The retention effect of staff education programme: Sustaining a decrease in hospital-acquired pressure ulcers via culture of care integration.

Hospital-acquired pressure ulcers (HAPUs) negatively affect patients during hospitalisation, putting patients at risk for further complications. HAPUs are one of the hospital quality key performance indicators (KPIs) that necessitate quality initiatives and/or programmes to minimise its occurrence and consequences. When quality initiatives are put into place and proven effective, the next important focus is sustainability of the effects. The original Saudi Arabian study based on data collected from 50 441 patients, showed that implementation of the pressure ulcer prevention programme (PUPP) was successful showing a statistically significant reduction of HAPUs from 0.20% in 2014 to 0.06% in 2018 (P value <.001). The aim of this follow-up check of the original study was to assess if the PUPP's effectiveness success was retained. Also, to try and determine why the implemented quality improvement programme to prevent HAPUs was so successfully retained. Designed and conducted as a systemic review, it tracked the outcomes of pressure ulcer rates during and post PUPP implementation that mostly focused on evidence-based staff education, concentrating on years 2016 to 2018. Statistically significant reductions were captured by data that have been presented through Pearson Chi squares. HAPU decline was notable between year 2017 and 2018. This was followed by a further reduction in year 2018. The results determine retention effect sustainability of the initial positive results achieved. By doing so, the study was further able to establish that the PUPP had been integrated into the hospital system's care culture as evidenced by the reduction of HAPUs despite a large inpatient growth. Consideration of what contributing factors led to this successful integration of new knowledge into the care culture are also examined. KPIs can be used as indicators to help reinforce staff education. Culture of care (support of values and interventions taught during the PUPP) offer hope that these may be duplicated in future improvement projects. The supportive nature of a given culture of care may in fact be just as important as the practical education provided to staff members.

Hospital-acquired pressure ulcer incident rates among hospitals that implement an education program for staff, patients, and family caregivers inclusive of an after discharge follow-up program in Saudi Arabia.

A tertiary public hospital in Saudi Arabia set out in 2015 to establish a team focused on reducing hospital-acquired pressure ulcers (HAPUs). The pressure ulcer prevention program (PUPP) had a multifaceted approach and data were collected for a period of 5 years. The results showed a definite reduction in the incidences of HAPUs. Many such programs show similar positive results and echo many of the same considerations of risk, prevention strategies, and the need for early intervention. However, none of the other studies either replicate the hospital's PUPP nor the extent of the positive and lasting effect of the program. Eager to determine the contributing factor(s) in order that the project success could be continued and possibly replicated in other quality improvement projects, it was decided that an examination and comparison of other similar programs and their results would be necessary in order to uncover the answer. It was determined that the in-person in-home discharge follow-up portion of the program most likely had the largest effect on the outcomes. Outcomes that were supported by the pre-work completed during the hospital portion of the PUPP towards reducing HAPUs and readmissions.

Nursing Surge Capacity Strategies for Management of Critically Ill Adults with COVID-19.

Background: There is a vital need to develop strategies to improve nursing surge capacity for caring of patients with coronavirus (COVID-19) in critical care settings. COVID-19 has spread rapidly, affecting thousands of patients and hundreds of territories. Hospitals, through anticipation and planning, can serve patients and staff by developing strategies to cope with the complications that a surge of COVID-19 places on the provision of adequate intensive care unit (ICU) nursing staff-both in numbers and in training. Aims: The aim is to provide an evidence-based starting point from which to build expanding staffing models dealing with these additional demands. Design/Method: In order to address and develop nursing surge capacity strategies, a five-member expert panel was formed. Multiple questions directed towards nursing surge capacity strategies were posed by the assembled expert panel. Literature review was conducted through accessing various databases including MEDLINE, CINAHL, Cochrane Central, and EMBASE. All studies were appraised by at least two reviewers independently using the Joanna Briggs Institute JBI Critical Appraisal Tools. Results: The expert panel has issued strategies and recommendation statements. These proposals, supported by evidence-based resources in regard to nursing staff augmentation strategies, have had prior success when implemented during the COVID-19 pandemic. Conclusion: The proposed guidelines are intended to provide a basis for the provision of best practice nursing care during times of diminished intensive care unit (ICU) nursing staff capacity and resources due to a surge in critically ill patients. The recommendations and strategies issued are intended to specifically support critical care nurses incorporating COVID-19 patients. As new knowledge evidence becomes available, updates can be issued and strategies, guidelines and/or policies revised. Relevance to Clinical Practice: Through discussion and condensing research, healthcare professionals can create a starting point from which to synergistically develop strategies to combat crises that a pandemic like COVID-19 produces.