Intervenção educativa para melhorar o conhecimento sobre úlceras por pressão em enfermeiros de Veracruz, México
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Publicado:
Abr 7, 2021
Palavras-chave:
Educação em enfermagem,
pesquisa em educação de enfermagem,
intervenção educacional,
lesão por pressão,
México,
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Resumo
Introdução: No México, as úlceras por pressão (UPP) são um indicador de qualidade no Sistema Nacional de Saúde, sendo relevantes os conhecimentos dos professionais de saúde quanto à abordagem integral das úlceras para o melhoramento da segurança do paciente.
Objetivo: Avaliar a efetividade de uma intervenção educativa como ferramenta para melhorar os conhecimentos de enfermagem na prevenção e tratamento das UPP.
Método: Estudo pré-experimental baseado em uma intervenção educativa aplicada a um grupo com pré e post medição. A amostra esteve constituída por 90 graduados de enfermagem que laboram em hospitais públicos de segundo e terceiro nível de atenção, localizados no porto de Veracruz. Desenharam-se doze sessões de 120 minutos cada uma para a intervenção; nestas foram abordados tópicos de prevenção, cuidado e tratamento das úlceras.
Resultados: A variável prevenção, no indicador adequado segundo com seus conhecimentos, obteve uma média inicial de 74±15 que incrementou na segunda medição para 91±9. t (p=.003). Na variável tratamento, o indicador adequado conforme seus conhecimentos, obteve uma média inicial de 57±16 e na segunda medição passou a 76±9. t (p=.002).
Conclusão: A aplicação da intervenção educativa possibilitou melhorar o conhecimento sobre a prevenção e o tratamento das UPP, embora a utilização na prática assistencial tenha sido menor.
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Dimensions citation
MÉTRICAS
Referências
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2. Tirgari B, Mirshekari L, Forouzi MA. Pressure injury prevention: Knowledge and attitudes of iranian intensive care nurses. Adv Ski Wound Care. 2018; 31(4): 1-8. https://doi.org/10.1097/01.ASW.0000530848.50085.ef
3. Garza-Hernández R, Meléndez-Méndez MC, Fang-Huerta MÁ, González-Salinas JF, Castañeda-Hidalgo H, Argumedo-Pérez NE. Conocimiento, actitud y barreras en enfermeras hacia las medidas de prevención de úlceras por presión. Cienc. enferm. 2017; 23(3): 47-58. http://dx.doi.org/10.4067/S0717-95532017000300047
4. Ortiz-Vargas I, García-Campos ML, Beltrán-Campos V, Gallardo-López F, Sánchez-Espinosa A, Ruiz-Montalvo ME. Cura húmeda de úlceras por presión. Atención en el ámbito domiciliar. Enferm. univ. 2017; 14(4): 243-50. http://dx.doi.org/10.1016/j.reu.2017.09.001
5. Dalvand S, Ebadi A, Gheshlagh RG. Nurses’ knowledge on pressure injury prevention: A systematic review and meta-analysis based on the pressure ulcer knowledge assessment tool. Clin Cosmet Investig Dermatol. 2018; 11: 613-20. https://doi.org/10.2147/CCID.S186381
6. Porter-Armstrong AP, Moore ZE, Bradbury I, McDonough S. Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev. 2018; 5(5): 1-50. https://doi.org/10.1002/14651858.CD011620.pub2
7. Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M. Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review. Int Wound J. 2019; 16(5): 1087-102. https://doi.org/10.1111/iwj.13147
8. Torra-Bou JE, Verdú-Soriano J, Sarabia-Lavin R, Paras-Bravo P, Soldevilla-Ágreda JJ, García-Fernández FP. Las úlceras por presión como problema de seguridad del paciente. Gerokomos. 2016; 27(4): 161-7. https://bit.ly/3b8CSdk
