Background

Pressure ulcers are a complex healthcare issue. Hospital-acquired pressure ulcers are used as proxy measurements for the quality and safety of nursing care. Medical device-related pressure ulcers are mostly facility acquired, but their reporting has only recently been widely adopted. Consequently, we do not yet know what factors impact their reporting by registered nurses.

Objectives

To identify and systematically report determinants of the practice of medical device-related pressure ulcers reporting using the Tailored Implementation for Chronic Diseases checklist.

Design

Descriptive, explorative design using semi-structured interviews to explore barriers and facilitators to reporting medical device-related pressure ulcers.

Setting

We undertook online, telephone, and face-to-face interviews with participants from 11 different countries.

Participants

We interviewed 17 participants who represented acute care (Adult, Paediatrics), academia, and industry. Eleven participants were healthcare professionals with more than 10 years' experience in wound care.

Methods

The interview recordings were transcribed and coded by the lead researcher. Data were analysed thematically using the codebook approach, and themes were developed inductively and deductively.

Results

Participants identified determinants of practice which clustered around four domains of the Tailored Implementation for Chronic Diseases checklist i) individual health professional factors, ii) professional interactions, iii) incentives and resources, and iv) capacity for organisational change. Knowledge, attitudes, workload, time, staffing, and perception of consequences, including financial, were identified as the main barriers to reporting. Factors supporting the practice were education, openness, and teamwork. Device procurement could take on characteristics of a barrier or facilitator depending on the organisation.

Conclusions

Reporting medical device-related pressure ulcers has been adopted in healthcare institutions worldwide. Understanding what drives the reporting practice enables improvements in incident reporting, which consequently can lead to improvements in the quality of nursing care and patient safety.

中文翻译：

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报告医疗器械相关压疮的障碍和促进因素：国际实践的定性探索

背景

压疮是一个复杂的医疗保健问题。医院获得性压疮被用作护理质量和安全性的替代指标。与医疗器械相关的压疮大多是设施获得的，但它们的报告直到最近才被广泛采用。因此，我们还不知道哪些因素会影响注册护士的报告。

目标

使用慢性病定制实施清单识别和系统报告医疗器械相关压疮报告实践的决定因素。

设计

描述性、探索性设计，使用半结构化访谈来探索报告医疗器械相关压疮的障碍和促进因素。

环境

我们对来自 11 个不同国家的参与者进行了在线、电话和面对面的采访。

参与者

我们采访了代表急症护理（成人、儿科）、学术界和工业界的 17 名参与者。11 名参与者是拥有超过 10 年伤口护理经验的医疗保健专业人员。

方法

访谈记录由首席研究员转录和编码。使用密码本方法对数据进行主题分析，并以归纳和演绎的方式开发主题。

结果

参与者确定了实践的决定因素，这些决定因素集中在慢性病定制实施清单的四个领域：i) 个人卫生专业因素，ii) 专业互动，iii) 激励和资源，以及 iv) 组织变革的能力。知识、态度、工作量、时间、人员配备和对后果的看法，包括财务，被确定为报告的主要障碍。支持这种做法的因素是教育、开放和团队合作。根据组织的不同，设备采购可能具有障碍或促进者的特征。

结论

报告与医疗器械相关的压疮已被全球医疗机构采用。了解推动报告实践的因素可以改进事件报告，从而提高护理质量和患者安全。