NURSES’ PATTERN OF REPOSITIONING PATIENTS AT-RISK FOR PRESSURE INJURY IN SELECTED WARDS OF THE UNIVERSITY COLLEGE HOSPITAL, IBADAN NIGERIA
Objective: The aim of this study was to examine the nurses’ pattern of repositioning patients at-risk for pressure injury over a three-shift period in selected wards of the University College Hospital (UCH).
Material and methods: In a cross-sectional mixed method (Convergent design), we examined nurses’ self-reported and researcher observed pattern of patients’ repositioning in Intensive Care Units (ICU), Medical and neurological wards of the University College Hospital. A convenient sample of 215(medical surgical 143, Neuro 48, ICU 24) nurses were selected; out of which 20 were observed in a-24 hour 3-shift duty in ICU and Neuro wards. The quantitative data were collected using a validated 43-item structured questionnaire to examine frequency of repositioning on support surfaces, techniques of repositioning of patients and barriers. Data were analyzed using descriptive and inferential statistics at 0.05 % level of significance.
Results: The mean age was 35.9±8.1 years and 107 (50.5) had between 1-5yrs clinical experience. For reported frequency of repositioning, patients on viscoelastic foam mattresses were repositioned 4hourly 82 (39.4%), those on regular mattress were repositioned 2hrly [137 (67.2%)}; and patients on 4inch foam support were mostly repositioned 2hrly [113(54.6%)]. On repositioning technique199 (94.8) dragged while lifting, only 55 (26.4%) reported that head of bed should over 300 while 89 (42.8%) reported that patient should be placed on 900 lateral positions. Observed practice showed that patients were placed at HOB >30o during the 24hr shifts. Patients were less frequently repositioned during the evening and night shifts. Mean duration of repositioning were: morning 4.03±0.3; afternoon 4.33± 0.3 and Night 7.0±0. Pattern or repositioning was significantly associated with unit of practice (χ2= 4.2; p= 0.040; >0.05)
Conclusion: There is a lack of consensus and consistency in the pattern and technique of repositioning of patients to prevent pressure injury. This calls for an established clinical practice guideline in the hospital.