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To determine the predictors of pressure injuries among residents living in Sri Lankan nursing homes.
A prospective multi-site longitudinal cohort study design.
Semi-structured observations and chart audits were used to gather data on 17 predictors of pressure injury from a consecutive sample of 210 residents (aged ≥ 60 years old) from nine nursing homes in Sri Lanka. Data were collected at baseline and followed up every week until the study endpoint: a new pressure injury or reaching the maximum 12 weeks of data collection, from July to October 2023. Validated semi-structured data collection forms and chart audits were utilised. Binary logistic regression was used to identify the predictors of pressure injuries. Generalised linear mixed models were used to assess the association between predictors and the development of new pressure injuries.
The cumulative incidence of pressure injuries was 17.1% (36/210) during the 12 weeks. The number of medical devices and baseline pressure injuries predicted the development of new pressure injuries. Each additional medical device increased the likelihood of developing a pressure injury by 2.3-fold, and individuals with a baseline pressure injury were 2.1 times more likely to develop a new pressure injury.
Multiple medical devices and baseline pressure injuries are predictors of pressure injury in older residents living in nursing homes.
This study provides evidence of pressure injury predictors among older residents living in nursing homes. Early identification of high-risk residents with an existing pressure injury and those with multiple medical devices is important for nurses and managers at nursing homes. Accurately assessing residents' risk of a pressure injury may result in implementing various preventive strategies that may ultimately help prevent future pressure injuries.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cohort studies guidelines.
No patient or public contribution.
To map the current literature on the characteristics of nurse-related medication errors in perioperative healthcare settings.
A scoping review.
This scoping review used the five-stage framework developed by Arksey and O'Malley (2005). The five stages are: (1) Identifying the Research Question; (2) Identifying Relevant Studies; (3) Study Selection; (4) Charting the Data; and (5) Collating, Summarising, and Reporting the Results. Findings were synthesised using the PAGER framework. An Ishikawa diagram was used to illustrate contributing factors of nurse-related medication errors.
In October 2024, using key search terms, five databases (Scopus, EBSCO Cumulative Index to Nursing and Allied Health Literature, OVID Embase, EBSCO Medline, EBSCO PsycInfo) and two grey literature platforms (opengrey, Policy commons) were searched. The articles were imported to the Covidence database from Endnote after removing duplicate literature. Selected article titles and abstracts, and subsequently full-text articles, were screened by two trained reviewers based on a priori inclusion and exclusion criteria. Data were extracted from the included full-text articles by one author, checked by another, and analysed descriptively.
Of the 967 articles identified through the searches, 7 full-text articles were included. The incidence of nurse-related medication errors in perioperative settings ranged from 6.4% to 33.7%, with errors including incorrect medication routes, missed or delayed doses, and miscommunication-related overdoses. Contributing factors were multifaceted, involving workload pressures, communication failures, system flaws, and organisational influences such as leadership and safety culture.
Medication errors in the perioperative setting pose a significant threat to patient safety yet remain underexplored compared to other healthcare contexts. A holistic approach incorporating human factors frameworks, improved communication, workload management, and leadership can help address the complex causes of these errors and guide targeted interventions to enhance perioperative safety and patient outcomes.
Scoping Reviews (PRISMA-ScR) checklist.
No Patient or Public Contribution.
Open science Framework Website. Registration DOI https://doi.org/10.17605/OSF.IO/EXT8C
Preventing pressure injuries among nursing home residents is a significant challenge that necessitates understanding the barriers and facilitators from the perspective of staff. This qualitative study aimed to describe these factors within Sri Lankan nursing homes. Semi-structured interviews were conducted with 15 nursing home staff members from nine nursing homes in and near the Colombo district, Sri Lanka. The study was informed by the capability, opportunity, motivation, and behaviour model that guided both data collection and analysis. Data were analysed using content analysis. Using deductive coding based on capability, opportunity, and motivation, followed by inductive analysis, four primary categories emerged: focusing on skincare is foundational for pressure injury prevention, pressure injury knowledge is critical for prevention, pressure injury prevention is a low organisational priority, and overcoming challenges to enact pressure injury prevention. Key facilitators included access to skincare products, maintaining clean and dry skin, recognising risk factors, proactively managing risks, and understanding the broader implications of pressure injuries on residents and their families. Conversely, barriers encompassed limited training, varying staff support, inadequate resources, and the complexities of managing multiple tasks. This research highlights that enhancing knowledge and allocating resources effectively can improve the implementation of pressure injury prevention strategies in Sri Lankan nursing homes.
Patient participation improves patient outcomes, but factors that predict participation in pressure injury prevention (PIP) are relatively unknown. This study aimed to identify patient-related factors predictive of patient participation in pressure injury prevention (PPPIP) in hospitalised medical and surgical patients and to assess the psychometric properties of the PPPIP scale. This observational substudy recruited consenting adults at risk of pressure who participated in a parent trial. The seven-item PPPIP scale was administered within 48 h of recruitment, with higher scores reflecting more participation. Multiple regression was used to identify patient-related factors predictive of patient participation. The scale's psychometric properties were assessed using confirmatory factor analysis and Cronbach's alpha. In total, usable data were obtained from 856 patients. Mean PPPIP scale scores were relatively high, with 571 (66.7%) scores reflecting agreement or strong agreement. The Cronbach's alpha was 0.81, and most confirmatory factor analysis criteria for construct validity were met. Only the use of mobility aids was statistically significant in the model, but it predicted a small amount of variability in PPPIP score (adjusted R 2 = 0.017; p < 0.001). Targeting patients with limited mobility may be a useful strategy when trying to engage patients in PIP if resources are limited.
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