Implementation of evidence in preventing medical device-related pressure injury in ICU patients using the i-PARIHS framework

J Nurs Manag. 2022 Jan;30(1):318-327. doi: 10.1111/jonm.13458. Epub 2021 Sep 14.

Abstract

Aim: To examine the effectiveness of implementing the evidence in preventing medical device-related pressure injury (MDRPI) in intensive care patients.

Background: MDRPI is a common problem that significantly complicates patients' medical condition. However, evidence in preventing MDRPI is not properly implemented in clinical practice.

Methods: A pre- and post-implementation study was conducted using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. A baseline survey was implemented; barriers and enablers of evidence implementation were analysed to inform facilitation support strategies, such as training nursing staff and developing resources and tools. Changes in nurses, patients and the system were assessed after evidence implementation.

Results: Nurses' knowledge scores and evidence compliance significantly improved. The incidence of MDRPI in patients decreased from 24.39% to 4.26%. Standardized care and workflows to prevent MDRPI were established.

Conclusion: The i-PARIHS framework supported effective implementation of the evidence in preventing MDRPI, narrowing the gap between evidence and clinical practice.

Implications for nursing management: We provide an effective case of transforming evidence into practice based on the i-PARIHS framework. It can be used as a reference for colleagues in intensive care unit (ICU) or other settings to implement MDRPI prevention.

Keywords: evidence-based nursing; intensive care; pressure injury.

MeSH terms

  • Clinical Competence*
  • Critical Care
  • Health Services
  • Humans
  • Intensive Care Units
  • Nurses*
  • Pressure Ulcer*