9. Soban LM, Kim L, Yuan AH, Miltner RS. Organisational strategies to implement hospital pressure ulcer prevention programmes: Findings from a national survey. J Nurs Manag. 2017; 25(6): 457-67. https://doi.org/10.1111/jonm.12416
10. González-Méndez MI, Lima-Serrano M, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018; 27(5-6): 1028-37. https://doi.org/10.1111/jocn.14091
11. Magnani-Fernandes L, Larcher-Caliri MH, Haas VJ. Efeito de intervenções educativas no conhecimento dos profissionais de enfemagem sobre prevenção de úlceras pressão. Acta Paul Enferm. 2008; 21(2): 305–11. https://bit.ly/2NvZzzO
12. Gul A, Andsoy II, Ozkaya B, Zeydan A. A descriptive, cross-sectional survey of Turkish nurses’ knowledge of pressure ulcer risk, prevention, and staging. Ostomy Wound Manage. 2017; 63(6): 40-6. https://bit.ly/3qonLTz
13. Usher K, Woods C, Brown J, Power T, Lea J, Hutchinson M, et al. Australian nursing students’ knowledge and attitudes towards pressure injury prevention: A cross-sectional study. Int J Nurs Stud. 2018; 81: 14-20. https://doi.org/10.1016/j.ijnurstu.2018.01.015
14. Secretaria de Salud. Comisión Permanente de Enfermería. Misión. Visión. México: CPE; 2017. https://bit.ly/2ZmDyGl
15. Kim JY, Lee YJ. Medical device-related pressure ulcer (MDRPU) in acute care hospitals and its perceived importance and prevention performance by clinical nurses. Int Wound J. 2019; 16(Suppl 1): 51-61. https://doi.org/10.1111/iwj.13023
16. Miyazaki MY, LArcher-Caliri MH, dos Santos CB. Knowledge on pressure ulcer prevention among nursing professionals. Rev. Latino-Am. Enfermagem. 2010; 18(6): 1203-11. https://doi.org/10.1590/s0104-11692010000600022
17. Souza-Galvão N, Barbosa-Serique MA, de Gouveia-Santos VLC, Nogueira PC. Knowledge of the nursing team on pressure ulcer prevention. Rev Bras Enferm. 2017; 70(2): 294-300. https://doi.org/10.1590/0034-7167-2016-0063
18. Fulbrook P, Lawrence P, Miles S. Australian nurses’ knowledge of pressure injury prevention and management: A cross-sectional survey. J Wound Ostomy Continence Nurs. 2019; 46(2): 106-12. https://doi.org/10.1097/WON.0000000000000508
19. Rodríguez-Renobato R, Esparza-Acosta GR, González-Flores SP. Conocimientos del personal de enfermería sobre la prevención y el tratamiento de las úlceras por presión. Vol. 25, Rev Enferm Inst Mex Seguro Soc. 2017. https://bit.ly/3rRUEYQ
20. Gunningberg L, Mårtensson G, Mamhidir AG, Florin J, Muntlin-Athlin Å, Bååth C. Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: A descriptive, comparative multicentre study in Sweden. Int Wound J. 2015; 12(4): 462-8. https://doi.org/10.1111/iwj.12138
21. De Meyer D, Verhaeghe S, Van Hecke A, Beeckman D. Knowledge of nurses and nursing assistants about pressure ulcer prevention: A survey in 16 Belgian hospitals using the PUKAT 2.0 tool. J Tissue Viability. 2019; 28(2): 59-69. https://doi.org/10.1016/j.jtv.2019.03.002
22. Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised national pressure ulcer advisory panel pressure Injury staging system: Revised pressure injury staging system. J Wound Ostomy Continence Nurs. 2016; 43(6): 585-97. https://doi.org/10.1097/WON.0000000000000281
23. Lee HJ, Ju YJ, Park EC, Kim J, Lee SG. Effects of home-visit nursing services on hospitalization in the elderly with pressure ulcers: A longitudinal study. Eur J Public Health. 2017; 27(5): 822-6. htpps://doi.org/10.1093/eurpub/ckx110
