importance, this is due to the number of people affected worldwide (Lyder, 2002). Prevention is the most efficient method to tackle the problem (EPUAP, 1998), and the quality of nursing care is considered as a key factor in dealing with pressure sores (EPUAP, 1998). A descriptive observational study was chosen to carry out this research project. An observation schedule was adopted to collect the data on the current practices to prevent pressure sores in elderly patients on an orthopaedic ward. In the present study, the local situation was addressed where nurses' behaviour was observed. Additionally, the ward environment was also assessed for factors that may enhance or inhibit optimum practice. Participants were chosen by convenience sampling which included 5 qualified nurses of different age groups, educational background and clinical experience together with 5 patients. A written informed consent was obtained from each of the participants before every observation. Each of the 5 nurses was observed during a morning shift which consists of 6 hours for 5 days. This time of the day was preferred since nursing care is more intense and hectic. Hence, a total of 30 hours of observational data was collected by a non- participant method. Observations were then thoroughly analyzed and data underwent quantitative content analysis. This research study has outlined many factors that need attention such as; the use of risk assessment tools, identification of risk factors, more frequent skin inspection of patients and the use of the right skin applications. Nutrition must also be taken into consideration and turning patients' position must be more frequent so as to avoid direct pressure on bony prominences. Last but not least education given to the patient is very important; but this was not done at all by the participants chosen. The results obtained induced the researcher to put forward some recommendations which include the use of risk assessment tools so as to be able to classify patients according to their needs and requirements. Another recommendation includes the use of clinical expertise which can provide more useful information regarding the management of pressure sores.