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Pressure Mapping in Elderly Care: A Tool to Increase Pressure Injury Knowledge and Awareness Among Staff

Hultin, Lisa; Olsson, Estrid; Carli, Cheryl; Gunningberg, Lena

Journal of Wound, Ostomy and Continence Nursing: March/April 2017 - Volume 44 - Issue 2 - p 142–147
doi: 10.1097/WON.0000000000000301
Wound Care

PURPOSE: The purpose of this study was to evaluate the use of a pressure mapping system with real-time feedback of pressure points in elderly care, with specific focus on pressure injury (PI) knowledge/attitudes (staff), interface pressure, and PI prevention activities (residents).

DESIGN: Descriptive, 1-group pretest/posttest study.

SUBJECTS AND SETTING: A convenience sample of 40 assistant nurses and aides participated in the study; staff members were recruited at daytime, and 1 nighttime meeting was held at the facility. A convenience sample of 12 residents with risk for PI were recruited, 4 from each ward. Inclusion criteria were participants older than 65 years, Modified Norton Scale score 20 or less, and in need of help with turning in order to prevent PI. The study setting was a care facility for the elderly in Uppsala, Sweden.

METHODS: A descriptive, comparative pretest/posttest study design was used. The intervention consisted of the use of a pressure mapping system, combined with theoretical and practical teaching. Theoretical and practical information related to PI prevention and the pressure mapping system was presented to the staff. The staff (n = 40) completed the Pressure Ulcer Knowledge and Assessment Tool (PUKAT) and Attitudes towards Pressure Ulcer (APuP) before and following study intervention. Residents' beds were equipped with a pressure mapping system during 7 consecutive days. Peak pressures and preventive interventions were registered 3 times a day by trained study nurses, assistant nurses, and aides.

RESULTS: Staff members' PUKAT scores increased significantly (P = .002), while their attitude scores, which were high pretest, remained unchanged. Peak interface pressures were significantly reduced (P = .016), and more preventive interventions (n = 0.012) were implemented when the staff repositioned residents after feedback from the pressure mapping system.

CONCLUSIONS: A limited educational intervention, combined with the use of a pressure mapping system, was successful as it improved staff members' knowledge about PI prevention, reduced interface pressure, and increased PI prevention activities. As many of the staff members lacked formal education in PI prevention and management, opportunities for teaching sessions and reflection upon PI prevention should be incorporated into the workplace. More research is needed to evaluate the effect of continuous pressure mapping on the incidence of PI.

Lisa Hultin, MNS, Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.

Estrid Olsson, MNS, Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.

Cheryl Carli, PhD, Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden; and University Hospital, Uppsala, Sweden.

Lena Gunningberg, PhD, Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala, Sweden.

Correspondence: Lena Gunningberg, Department of Public Health and Caring Sciences, Uppsala University, Box 256, 751 05 Uppsala, Sweden (lena.gunningberg@pubcare.uu.se).

The authors declare no conflicts of interest.

© 2017 by the Wound, Ostomy and Continence Nurses Society.