| Objective:This study aimed to evaluate the gap between the current practice of pressure injury prevention in nursing homes and the best evidence,to apply the evidence-based practice program for pressure injury prevention to the nursing homes,and to explore its application effect.Methods:This study used the Ottawa research model to conduct a quasi-experimental study,using convenience sampling method to select the nursing assistants and the elderly as the subjects in two residential buildings of a nursing home in Shenyang from June 2022 to January 2023.By analyzing the barriers and promoting factors of evidence-based practice,this study formulated reform strategies and an action plan,and introduced them into the nursing home,including training of nursing assistants,health education for the elderly and their families.Norton scale,the questionnaire of nursing assistants’knowledge and behavior of pressure injury prevention constructed by the research group and the nursing record and review form constructed in this study were used to compare the differences before and after evidence-based practice.This study used the purpose sampling method to select the nursing assistants as the subjects,using semi-structured interview method to collect their experiences.IBM SPSS25.0 was used for the analysis of the data.The X±S,median and quartile range,frequency and percentage were used for statistical description.Paired t test,Wilcoxon rank sum test,X~2test,Fisher’s exact probability test and Mann-Whitney U test were used for statistical analysis,and P<0.05 was considered statistically significant to compare the differences before and after evidence-based practice.Qualitative data were extracted by content analysis.Results:(1)Nursing assistants:A total of 45 nursing assistants participated in this study,and there was no statistical difference in general data before and after evidence-based practice(P>0.05).After evidence-based practice,the nursing assistants’pressure injury prevention knowledge score increased from(20.78±4.64)points to(26.78±1.13)points,and the behavior score increased from(75.34±7.31)points to(93.39±2.87)points,with statistical differences(P<0.001).20 indicators’implementation rates were improved,12 of them with statistical differences(P<0.05).Four themes were extracted from the qualitative interview:passivity and resistance,anxiety and anxiety relief,adaptation and participation,and active coping and reflection.(2)The elderly and their families:A total of 86 elderly people participated in the study,and there was no statistical difference in general data before and after this study(P>0.05).After this study,the score of Norton Scale of the elderly increased from(11.64±3.61)points to(13.44±2.45)points,the pressure injury risk decreased,and the elderly at high risk decreased from 48 to 34,with statistical differences(P<0.05).6 indicators’implementation rates were improved,all of them with statistical differences(P<0.05).(3)System management:After this study,14indicators’implementation rates were improved,and 12 of them reached 100.0%.Conclusion:1.This study under the Ottawa research model,followed the evidence-based practice process to carry out.Based on the baseline survey results,the risk assessment form,nursing record form,health education manual,review sheet,etc,were designed.At the same time,multidisciplinary cooperation was carried out to ensure the implementation of evidence-based practice program for the prevention of pressure injury in elderly people in nursing homes.2.The introduction of evidence-based practice program can improve the knowledge and behavior level of pressure injury prevention of nursing assistants,reduce the risk level and incidence of pressure injury of the elderly,and improve the pressure injury prevention management mode of nursing homes.3.The review form,health manual,publicity posters and training videos constructed in this study can provide reference for more nursing homes to carry out the prevention of pressure injury. |
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