Bedsore prevention was not given priority in the benchmarks used to grade nursing effectiveness and insufficient care and attention was devoted to ensuring that nurses followed standardized preventative procedures. Nurses themselves cited many perceived barriers to being able to take full precautions, including a lack of time, having to work long shifts and being over-tired, and a lack of emphasis on such routine patient care overall.
An important implication of this study is that nursing knowledge does not automatically translate into effective nursing practice. It also shows that an intellectual awareness of the seriousness of a health problem such as bedsores likewise does not cause a behavioral change unless there are radical changes in the nursing environment as a whole, and implementation must be supported on a holistic level.
Overburdened nurses face obstacles that prevent adequate oversight of patients and inhibit the administration routine, essential care, such as the patient being turned in his or her bed, changing of dressings, etcetera.
The only positive news to emerge from the study is that nurses seem to know what needs to be done: the question is: how to improve the chances that they will engage in effective practices? Punitive strategies against nurses seem less likely to be effective than changes in the healthcare system as a whole. An increase in the risk of pressure ulcers is a symptom of wider, systemic problems within healthcare.
Moore Z, Price P. (2004). Nurses attitudes, behaviors and perceived barriers towards pressure ulcer prevention. Journal of Clinical Nursing, 13.