An exploration of the patient and family or carer experience of implementing the pressure ulcer prevention care bundle (known as SSKIN) within a regional quality improvement collaborative
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Introduction: Pressure ulcers (PUs) are common, costly and impact negatively on patients’ quality of life. Bearing this in mind, in Ireland, a regional quality improvement collaborative was established within the Health Service Executive entitled ‘Pressure Ulcers to Zero’, utilizing the SSKIN care bundle in pressure ulcer prevention. As the involvement of patient and family/carer is a central component of health care delivery, this study set out to explore the patient and family/carer experiences and involvement within the collaborative including use of the SSKIN care bundle.
Methods: A qualitative descriptive approach was adopted. Since there were 3 main healthcare settings involved in the collaborative (acute /specialist, residential and primary care), one unit from each of these settings was purposively selected to participate. Following ethical approval and written informed consent, data were collected over a 6 week period using semi-structured, one to one interviews with patients, and focus group interviews with family members/carers. Twenty five persons agreed to participate; 16 patients, with varying levels of dependency, and 9 family members/carers .
Results: Data were analysed using Colaizzi’s Framework, 6 main themes with corresponding subthemes emerged from the analysis: awareness, patient involvement, family/carer involvement, ‘prevention is better than cure’, ‘communication is key’ and resources in prevention.
Discussions: Both patients and family/carer had limited involvement in PU prevention within the collaborative. Further, a general lack of awareness of the SSKIN care bundle was identified with some confusion surrounding its acronym. Participants expressed the desire to be more involved in PU prevention and the collaborative processes, henceforth, empowering patients and family/carers through education and communication may increase their level of involvement. This has meaning for future collaboratives, where tools, such as acronyms and activities, for example the design and presentation of visual aids pertaining to the collaborative subject, require a patient as well as a professional focus.
Clinical Relevance: Educating patients and families/carers on PU prevention through utilization of the SSKIN care bundle may facilitate a greater willingness of the patient and family/carer to participate in PU prevention. Also informing and including them in collaborative activities may address quality care issues.