ABSTRACT
The objective of this study was to evaluate the effects of nursing intervention based on clinical nursing practice guidelines for pressure ulcer prevention in orthopaedic patients. 30 orthopaedic patients, aged 15 years and over who had risks of pressure ulcers and were admitted to the male orthopaedic ward at Nopparatrajathanee Hospital between January 1st and March 8th, 2003 were enrolled in this study. These 30 patients were divided into 2 groups; 15 patients in the experimental group who received nursing intervention according to the Clinical Nursing Practic Guidelines for Pressure Ulcer Prevention and 15 patients in the control group who received regular nursing care. Data was collected daily beginning at hospital admission until they were discharged from the hospital, referred to other wards or until the patients with no longer at risk of developing a pressure ulcer. The results revealed that most of the orthopaedic patients with risk pressure ulcers were adolescents to middle age adults (15-59 years). Most of them had multiple fractures. The patients in the experimental group developed no pressure ulcers, while 26.7% (4 patients) of patients who received regular nursing care as given by the nursing staff developed pressure ulcers. The patients who developed pressure ulcers had a low to high risk of pressure ulcers (Braden score 12-16) and most of them had high body temperature at initial admission (3 in 4 patients). Pressure ulcers developed on the 4th - 6th day of hospitalization and the severity of the skin lesions progressed from stage 1 to stage 2 or 3 within 2 weeks. The pressure ulcers were located at the coccyx and buttocks. The results indicated that nursing intervention utilizing the Clinical Nursing practice Guidelines for Pressure Ulcer Prevention could prevent pressure ulcers effectively. Developing strategies to implement these guidelines as standard care for orthopaedic patients as well as developing strategies help make this kind of care part of ongoing treatment are strongly recommended. Patients’ and caregivers’ participation should be promoted. The contribution of this finding is also crucial because these guidelines still require feedback to assist in their further improvement.