Impact of educational guidelines about prevention of pressure injuries among infants in Intensive Care Unit

Abstract

Most pressure injuries are preventable. Nurses have an essential role in their prevention, but they need to acquire related evidence-based knowledge and skills. The study aim was to evaluate the effectiveness of educational guidelines for pediatric nurses on the prevention of pressure injury (PI) among infants in intensive care unit (ICU). The study was carried out in ICU at El-Monira Children Hospital, affiliated to Cairo University hospitals using quasi-experimental design with pre-post evaluation. It involved 50 pediatric nurses and 50 infants under their care. Infants were 1-12 months old, newly admitted in pediatric intensive care unit (PICU), and connected to a mechanical ventilator. A self-administered questionnaire was used for nurse’s knowledge, an observation checklist for practice, and the PI risk assessment scale. The educational guidelines prepared by the researcher based on assessment information and pertinent literature, and implemented it in small group sessions, and its effects evaluated immediately after, and one-month later. Two-thirds of the infants (64%) were not at risk of PI at the admission and first follow-up days. This was reduced to 56% on day 4. Nurses’ knowledge was deficient in all aspects. In total, only one (2.0%) nurse had satisfactory knowledge before the intervention; this increased to 92.0% at the post-intervention phase, and 78% at follow-up. Moreover, none of the nurses had adequate total practice before the intervention; this rose to 74.0% at the post-intervention and follow-up phases. A higher admission risk score was a protective factor with Odds Ratio (OR) 0.87 for the incidence of pressure injuries, while a higher injury risk score on day 3 was a significant risk factor with OR 1.20. Thus, nurses in PICUs can gain evidence-based knowledge and skills related to PI prevention through simple educational guidelines associated with practical training.