24. Kaddourah B, Abu-Shaheen AK, Al-Tannir M. Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: A cross-sectional study. BMC Nurs. 2016; 15(17): 1-6. https://doi.org/10.1186/s12912-016-0138-6
25. Stadnyk B, Mordoch E, Martin D. Factors in facilitating an organisational culture to prevent pressure ulcers among older adults in health-care facilities. J Wound Care. 2018; 27(Sup 7): S4-S10. https://doi.org/10.12968/jowc.2018.27.Sup7.S4
26. Shanley E, Moore Z, Patton D, O´Connor T, Avsar P, Nugent L, et al. Development and psychometric evaluation of the patient knowledge of, and attitudes and behaviours towards pressure ulcer prevention instrument (KPUP). Int Wound J. 2019; 17(2): 339-50. https://doi.org/10.1111/iwj.13278
27. Suva G, Sharma T, Campbell KE, Sibbald RG, An D, Woo K. Strategies to support pressure injury best practices by the inter-professional team: A systematic review. Int Wound J. 2018; 15(4): 580-9. https://doi.org/10.1111/iwj.12901
28. Pool IA, Poell RF, ten Cate TJ. Perspectives on age and continuing professional development for nurses: A literature review. VOCAT LEARN. 2013; 297-321. https://doi.org/10.1007/s12186-013-9096-2
29. Fernández-Sánchez H, Guzmán-Facundo FR, Herrera-Medina D, Sidani S. Importancia del estudio piloto en un proyecto de intervención. Index enferm. 2021; (Preedición): e12860. https://bit.ly/2NalxbX
30. Sidani S, Braden CJ. Design, Evaluation, and Translation of Nursing Interventions. Nueva Jersey: Wiley-Blackwell; 2011. https://doi.org/10.1002/9781118785553
31. Pancorbo-Hidalgo PL, García-Fernández FP, López-Medina IM, López-Ortega J. Pressure ulcer care in Spain: nurses’ knowledge and clinical practice. J Adv Nurs. 2007; 58(4): 327-38. https://doi.org/10.1111/j.1365-2648.2007.04236.x
32. Secretaría de Salud. Ley General de Salud. México: Diario Oficial de la Federación (DOF); 2021(última reforma). https://bit.ly/3dfpzdP
33. Baron MV, Reuter CP, Burgos MS, Cavalli V, Brandenburg C, Frantz-Krug SB. Experimental study with nursing staff related to the knowledge about pressure ulcers. Rev. Latino-Am. Enfermagem. 2016; 24: e2831. http://dx.doi.org/10.1590/1518-8345.1134.2831
34. Pancorbo-Hidalgo PL, García-Fernández FP, Rodríguez-Torres MC, Torres-García M, López-Medina MI. Conocimientos y creencias de las enfermeras sobre el cuidado de las úlceras por presión: revision sistemática de la literatura. Gerokomos. 2007; 18(4): 30-8. https://bit.ly/3dk15A3
35. Hommel A, Gunningberg L, Idvall E, Bååth C. Successful factors to prevent pressure ulcers-an interview study. J Clin Nurs. 2017; 26(1-2): 182-9. https://doi.org/10.1111/jocn.13465
2. Tirgari B, Mirshekari L, Forouzi MA. Pressure injury prevention: Knowledge and attitudes of iranian intensive care nurses. Adv Ski Wound Care. 2018; 31(4): 1-8. https://doi.org/10.1097/01.ASW.0000530848.50085.ef
3. Garza-Hernández R, Meléndez-Méndez MC, Fang-Huerta MÁ, González-Salinas JF, Castañeda-Hidalgo H, Argumedo-Pérez NE. Conocimiento, actitud y barreras en enfermeras hacia las medidas de prevención de úlceras por presión. Cienc. enferm. 2017; 23(3): 47-58. http://dx.doi.org/10.4067/S0717-95532017000300047
4. Ortiz-Vargas I, García-Campos ML, Beltrán-Campos V, Gallardo-López F, Sánchez-Espinosa A, Ruiz-Montalvo ME. Cura húmeda de úlceras por presión. Atención en el ámbito domiciliar. Enferm. univ. 2017; 14(4): 243-50. http://dx.doi.org/10.1016/j.reu.2017.09.001
