Nursing team knowledge assessment instruments about pressure injury: integrative review

Main Article Content

Gisele Santana Pereira Carreiro
https://orcid.org/0000-0002-6765-0759
Maria Júlia Oliveira Guimarães Soares
https://orcid.org/0000-0001-8025-9802
Simone Helena Santos Oliveira
https://orcid.org/0000-0002-9556-1403
Ana Elza Oliveira Mendonça
https://orcid.org/0000-0001-9015-211X

Abstract

Objectives: to identify in the scientific literature how the assessment of knowledge of the nursing team about pressure injuries is conducted, which instruments are used, and their psychometric properties. Methods: integrative review conducted with 44 scientific articles. The search was conducted between October and December 2021 in the following data sources: BDENF, Cinahl, Lilacs, MEDLINE, Scopus, Google Scholar, and Web of Science, using the strategy in Portuguese: ("lesão por pressão" OR "úlcera por pressão" OR "úlcera de decúbito" OR "escara de decúbito") AND enfermagem AND conhecimento, and, in English, ("pressure ulcer" OR "bed sore" OR "bed sores" OR bedsore OR bedsores) AND nursing AND knowledge. Articles published between 2012 and November 2021 were included, with text available in full, in open access, in English, Portuguese, or Spanish, resulting from original research related to care in the hospital area. Results: The most used knowledge assessment instrument was the P-PUKT and its versions, used in 50% of the studies, followed by the PUKAT and its versions. Three studies also used instruments constructed and validated by the authors, five qualitative studies, and four studies used non-validated instruments. Conclusion: Valid instruments to assess knowledge are essential to identify possible failures in patient care. Heterogeneity in the samples and in the classification criteria of the participants' level of knowledge made it impossible to compare the results obtained in the studies, constituting a limitation.



Article Details

How to Cite
1.
Carreiro GSP, Soares MJOG, Oliveira SHS, Mendonça AEO. Nursing team knowledge assessment instruments about pressure injury: integrative review. HSJ [Internet]. 2022 Jun. 26 [cited 2024 Nov. 4];12(2):43-60. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1274
Section
ORIGINAL ARTICLE
Author Biographies

Gisele Santana Pereira Carreiro, Federal University of Rio Grande do Norte

Assistant Professor at the Nursing Department at the Federal University of Rio Grande do Norte. PhD student in Nursing at the Federal University of Paraíba.

Maria Júlia Oliveira Guimarães Soares, Federal University of Paraiba

Professor at the Federal University of Paraíba. Professor of the Postgraduate Program in Nursing at the Federal University of Paraíba.

Simone Helena Santos Oliveira, Federal University of Paraiba

Professor at the Technical School in Health at the Federal University of Paraíba. Professor of the Postgraduate Program in Nursing at the Federal University of Paraíba.

Ana Elza Oliveira Mendonça, Federal University of Rio Grande do Norte

Adjunct Professor at the Nursing Department at the Federal University of Rio Grande do Norte.

References

Silva DRA, Bezerra SMG, Costa JP, Luz MHBA, Lopes VCA, Nogueira LT. Pressure ulcer dressings in critical patients: a cost analysis. Rev Esc Enferm USP. 2017;51:e03231. https://doi.org/10.1590/s1980-220x2016014803231

Ferreira DL, Souza ABF, Rodrigues R, Vituri DW, Meier DAP. Incidência de lesão por pressão e medidas preventivas em pacientes críticos. Cienc Cuid Saude. 2018;17(2):1-7. https://doi.org/10.4025/cienccuidsaude.v17i2.41041

Rocha DM, Bezerra SMG, Oliveira AC, Silva JS, Ribeiro IAP, Nogueira LT. Custo da terapia tópica em pacientes com lesão por pressão. Rev Enferm UFPE. 2018;12(10):2555-63. https://doi.org/10.5205/1981-8963-v12i10a237569p2555-2563-2018

Ferreira BEM, Santos DM, Silveira AP, Souza WF, Carniel F. Adesão dos profissionais de enfermagem as metas de segurança da OMS: uma revisão de literatura. REAEnf. 2021;8:e5967. https://doi.org/10.25248/reaenf.e5967.2021

Brasil, Agência Nacional de Vigilância Sanitária. Boletim Segurança do Paciente e Qualidade em Serviços de Saúde nº 20. Brasília, DF: ANVISA; 2018.

