Pressure injury prevention practices of intensive care unit nurses in Turkey: A descriptive multiple-methods qualitative study

Objective: To examine the thoughts, deliberations and actual practices of intensive care unit (ICU) nurses regarding pressure injury (PI) prevention.Design: and Methods: This descriptive multi-method qualitative study was conducted using maximum variation sampling. Data were collected through semi-structured non-participating observations and semi-structured face -to-face interviews. The combination of observational and interview data was analysed together with the descriptive content analysis.Findings: Nine nurses were recruited. The main emerged themes were 'heuristic PI risk assessment', 'PI preventive practices' and 'factors affecting preventive practices.' The nurses performed risk assessment based on patients' activity-mobility level, pressure sources, body mass index, skin condition, nutritional issues, comorbidities, admission diagnosis and age. The PI preventive practices for reducing and relieving mechanical load were repositioning, mobilisation, supporting the body parts, measures for medical devices and applying massage. The practices for improving tissue tolerance were skin cleansing and moisturising, preventing excessive moisture and ensuring food intake. However, these measures did not entirely conform to evidence-based recommendations in actual practice. The nurses attributed the divergences to factors affecting their practice. In this respect, the factors affecting preventive practices were the availability of support materials and skincare products, patient/ nurse ratios, the clinical condition of the patient, individual skin characteristics and interdependent nurse roles.Conclusion: ICU nurse practices in PI prevention lack systematic approaches and evidence-based recommenda-tions. These disadvantages emerge as inter-and intra-individual variances in implementing preventive practices in actual practice. Considering these divergences is crucial for the effective management of PI risk.