Goiânia, 07 de novembro de 2005.
PRESSURE ULCER PREVENTION IN HOMECARE: CONTRIBUTION OF PROTOCOL
Lídice Maria Chaves
Mieke Grypdonck
Tom Defloor
Objective: The purpose of the study is to gain a better insight into the availability and quality of protocols on prevention of pressure ulcers in home care in the Netherlands. Design: A descriptive study with quantitative approach is used.
Setting and Subjects: 41 home care institutions in the Netherlands that provide nursing care and have a pressure ulcer prevention protocol.
Instruments: A structured questionnaire containing 46 mostly closed questions.
A checklist for experts to analyze the protocols with respect to conformity to guidelines. A score list to analyze the experts reviews.
Methods: A questionnaire was mailed to all home care institutions providing nursing care in the Netherlands. The responses to the questionnaire were analyzed using descriptive statistics.
The quality of each protocol was judged and scored by three experts. The scores were analyzed using quantitative and descriptive statistics.
Results: A pressure ulcer protocol is available in 78% of the institutions. 75% have at least one pressure ulcer nurse who spends an average of 10 hours per week on pressure ulcers. In 20% of the cases no introduction or instruction was given to the nurses when the protocol came into effect. In 25% of the cases no nurses participated in the revision of the protocol. At the end of 2003 only 13% of the institutions had executed one or more revisions of their protocol since 1992, the introduction of the previous Dutch pressure ulcer (prevention) protocol. The 26 checked pressure ulcer prevention protocols have a total average score of 47 points from a maximum of 100 points (47%). The difference in total scores goes from a protocol with a minimum of 9 points to a protocol with a maximum of 82 points.
Conclusions: Although the use of protocols is considered important in the prevention of pressure ulcers, 22 % of the institutions do not have a pressure ulcer (prevention) protocol. The introduction to and revision of pressure ulcer protocols need to be improved. Only 75% of the institutions have pressure ulcer nurses. The total scores itself and the difference in scores of the checked protocols shows a lot of room for improvement.