5. Dalvand S, Ebadi A, Gheshlagh RG. Nurses’ knowledge on pressure injury prevention: A systematic review and meta-analysis based on the pressure ulcer knowledge assessment tool. Clin Cosmet Investig Dermatol. 2018; 11: 613-20. https://doi.org/10.2147/CCID.S186381
6. Porter-Armstrong AP, Moore ZE, Bradbury I, McDonough S. Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev. 2018; 5(5): 1-50. https://doi.org/10.1002/14651858.CD011620.pub2
7. Gaspar S, Peralta M, Marques A, Budri A, Gaspar de Matos M. Effectiveness on hospital-acquired pressure ulcers prevention: a systematic review. Int Wound J. 2019; 16(5): 1087-102. https://doi.org/10.1111/iwj.13147
8. Torra-Bou JE, Verdú-Soriano J, Sarabia-Lavin R, Paras-Bravo P, Soldevilla-Ágreda JJ, García-Fernández FP. Las úlceras por presión como problema de seguridad del paciente. Gerokomos. 2016; 27(4): 161-7. https://bit.ly/3b8CSdk
9. Soban LM, Kim L, Yuan AH, Miltner RS. Organisational strategies to implement hospital pressure ulcer prevention programmes: Findings from a national survey. J Nurs Manag. 2017; 25(6): 457-67. https://doi.org/10.1111/jonm.12416
10. González-Méndez MI, Lima-Serrano M, Martín-Castaño C, Alonso-Araujo I, Lima-Rodríguez JS. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018; 27(5-6): 1028-37. https://doi.org/10.1111/jocn.14091
11. Magnani-Fernandes L, Larcher-Caliri MH, Haas VJ. Efeito de intervenções educativas no conhecimento dos profissionais de enfemagem sobre prevenção de úlceras pressão. Acta Paul Enferm. 2008; 21(2): 305–11. https://bit.ly/2NvZzzO
12. Gul A, Andsoy II, Ozkaya B, Zeydan A. A descriptive, cross-sectional survey of Turkish nurses’ knowledge of pressure ulcer risk, prevention, and staging. Ostomy Wound Manage. 2017; 63(6): 40-6. https://bit.ly/3qonLTz
13. Usher K, Woods C, Brown J, Power T, Lea J, Hutchinson M, et al. Australian nursing students’ knowledge and attitudes towards pressure injury prevention: A cross-sectional study. Int J Nurs Stud. 2018; 81: 14-20. https://doi.org/10.1016/j.ijnurstu.2018.01.015
14. Secretaria de Salud. Comisión Permanente de Enfermería. Misión. Visión. México: CPE; 2017. https://bit.ly/2ZmDyGl
15. Kim JY, Lee YJ. Medical device-related pressure ulcer (MDRPU) in acute care hospitals and its perceived importance and prevention performance by clinical nurses. Int Wound J. 2019; 16(Suppl 1): 51-61. https://doi.org/10.1111/iwj.13023
16. Miyazaki MY, LArcher-Caliri MH, dos Santos CB. Knowledge on pressure ulcer prevention among nursing professionals. Rev. Latino-Am. Enfermagem. 2010; 18(6): 1203-11. https://doi.org/10.1590/s0104-11692010000600022
17. Souza-Galvão N, Barbosa-Serique MA, de Gouveia-Santos VLC, Nogueira PC. Knowledge of the nursing team on pressure ulcer prevention. Rev Bras Enferm. 2017; 70(2): 294-300. https://doi.org/10.1590/0034-7167-2016-0063
18. Fulbrook P, Lawrence P, Miles S. Australian nurses’ knowledge of pressure injury prevention and management: A cross-sectional survey. J Wound Ostomy Continence Nurs. 2019; 46(2): 106-12. https://doi.org/10.1097/WON.0000000000000508
19. Rodríguez-Renobato R, Esparza-Acosta GR, González-Flores SP. Conocimientos del personal de enfermería sobre la prevención y el tratamiento de las úlceras por presión. Vol. 25, Rev Enferm Inst Mex Seguro Soc. 2017. https://bit.ly/3rRUEYQ
20. Gunningberg L, Mårtensson G, Mamhidir AG, Florin J, Muntlin-Athlin Å, Bååth C. Pressure ulcer knowledge of registered nurses, assistant nurses and student nurses: A descriptive, comparative multicentre study in Sweden. Int Wound J. 2015; 12(4): 462-8. https://doi.org/10.1111/iwj.12138
