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Pressure Injury (PI) Risk Assessment


In the article, “Does Conducting a Risk Assessment Facilitate Better Care for Patients at Risk of Pressure Injuries?”, Hödl, Eglseer, and Lohrmann (2019) sought to evaluate whether the use of PI risk assessment is correlated to increased application of international evidence-based guidelines when dealing with patients at risk of PI. For this quantitative study, data were collected using a cross-sectional study that had been conducted in 2007. Hödl et al. (2019) analyzed data obtained from 532 patients aged over 65 years or older and at risk of PI. Data were analyzed statistically using SPSS version 24.0. The results showed that conducting risk assessment among hospitalized patients at risk of PI increased the probability of performing internationally recommended PI preventive interventions, hence improving patient outcomes.

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In the qualitative study, “Barriers and Facilitators to Preventing Pressure Ulcers in Nursing Home Residents: A Qualitative Analysis Informed by the Theoretical Domains Framework”, Lavallée, Gray, Dumville, and Cullum (2018) wanted to understand the context of PI prevention in different nursing home environments and assess facilitators and barriers to evidence-based practices. Data were collected using semi-structured interviews with 25 participants in the North West of England and analyzed using framework analysis. The findings showed four major barriers to evidence-informed practices – environmental contexts and resources, social influence, physical skills, and knowledge. Additionally, six facilitator domains were noted including “interpersonal skills, environmental context and resources, social influences, beliefs about capabilities, beliefs about consequences and social/professional role and identity” (Lavallée et al., 2018, p. 79). The authors concluded that within the context of nursing homes, PI prevention is a complex issue, as it is subject to various factors.

The third article, “Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs”, by Soban, Finley, and Miltner (2016) is a qualitative study that sought to describe the absence or presence of important components of hospital PI prevention strategies in six acute care hospitals. The study design is a multisite comparative study and data were collected using semi-structured face-to-face interviews. Data were analyzed using structured coding of 5 key components of PI prevention strategies and cross-case analysis. The results showed that the sampled hospitals had implemented various components of PI prevention programs even though they varied from one facility to another.

The last article is a quantitative study by Yilmazer, Inkaya, and Tuzer (2019) titled “Care Under the Guidance of Pressure Injury Prevention Protocol: A Nursing Home Sample”. The authors wanted to evaluate how care delivered following the guidance of PI management protocols affects patient outcomes in a nursing home. The study was carried out in four phases – split equally before and after training nurses on PI protocols. Data were collected using socio-demographic forms and analyzed via descriptive statistics. Friedman’s analysis was used to analyze the level of change in nurses’ knowledge scores, especially after the training. The results showed that nurses’ knowledge improved significantly from 8.19±1.83 pre-training to 12.71±2.05 post-training and their frequency to offer preventive care practices also increased after the training. PI incidences dropped from 17.39 per 1000 bed-days pre-training period to 10.87 per 1000-bed days post-training period.

Comparison of the Overall Characteristics

Qualitative and quantitative studies differ in various ways as shown in the four articles used in this paper. First, statistical tests are used to analyze data in quantitative studies while in qualitative studies coding or thematic analyses are used. For example, in their quantitative study, Hödl et al. (2019) used SPSS version 24.0 for statistical analysis and conducted χ2 tests to calculate statistical associations. Similarly, Yilmazer et al. (2019) conducted a quantitative study and used descriptive statistics to assess data. They applied Friedman analysis to test nurses’ knowledge scores, compared frequency of preventive care practices pre-and post-training periods using paired t-test, and evaluated pressure injury incidences using McNemar test. On the other hand, qualitative studies by Lavallée et al. (2018) and Soban et al. (2016) used framework analysis and structured coding, respectively for data analyses. Another difference between qualitative and quantitative studies is in data collection.

In the quantitative study by Hödl et al. (2019), structured questionnaires were used to collect data, whereby respondents had fixed response options while Lavallée et al. (2018) used semi-structured interviews thus giving the respondents the room to explain their answers. Finally, quantitative studies are highly objective, as they offer observed effects of a specified program or strategy on a problem. For example, Yilmazer et al. (2019) analyzed the effect of training nurses on PI protocols on patient outcomes. On the other hand, qualitative studies are subjective, as they describe a problem based on the perspective of those experiencing it. In this case, Lavallée et al. (2018) assessed the barriers and facilitators of PI prevention in a nursing home based on the experiences of the 25 participants who were selected for the study. The only similarity between these qualitative and quantitative studies is that they both produced useful data that could be used to better understand PI prevention programs and improve care outcomes among patients at risk of this health issue.


Hödl, M., Eglseer, D., & Lohrmann, C. (2019). Does conducting a risk assessment facilitate better care for patients at risk of pressure injuries? Advances in Skin & Wound Care, 32(8), 365-369.

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Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2018). Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework. International Journal of Nursing Studies,82, 79-89.

Soban, L. M., Finley, E. P., & Miltner, R. S. (2016). Identifying patterns in implementation of hospital pressure ulcer prevention programs. Journal of Wound, Ostomy and Continence Nursing, 43(3), 248-253.

Yilmazer, T., Inkaya, B., & Tuzer, H. (2019). Care under the guidance of pressure injury prevention protocol: A nursing home sample. British Journal of Community Nursing, 24(12), 26-33.

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