Background: Hospital-acquired pressure injuries (PIs) are mostly preventable adverse events that increase patients’ pain, morbidity, and hospital length of stay. While 90% of adult patients in Alberta hospitals are assessed for PI risk, 18% experience a PI. We aimed to identify barriers and facilitators influencing the implementation of PI prevention (PIP) strategies for the care of adult inpatients, through a theoretically-informed implementation-science lens.
Materials and Methods: This nursing-led research involved interpretive description and semi-structured interviews with multidisciplinary providers. A semi-structured question guide queried perceptions on current PIP practices, risk assessment and perceived challenges and opportunities. Interviews were audio recorded, transcribed verbatim and independently coded by two researchers. Codes were both deductively mapped to the Theoretical Domains Framework (TDF) and inductively themed; both deductive and inductive approaches were bridged into an overarching thematic framework by four researchers.
Results: Twenty-two interviews with multidisciplinary providers were completed (health care aides, managers, nurses, occupational therapists and wound care specialists) at five diverse adult inpatient units throughout Alberta. Themes that emerged were: culture and context, equipment and resources, process models and best practices, communication, frontline staff, specialized staff, patient and family engagement, patient complexity, leveraging opportunities, and negative outcomes.
Conclusions: This study identified numerous barriers and facilitators to PIP in frontline clinical practice and at the organizational level. Nursing researchers will collaborate with leadership and local champions to develop targeted strategies to overcome the identified barriers.