Teixeira AKS, Nascimento TS, Sousa ITL, Sampaio LRL, Pinheiro ARM. Incidência de lesões por pressão em Unidade de Terapia Intensiva em hospital com acreditação. ESTIMA. 2017;15(3):152-60. https://doi.org/10.5327/Z1806-3144201700030006

Carvalho F, Donoso MTV, Couto BRGM, Matos SS, Lima LKB, et al. Prevalência de lesão por pressão em pacientes internados em hospital privado do estado de Minas Gerais. Enferm Foco. 2020;10(4):159-64. https://doi.org/10.21675/2357-707X.2019.v10.n4.2269

Zarei E, Madarshahian E, Nikkhah A, Khodakarim S. Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran. J Tissue Viability. 2019;28(2):70-74. https://doi.org/10.1016/j.jtv.2019.02.001

Candaten AE, Boeira YB, Barcellos RA. Incidência de lesões por pressão em pacientes internados em unidades de terapia intensiva. Rev Uningá [Internet]. 2019 [cited 2022 Jun 1];56(S2):30-40. Available from: https://revista.uninga.br/uninga/article/view/1455

Medeiros LNB, Silva DR, Guedes CDFS, Souza TKC, Araújo Neta BPA. Prevalência de úlceras por pressão em unidades de terapia intensiva. Rev Enferm UFPE [Internet]. 2017 [cited 2022 Jun 1];11(7):2697-703. Available from: https://bit.ly/3x5rgE6

Jesus MAP, Pires PS, Biondo CS, Matos RM. Incidência de lesão por pressão em pacientes internados e fatores de risco associados. Rev Baiana Enferm. 2020;34:e36587. https://doi.org/10.18471/rbe.v34.36587

Santos JBS, Souza MAO, Silva APA, Silva MB, Silva VMC, Nogueira RM. Incidência de lesão por pressão em pacientes na unidade de terapia intensiva de um hospital filantrópico. Nursing. 2020;23(265):4233-44. https://doi.org/10.36489/nursing.2020v23i265p4233-4244

Azevedo RF, Garcia RMP, Calasans MT. Knowledge on therapies for pressure ulcer: an integrative review. Rev Rene. 2021;22:e60265. https://doi.org/10.15253/2175-6783.20212260265

Sousa LMM, Marques-Vieira CMA, Severino SSP, Antunes AV. A metodologia da revisão integrativa da literatura em enfermagem. Rev Invest Enferm. 2017 Nov:17-26. Available from: https://bit.ly/3aCuYwb

Melnyk BM, Fineout-Overholt E, Gallagher-Ford L, Kaplan L. The state of evidence-based practice in US nurses: critical implication for nurse's leaders and educators. J Nurs Adm. 2012;42(9):410-17. https://doi.org/10.1097/NNA.0b013e3182664e0a

Araújo TM, Araújo MFM, Barros LM, Oliveira FJG, Silva LA, Caetano JA. Intervenção educativa para avaliação do conhecimento de enfermeiros intensivistas sobre lesão por pressão. Rev Rene. 2019;20:e41359. https://doi.org/10.15253/2175-6783.20192041359

Gul A, Andsoy II, Ozkaya B, Zeydan A. A descriptive, cross-sectional survey of Turkish nurses' knowledge of pressure ulcer risk, prevention, and staging. Ostomy Wound Manage. 2017;63(6):40-46. PMID: 28657899

Khojastehfar S, Najafi GT, Haghani S. Factors related to knowledge, attitude, and practice of nurses in intensive care unit in the area of pressure ulcer prevention: A multicenter study. J Tissue Viability. 2020;29(2):76-81. https://doi.org/10.1016/j.jtv.2020.02.002

Lotfi M, Aghazadeh AM, Asgarpour H, Nobakht A. Iranian nurses' knowledge, attitude and behaviour on skin care, prevention and management of pressure injury: A descriptive cross-sectional study. Nursing Open. 2019;6(4):1600-5. https://doi.org/10.1002/nop2.365

Ilesanmi RE, Ofi BA, Adejumo PO. Nurses' knowledge of pressure ulcer prevention in ogun state, Nigeria: results of a pilot survey. Ostomy Wound Manage. 2012;58(2):24-32. PMID: 22316630

Charalambous C, Koulouri A, Roupa Z, Vasilopoulos A, Kyriakou M, Vasiliou M. Knowledge and attitudes of nurses in a major public hospital in Cyprus towards pressure ulcer prevention. J Tissue Viability. 2019;28(1):40-5. https://doi.org/10.1016/j.jtv.2018.10.005

Rodríguez-Renobato R, Esparza-Acosta GR, González-Flores SP. Conocimientos del personal de enfermería sobre la prevención y el tratamiento de las úlceras por presión. Rev Enferm Inst Mex Seguro Soc [Internet]. 2017 [cited 2022 Jun1];25(4):245-56. Available from: https://bit.ly/3945pUn