21. De Meyer D, Verhaeghe S, Van Hecke A, Beeckman D. Knowledge of nurses and nursing assistants about pressure ulcer prevention: A survey in 16 Belgian hospitals using the PUKAT 2.0 tool. J Tissue Viability. 2019; 28(2): 59-69. https://doi.org/10.1016/j.jtv.2019.03.002
22. Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised national pressure ulcer advisory panel pressure Injury staging system: Revised pressure injury staging system. J Wound Ostomy Continence Nurs. 2016; 43(6): 585-97. https://doi.org/10.1097/WON.0000000000000281
23. Lee HJ, Ju YJ, Park EC, Kim J, Lee SG. Effects of home-visit nursing services on hospitalization in the elderly with pressure ulcers: A longitudinal study. Eur J Public Health. 2017; 27(5): 822-6. htpps://doi.org/10.1093/eurpub/ckx110
24. Kaddourah B, Abu-Shaheen AK, Al-Tannir M. Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: A cross-sectional study. BMC Nurs. 2016; 15(17): 1-6. https://doi.org/10.1186/s12912-016-0138-6
25. Stadnyk B, Mordoch E, Martin D. Factors in facilitating an organisational culture to prevent pressure ulcers among older adults in health-care facilities. J Wound Care. 2018; 27(Sup 7): S4-S10. https://doi.org/10.12968/jowc.2018.27.Sup7.S4
26. Shanley E, Moore Z, Patton D, O´Connor T, Avsar P, Nugent L, et al. Development and psychometric evaluation of the patient knowledge of, and attitudes and behaviours towards pressure ulcer prevention instrument (KPUP). Int Wound J. 2019; 17(2): 339-50. https://doi.org/10.1111/iwj.13278
27. Suva G, Sharma T, Campbell KE, Sibbald RG, An D, Woo K. Strategies to support pressure injury best practices by the inter-professional team: A systematic review. Int Wound J. 2018; 15(4): 580-9. https://doi.org/10.1111/iwj.12901
28. Pool IA, Poell RF, ten Cate TJ. Perspectives on age and continuing professional development for nurses: A literature review. VOCAT LEARN. 2013; 297-321. https://doi.org/10.1007/s12186-013-9096-2
29. Fernández-Sánchez H, Guzmán-Facundo FR, Herrera-Medina D, Sidani S. Importancia del estudio piloto en un proyecto de intervención. Index enferm. 2021; (Preedición): e12860. https://bit.ly/2NalxbX
30. Sidani S, Braden CJ. Design, Evaluation, and Translation of Nursing Interventions. Nueva Jersey: Wiley-Blackwell; 2011. https://doi.org/10.1002/9781118785553
31. Pancorbo-Hidalgo PL, García-Fernández FP, López-Medina IM, López-Ortega J. Pressure ulcer care in Spain: nurses’ knowledge and clinical practice. J Adv Nurs. 2007; 58(4): 327-38. https://doi.org/10.1111/j.1365-2648.2007.04236.x
32. Secretaría de Salud. Ley General de Salud. México: Diario Oficial de la Federación (DOF); 2021(última reforma). https://bit.ly/3dfpzdP
33. Baron MV, Reuter CP, Burgos MS, Cavalli V, Brandenburg C, Frantz-Krug SB. Experimental study with nursing staff related to the knowledge about pressure ulcers. Rev. Latino-Am. Enfermagem. 2016; 24: e2831. http://dx.doi.org/10.1590/1518-8345.1134.2831
34. Pancorbo-Hidalgo PL, García-Fernández FP, Rodríguez-Torres MC, Torres-García M, López-Medina MI. Conocimientos y creencias de las enfermeras sobre el cuidado de las úlceras por presión: revision sistemática de la literatura. Gerokomos. 2007; 18(4): 30-8. https://bit.ly/3dk15A3
35. Hommel A, Gunningberg L, Idvall E, Bååth C. Successful factors to prevent pressure ulcers-an interview study. J Clin Nurs. 2017; 26(1-2): 182-9. https://doi.org/10.1111/jocn.13465
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