Nursing practice in the prevention of pressure ulcers: an observational study of German Hospitals

Aims and objectives The study aimed to establish the range and extent of preventive interventions undertaken by nurses for patients who are at high risk of developing or currently have a pressure ulcer. Background Since 2000, the German National Expert Standard for the prevention of pressure ulcers has provided evidence‐based recommendations, but limited studies have been published on its adherence in hospitals. There are also limited observational studies that investigated whether patients who are at risk of or have pressure ulcers are provided with appropriate preventative measures. Design A nonparticipant observational descriptive design was used. Methods A sample of 32 adult patients who were at high risk of developing or currently had a pressure ulcer were observed during all shifts in medical and surgical wards in two general hospitals in Germany. Results A range of preventive interventions that were in line with the German National Expert Standard was observed. The most frequent preventive measures were ‘cleaning the patients’ skin’ and ‘minimizing exposure to moisture’ that were undertaken in more than 90% of all patients. The least frequent measures were ‘patient and relative education’, ‘assessment and recording of nutritional status’. Conclusion This study demonstrates that the pressure ulcers preventive interventions as set out in the German National Expert Standard were not fully implemented. The study highlights the need for further studies on the barriers that impede the undertaking of the interventions that may prevent the development or deterioration of pressure ulcers and the delivery of evidence‐based preventative care. Relevance to clinical practice This study provides an insight into the extent of pressure ulcers preventive practices used by nurses. The results may serve as a basis for developing an effective strategy to improve nursing practice in this area and the promotion of evidence‐based practice. However, our results refer to two general hospitals and for a broader population, further studies with larger data samples are needed.