Tirgari B, Mirshekari L, Forouzi MA. Pressure injury prevention: knowledge and attitudes of iranian intensive care nurses. Adv Skin Wound Care. 2018;31(4):1-8. https://doi.org/10.1097/01.ASW.0000530848.50085.ef

Beeckman D, Vanderwee K, Demarré L, Paquay L, Van Hecke A, Defloor T. Pressure ulcer prevention: development and psychometric validation of a knowledge assessment instrument. Int J Nurs Stud. 2010;47(4):399-410. https://doi.org/10.1016/j.ijnurstu.2009.08.010

Sengul T, Karadag A. Determination of nurses' level of knowledge on the prevention of pressure ulcers: the case of Turkey. J Tissue Viabil. 2020;29(4):337-41. https://doi.org/10.1016/j.jtv.2020.06.005

Halász GB, Bérešová A, Tkáčová Ľ, Magurová D, Lizáková Ľ. Nurses' knowledge and attitudes towards prevention of pressure ulcers. Int J Environ Res Public Health. 2021;18(4):1705. https://doi.org/10.3390/ijerph18041705

Hu L, Sae-Sia W, Kitrungrote L. Intensive care nurses' knowledge, attitude, and practice of pressure injury prevention in China: a cross-sectional study. Risk Manag Healthc Policy. 2021;14:4257-67. https://doi.org/10.2147/RMHP.S323839

Esan DT, Fasoro AA, Ojo EF, Obialor B. A descriptive, cross-sectional study to assess pressure ulcer knowledge and pressure ulcer prevention attitudes of nurses in a tertiary health institution in Nigeria. Ostomy Wound Manage. 2018;64(6):24-28. https://doi.org/10.25270/owm.2018.6.2428

Kopuz E., Karaca A. Evaluation of nurses' knowledge about risk monitoring and risk prevention for pressure ulcers. Clin Exp Health Sci. 2019;9(2):157-65. https://doi.org/10.33808/clinexphealthsci.563897

Nuru N, Zewdu F, Amsalu S, Mehretie Y. Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC Nurs. 2015;14:34. https://doi.org/10.1186/s12912-015-0076-8

Dlungwane TP. Nurses' knowledge, attitudes and practices regarding pressure ulcer prevention in the Umgungundlovu District, South Africa. AJN. 2020;22(2):17 pages. https://doi.org/10.25159/2520-5293/7691

Martins NBM, Brandão MGSA, Silva LA, Mendes AMV, Caetano JA, Araújo TM, et al. Percepção de enfermeiros de terapia intensiva sobre prevenção de lesão por pressão. Rev Aten Saúde. 2020;18(63):43-51. https://doi.org/10.13037/ras.vol18n63.6270

Barros CIM, Almeida FCA, Guimarães KSL, Cruz RAO, Ferreira TMC. Nascimento WS. Percepção de enfermeiros acerca dos cuidados e a utilização de hidrogel em locais por pressão. Enferm Actual Costa Rica. 2020;39:38-50. https://doi.org/10.15517/revenf.v0i39.39530

Rolim JA, Vasconcelos JMB, Caliri MHL, Santos IBC. Prevenção e tratamento de úlceras por pressão no cotidiano de enfermeiros intensivistas. Rev Rene [Internet]. 2013 [cited 2022 Jun 1];14(1):148-57. Available from: https://bit.ly/3PY04yD

Ferreira TMC, Lima CLJ, Ferreira JDL, Oliveira PS, Agra G, Ferreira IMC, et al. Conhecimento de enfermeiros sobre o uso da colagenase em lesões por pressão. Rev Enferm UFPE on line. 2018;12(1):128-36. https://doi.org/10.5205/1981-8963-v12i1a23190p128-136-2018

Galetto SGS, Nascimento ERP, Hermida PMV, Lazzari DD, Reisdorfer N, Busanello J. Percepção de profissionais de enfermagem sobre lesões por pressão relacionadas a dispositivos médicos. Esc Anna Nery. 2021;25(2):e20200225. https://doi.org/10.1590/2177-9465-ean-2020-0225

Mwebaza I, Katende G, Groves S, Nankumbi J. Nurses' knowledge, practices, and barriers in care of patients with pressure ulcers in a Ugandan teaching hospital. Nurs Res Pract. 2014;2014:973602. https://doi.org/10.1155/2014/973602

França APFM, Rassy MEC, Portilho RCB, Serrão ACFM, França AS, Miranda ESS. Conhecimento de enfermeiros sobre o manejo de lesões por pressão em unidade de terapia intensiva. Rev Eletr Acervo Saúde.2019;11(8):e576. https://doi.org/10.25248/reas.e576.2019

