Clinical Settings, Manual Pressure Ulcer, NCK Guidelines

Abstract

Pressure ulcer refers to a breakdown of skin due to prolonged pressure or shear. The incidence of pressure ulcers is about 20% in most clinical settings, despite existence of numerous national and international guidelines. The aim of this study was to assess the level of adherence to the Nursing Council of Kenya (NCK) procedure manual on pressure ulcer guidelines among nurses working at Embu Level 5 Hospital, and the associated challenges. This was an institution based descriptive cross-sectional study. Data was collected using a researcher developed self-administered questionnaire based on NCK procedure manual guidelines. 145 respondents were selected using stratified random sampling combined with systematic random sampling. Data was analyzed using SPSS version 21. On adherence to NCK guidelines, the study showed that, 53.91% always adhered to NCK guidelines, 36.5% sometimes adhered and 9.6% never adhered. The main reported challenges to adherence of guidelines were shortage of staffs (36.3%) and inadequate equipment (24.7%). Others were lack of the guidelines in the wards, lack of time for documentation and patient turning. Availability of guidelines in the wards (X2 =5.546, df=1, P=0.019), lack of time for documentation (X2 =5.642, df=1, P=0.018, RR=2.63) and patient turning (X2 =5.817, df=1, P=0.016, RR=2.72) were statistically significant at P<0.05. The study concluded that, Adherence to NCK guidelines was low, and significant challenges were lack of guidelines in the ward, lack of time for documentation and patient turning