A qualitative study of the thoughts and experiences of hospital nurses providing pressure injury prevention and management

Background: Hospital-acquired pressure injuries are a quality indicator in healthcare, including nursing care. Successful implementation of interventions to prevent pressure injuries can be impeded by factors beyond the control of nursing staff. Limited research exists on nurses' experiences of providing pressure injury prevention and management in a hospital setting. Aim: To gain an in-depth understanding of nurses' experiences concerning pressure injury prevention and management in a hospital setting. Methods: A qualitative study design was employed. The purposive sample consisted of twenty nurses working in units with a high incidence of pressure injuries across a local health district in Sydney, Australia. Participants were interviewed between May and September 2016, either individually or as a group using semi-structured interviews. Findings: Four themes were identified that captured the experiences of nurses providing pressure injury prevention and management in a hospital setting: "managing competing demands in complex clinical settings"; "the importance of knowledge and skill"; "clarifying organisational expectations, purpose and successes"; and "feeling ethically challenged when unable to provide quality patient care". Discussion: Participants were aware of the importance of pressure injury prevention and management but found it difficult to provide quality care due to competing priorities and challenges faced at both an organisational and patient level. Conclusion: Pressure injury prevention and management is just one aspect of patient care and should not be considered on its own to change existing practice. Participants wanted to implement preventative strategies and provide optimal pressure injury care, however, complexities associated with a hospital setting hindered this process. Hospitals need to put measures in place that support and enable nurses to deliver the quality care required to prevent and manage pressure injuries. (C) 2018 Australian College of Nursing Ltd. Published by Elsevier Ltd.