Barriers and Facilitators to Implementing Pressure Injury Guidelines for Nutrition Assessment and Alternating Pressure Air Mattress Allocation: A Qualitative Study.
Ching Shan Wan, Mika Musgrave-Takeda, Brigid M Gillespie and 2 others
PMID 39936558WHAT IT FOUND
Clinicians described pressure injury prevention being weakened when nutrition screening was incomplete and air mattresses replaced repositioning.
Shared decisions, patient input, ward champions and audits were seen as ways to improve.
Key findings
01Nurses sometimes relied on clinical judgement instead of structured pressure injury and malnutrition screening, and prioritised vital signs over completing risk assessments.
02Air mattresses were sometimes used for patients at low pressure injury risk as a quick fix instead of repositioning, and nurses were overcautious about downgrading them.
03Participants described nurse-led multidisciplinary communication, patient and carer involvement, ward champions, audit and feedback, and ongoing education as ways to support guideline uptake.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was conducted in a single hospital, so it may not match your ward. It included only nurses, dietitians and occupational therapists, not physicians or physiotherapists. The interview guide was not piloted before data collection. It reports clinicians' views, not patient outcomes or whether pressure injuries changed.
Declared interests
The authors declared no conflicts of interest. Funding was provided by St Vincent's Hospital Melbourne and the National Health and Medical Research Council.
The easy way to misread this
Do not read these themes as proof that a pressure injury prevention programme works. The study asked clinicians in a single hospital about barriers and facilitators. It did not test patient outcomes.