Debra Jackson1,2,3, Marie Hutchinson4, Susan Barnason5, William Li6, Judy Mannix7, Stephen Neville8, Donella Piper9, Tamara Power10, Graeme D Smith11, Kim Usher9. 1. Oxford Brookes University, Oxford, UK. djackson@brookes.ac.uk. 2. Oxford University Hospital NHS Foundation Trust, Oxford, UK. djackson@brookes.ac.uk. 3. University of New England, Lismore, New South Wales, Australia. djackson@brookes.ac.uk. 4. Southern Cross University, Lismore, New South Wales, Australia. 5. University of Nebraska Medical Center, Lincoln, Nebraska, USA. 6. The University of Hong Kong, Hong Kong, China. 7. Western Sydney University, Sydney, New South Wales, Australia. 8. Auckland University of Technology, Auckland, New Zealand. 9. University of New England, Lismore, New South Wales, Australia. 10. University of Technology Sydney, Sydney, New South Wales, Australia. 11. Edinburgh Napier University, Scotland, UK.
Abstract
AIMS: To analyse influential policies that inform practice related to pressure injury management in Australia, England, Hong Kong, New Zealand, Scotland and the United States of America. BACKGROUND: Pressure injuries are associated with significant harm to patients, and carry economic consequences for the health sector. Internationally, preventing and managing pressure injuries is a key nursing activity and quality indicator. EVALUATION: Comparative review and synthesis of pressure injury policies that inform practice. KEY ISSUES: The predominant focus of policy is on patient risk assessment, compliance with documentation and pressure relief. Financial penalty for institutions is emerging as a strategy where pressure injuries occur. Comparisons of prevalence rates are hampered by the lack of consensus on data collection and reporting. To date there has been little evaluation of policy implementation and implemented policy strategies, associated guidelines remain founded upon expert opinion and low-level evidence. IMPLICATIONS FOR NURSING MANAGEMENT: The pressure injury policy agenda has fostered a discourse of attention to incidents, compliance and penalty (sanctions). Prevention and intervention strategies are informed by technical and biomedical interpretations of patient risk and harm, with little attention given to the nature or design of nursing work. Considerable challenges remain if this policy agenda is successfully to eliminate pressure injury as a source of patient harm.
AIMS: To analyse influential policies that inform practice related to pressure injury management in Australia, England, Hong Kong, New Zealand, Scotland and the United States of America. BACKGROUND: Pressure injuries are associated with significant harm to patients, and carry economic consequences for the health sector. Internationally, preventing and managing pressure injuries is a key nursing activity and quality indicator. EVALUATION: Comparative review and synthesis of pressure injury policies that inform practice. KEY ISSUES: The predominant focus of policy is on patient risk assessment, compliance with documentation and pressure relief. Financial penalty for institutions is emerging as a strategy where pressure injuries occur. Comparisons of prevalence rates are hampered by the lack of consensus on data collection and reporting. To date there has been little evaluation of policy implementation and implemented policy strategies, associated guidelines remain founded upon expert opinion and low-level evidence. IMPLICATIONS FOR NURSING MANAGEMENT: The pressure injury policy agenda has fostered a discourse of attention to incidents, compliance and penalty (sanctions). Prevention and intervention strategies are informed by technical and biomedical interpretations of patient risk and harm, with little attention given to the nature or design of nursing work. Considerable challenges remain if this policy agenda is successfully to eliminate pressure injury as a source of patient harm.
Authors: Jan Kottner; Elisabeth Hahnel; Andrea Lichterfeld-Kottner; Ulrike Blume-Peytavi; Andreas Büscher Journal: Int Wound J Date: 2017-11-27 Impact factor: 3.315