Pressure Ulcers as adverse events: patient safety issues, knowledge, attitudes and perceived barriers by nurses in Spain (SECOACBA Project) Pressure ulcers (PUs) are dependence-related injuries. The data on the prevalence of these injuries in the 4th National Prevalence Study in 2013 indicate that these values, far from being reduced, have been doubled, with the highest percentages being found in social and health centres and in the Intensive Care Units (ICUs) of hospital centres. The same study shows that 65% of these injuries are nosocomial, i.e. generated during the stay of people cared for by health professionals. The high percentage of nosocomial lesions found in the prevalence study shows us that it is important to make a “diagnostic analysis” of nurses’ knowledge of UPP prevention. Training is a key part of UPP prevention, however, although an educational programme to prevent UPPs can improve knowledge, it has been observed that after some time, these results are not maintained even at baseline levels. The lack of success of educational interventions in the long term makes us see that it is necessary to consider not only knowledge, but other factors such as attitudes and the existence of other related barriers, such as institutional support or the availability of both material and personal resources. Several studies have been carried out at national level to determine the magnitude and determinants of healthcare risk in Spain, in which the UPPs are present as an adverse effect (AE) related to healthcare. At present, no research has been carried out in the Spanish context to determine the knowledge, perception of patient safety, attitudes and perceived barriers that nursing professionals have in the prevention of UPP. We believe that the study of these variables and their relationship will provide keys to the prevention of the problem of these injuries related to dependence. Objectives: The general objectives are:

  • To establish the level of knowledge, perception of patient safety, attitudes and perceived barriers that nurses have for the prevention of Pressure Ulcers in Spanish hospitals.
  • To identify whether there is any association between nursing staff knowledge, perception of patient safety, attitudes and perceived barriers to the prevention of UP.
  • To identify demographic and formative factors, typical of Nursing professionals that influence their knowledge and attitudes.

The specific objectives are:

  • To develop and validate a questionnaire to measure nurses’ knowledge of pressure ulcer prevention based on updated clinical guidelines.
  • To develop and validate a questionnaire on perceived barriers to pressure ulcer prevention.
  • To validate a Spanish version of the Attitude towards Pressure Ulcer Prevention (APUP) instrument.

Research team:

  • Mª Dolores López Franco (IP). University of Jaén
  • Pedro Luis Pancorbo Hidalgo (co-IP). University of Jaén
  • Francisco Pedro García Fernández. University of Jaén.
  • Leonor Hernández Sánchez. Puerta de Hierro University Hospital.
  • Nerea Rentería López. Marqués de Valdecilla University Hospital.
  • Miguel Ángel Barbas Monjo. Guadarrama Hospital.
  • José María Rumbo Prieto. University Hospital Complex of Ferrol.
  • Aina Serra Blasco. Germans Trias i Pujol Hospital.
  • Ana Cazalla Foncueva. Virgen del Rocío Hospital.
  • Luis Real Lopez. University Hospital of Burgos.

Methodology: The project will be developed through three phases: 1. Development and cultural adaptation of  the instruments:

  • Development of the UPP prevention knowledge questionnaire by reviewing updated clinical practice guidelines and validating content by experts.
  • Development of a questionnaire on barriers to UPP prevention through literature review and validation of content by experts.
  • Translation and cultural adaptation of the Attitude towards Presure ulcer Prevention instrument (APUP).

2. Clinical validation of the instruments at the University Hospital  of Jaén. 3. Field study in a sample of hospitals nationwide.