Aim: To examine the effectiveness of a pressure injury prevention program for private for-profit nursing homes.
Design: This study was a two-arm cluster randomized controlled trial. Ten private for-profit nursing homes made up the clusters.
Methods: The participants were nursing home residents who aged 60 or above regardless of whether or not having pre-existing pressure injuries and also three types of nursing home assistants who provided direct care to the residents from 10 private for-profit nursing homes. These 10 nursing homes were randomly assigned to either the experimental or the control group. There were 477 and 536 resident participants and 51 and 62 nursing assistant participants in the experimental and control groups, respectively. The residents were the study participants and the nursing assistant participants were the interveners. The experimental group had the pressure injury prevention program implemented while the control group received the usual care. The primary study outcome which was the pressure injury incidence was analysed by GEE. Significance was set at a p-value of ≤.05. The data were collected between September 2017-March 2018.
Result: There were significant interactive effects of time and group on the incidence of pressure injuries (p = .0015) and on the skill performance of the nursing assistant participants (p < .0001).
Conclusions: An evidence-based pressure injury prevention program reduced the development of the pressure injuries and improved the skill performance of the nursing assistant participants. It is highly recommended that private for-profit nursing homes with high proportion of non-professional nursing assistants and insufficient nurses adopt this program for improving the prevention care of pressure injuries.
Impact: This research has an impact on prevention care of pressure injury in private for-profit nursing homes with high proportion non-professional nursing assistants which have the similar characteristics as the nursing homes studied in various regions and countries.
Trial registration: The Controlled Trial registration ID is NCT02270385.
目的: 探讨私人民营疗养院压力伤害预防方案的效果。 设计: 本研究采取两个治疗组群的随机对照试验。组群由十家私人民营疗养院组成。 方法: 研究受访者是年龄在60岁及60岁以上无论有无压力伤害的疗养院患者,以及为10家私人民营疗养院住院患者提供直接护理的三类疗养院助理。这10所疗养院随机分为实验组和对照组。实验组477人,对照组536人,试验组的助理护士51人,对照组62人。疗养院患者是本次研究的受访者,助理护士是干预者。实验组采取了压力伤害预防方案,对照组采取了常规护理。通过广义估计方程分析压力伤害发生率的主要研究成果。将显著性设为p值≤0.05。收集2017年9月至2018年3月的数据。 结果: 时间和实验组对压力伤害发生率(p =0.0015)和助理护士受访者的技能表现(p <0.0001)存在明显的交互作用。 结论: 循证的压力伤害预防方案减少了压力伤害的发生,提高了助理护士受访者的技能水平。强烈建议非专业助理护士比例高、护士人手不足的私人民营养老院采用本方案,提高对压力伤害的预防护理水平。 影响: 本研究对非专业助理护士比例高的私人民营养老院的压力伤害预防护理有一定的影响,其特点与各地区、国家所研究的养老院特点相似。 试验注册: 试验注册号为NCT02270385。.
Keywords: nursing assistants; nursing home care; pressure injury prevention.
© 2020 John Wiley & Sons Ltd.