The evaluation of the adherence to the recommended pressure ulcer guidelines within the aged care sector

Pressure ulcers are debilitating, costly and potentially fatal, particularly for the frail and elderly. In addition, pressure ulcer prevalence remains a major concern in both the acute

and aged care sectors. However, the most sobering reality is that the utilisation of recommended clinical practice, at the bedside, has the potential to prevent pressure ulcers.

This thesis reports on a study aimed at establishing the pressure ulcer prevention and management practices of the aged care organisation and nurse within the Queensland aged care sector, including the identification of the enablers and inhibitors.

A mixed method approach utilising questionnaire, audit and focus group was undertaken. The priority of the quantitative data was a key element in the research design, however, a

qualitative approach was used to explore pre-identified quantitative findings. An audit and focus group were conducted in each of the seven aged care facilities and 118 aged care nurses from these aged care facilities provided the data for the survey. A Factor Analysis was the initial step in the statistical analysis of the quantitative data. Furthermore, a thematic approach was utilised to categorise and interpret the qualitative data.

The main findings of this study are: aged care organisational pressure ulcer prevention and management strategies influence the aged care nurses pressure ulcer prevention and management practices; the utilisation of evidence based pressure ulcer prevention and management varied across aged care facilities and the type of pressure ulcer prevention and management strategy; aged care political and economical drivers have a motivational influence on the organisation; and inhibitors (lack of time and resources) and enablers (education, pressure ulcer prevention and management policies and wound champions) moderate pressure ulcer prevention and management practice.

Exploring the pressure ulcer prevention and management practices utilised in the aged care sector has assisted in delineating processes that will encourage the adherence of aged care nurses to the recommended pressure ulcer guidelines. Furthermore, it has become increasingly apparent that organisational pressure ulcer prevention and management strategies play a vital role in the aged care nurse’s pressure ulcer prevention and management practices and that organisational pressure ulcer prevention and management strategies are, in the main, less then ideal.