Braquehais AR, Dallarosa FS. Nurse's knowledge on the prevention of ulcers by pressure in a intensive therapy unit. Rev Enferm UFPI. 2016;5(4):13-8. https://doi.org/10.26694/reufpi.v5i4.5426

Ghosh D, Nida Y, Yadav U. A study to assess the knowledge on decubitus ulcer and its management among the staff nurses in selected tertiary care hospital of Moradabad, Uttar Pradesh: a original study. Int J Nurs Edu [Internet]. 2019 [cited 2022 jun 1];11(4):203-6. Available from: https://bit.ly/3z8fgmJ

Albuquerque AM, Souza MA, Torres VSF, Soares MJGO, Torquato IMB. Avaliação e prevenção da úlcera por pressão pelos enfermeiros de terapia intensiva: conhecimento e prática. Rev Enferm UFPE on line. 2014 [cited 2022 jun 1];8(2):229-39. Available from: https://bit.ly/3NNzOov

Fernandes LM, Caliri MHL, Vanderlei JH. Efeito de intervenções educativas no conhecimento dos profissionais de enfermagem sobre prevenção de úlceras pressão. Acta Paul Enferm. 2008;21(2):305-11. Available from: https://bit.ly/3NOIf33

Rabeh SAN, Palfreyman S, Souza CBL, Bernardes RM, Caliri MHL. Cultural adaptation of the Pieper-Zulkowski Pressure Ulcer Knowledge Test for use in Brazil. Rev Bras Enferm. 2018;71(4):1977-84. https://doi.org/10.1590/0034-7167-2017-0029

Fulbrook P, Lawrence P, Miles S. Australian nurses' knowledge of pressure injury prevention and management: a cross-sectional survey. J Wound Ostomy Continence Nurs. 2019;46(2):106-12. https://doi.org/10.1097/WON.0000000000000508

Moreira JVB, Rosa LMF, Soares DJM, Soares TEA. Análise clássica de avaliações: um estudo de caso. Braz J Develop. 2020;6(2):7962-70. https://doi.org/10.34117/bjdv6n2-197

Manderlier B, Van Damme N, Vanderwee K, Verhaeghe S, Van Hecke A, Beeckman D. Development and psychometric validation of PUKAT 2·0, a knowledge assessment tool for pressure ulcer prevention. Int Wound J. 2017;14(6):1041-51. https://doi.org/10.1111/iwj.12758

Ambiel RAM, Carvalho LF. Definições e papel das evidências de validade baseadas na estrutura interna em Psicologia. In: Damasio BF, Borsa JC [Org.]. Manual de desenvolvimento de instrumentos psicológicos. São Paulo,SP: Vetor; 2017. p. 85-100.

Mantovani MF, Sarquis LM, Kalinke LP, Kuznier TP, Pizzolato AC, Mattei AT. Pesquisa metodológica: da teoria à prática. In: Lacerda MR, Ribeiro RP, Costenaro RGS. Metodologia da pesquisa para enfermagem e saúde: da teoria à prática. Porto Alegre,RS: Moriá; 2018. p.151-176.

Catunda HLO, Bernardo EBR, Vasconcelos CTM, Moura ERF, Pinheiro AKB, Aquino PS. Percurso metodológico em pesquisas de enfermagem para construção e validação de protocolos. Texto Contexto Enferm. 2017;26(2):e00650016. https://doi.org/10.1590/0104-07072017000650016

Zhang YB, He L, Gou L, Pei JH, Nan RL, Chen HX, et al. Knowledge, attitude, and practice of nurses in intensive care unit on preventing medical device-related pressure injury: a cross-sectional study in western China. Int Wound J. 2021;18(6):777-86. https://doi.org/10.1111/iwj.13581

Armstrong DG, Meyr A. Basic priciples of wound management. In: Eidt JF, Mills JL, Bruera E. Berman R (Ed). Up to date. 2022 May 31 [cited 2022 Jun 1]. Available from: https://bit.ly/3tazSqN

Galvão NS, Serique MAB, Santos VLCG, Nogueira PC. Knowledge of the nursing team on pressure ulcer prevention. Rev Bras Enferm. 2017;70(2):294-300. https://doi.org/10.1590/0034-7167-2016-0063

Qaddumi J, Khawaldeh A. Pressure ulcer prevention knowledge among Jordanian nurses: a cross-sectional study. BMC Nurs. 2014;13(1):6. https://doi.org/10.1186/1472-6955-13-6

Muhammed EM, Bifftu BB, Temachu YZ. et al. Nurses' knowledge of pressure ulcer and its associated factors at Hawassa University comprehensive specialized hospital Hawassa, Ethiopia. BMC Nurs. 2020;19:51. https://doi.org/10.1186/s12912-020-00446-6

Ebi WE, Hirko GF, Mijena DA. Nurses' knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design. BMC Nurs. 2019;18:20. https://doi.org/10.1186/s12912-019-0346-y

Aydogan S, Caliskan NA. Descriptive study of Turkish intensive care nurses' pressure ulcer prevention knowledge, attitudes, and perceived barriers to care. Wound Manag Prev. 2019;65(2):39-47. PMID: 30730304

Gul A, Andsoy II, Ozkaya B, Zeydan A. A descriptive, cross-sectional survey of turkish nurses' knowledge of pressure ulcer risk, prevention, and staging. Ostomy Wound Manage. 2017;63(6):40-46. PMID: 28657899

Baron MV, Reuter CP, Burgos MS, Cavalli V, Brandenburg C, Krug SBF. Experimental study with nursing staff related to the knowledge about pressure ulcers. Rev Latino-Am Enfermagem. 2016;24:e2831. https://doi.org/10.1590/1518-8345.1134.2831

Hernández RG, Méndez MM, Concepción FHMÁ, González SJF, Castañeda-Hidalgo H, Argumedo PNE. Conocimiento, actitud y barreras en enfermeras hacia las medidas de prevención de úlceras por presión. Cienc Enferm. 2017;23(3):47-58. https://doi.org/10.4067/S0717-95532017000300047

Adriani PA, Paggiaro AO, Ferreira MC, Carvalho VF. Aplicação do pressure ulcer knowledge test em enfermeiros de um hospital de atenção secundária - estudo transversal. Rev Enferm Atual In Derme. 2019;87(25). Available from: https://bit.ly/3m5F3nP

Cracoo LAA, Merli RLS, Lombardi FR, Bacci ACS, Marques SFG. Conhecimento da equipe de enfermagem sobre prevenção, avaliação e tratamento da úlcera por pressão. Rev Estudos Pesquisas [Internet]. 2017; [citado 2020 dez 25];1(1):1-10. Available from: https://bit.ly/39rTEak

Sousa RC, Faustino AM. Conhecimento de enfermeiros sobre prevenção e cuidados de lesão por pressão. R Pesq Cuid Fundam Online. 2019;11(4):992-7. https://doi.org/10.9789/2175-5361.2019.v11i4.992-997

Orosco SS. Conhecimento dos profissionais de enfermagem da unidade de terapia intensiva sobre úlcera por pressão e medidas de prevenção. Enferm Brasil. 2012;11(4):200-9. https://doi.org/10.33233/eb.v11i4.3807

Rocha LES, Ruas EFG, Santos JADS, Lima CA, Carneiro JÁ, Costa FM. Prevenção de úlceras por pressão: avaliação do conhecimento dos profissionais de enfermagem. Cogitare Enferm. 2015;20(3):596-604. https://doi.org/10.5380/ce.v20i3.41750

Cardoso DS, Carvalho FMO, Rocha GB, et al. Conhecimento dos enfermeiros sobre classificação e prevenção de lesão por pressão. Rev Fund Care Online. 2019;11(3):560-6. https://doi.org/10.9789/2175-5361.2019.v11i3.560-566

Crosewski NI, Lemos DS, Mauricio AB, Roehrs H Meier MJ. Conhecimento dos profissionais de enfermagem sobre úlceras por pressão em duas unidades cirúrgicas - parte 1. Cogitare Enferm. 2015;20(1):74-80. https://doi.org/10.5380/ce.v20i1.35097

Lemos DS, Crosewski NI, Mauricio AB, Roehrs H. Conhecimentos dos profissionais de enfermagem relacionados às úlceras por pressão no Centro de Terapia Semi-intensivo. Rev Enferm UFSM. 2014;4(4):751-60. https://doi.org/10.5902/2179769211707

Mauricio AB, Lemos DS, Crosewski NI. Conhecimentos dos profissionais de enfermagem sobre úlceras por Pressão na Clínica Médica. Rev Enferm UFPI. 2014;3(3):5-1. https://doi.org/10.26694/reufpi.v3i3.1773

Tirgari B, Mirshekari L, Forouzi MA. Pressure injury prevention: knowledge and attitudes of iranian intensive care nurses. Adv Skin Wound Care. 2018;31(4):1-8. https://doi.org/10.1097/01.ASW.0000530848.50085.ef