Irene Hartigan

Prevalence of pressure ulcers in three university teaching hospitals in Ireland

AIM Pressure ulceration is a significant, but preventable, cause of morbidity and resource utilisation in hospital populations. Data on pressure ulcer prevalence in Ireland are limited. This study aims to determine (i) the point-prevalence of pressure ulcers in three teaching hospitals in Ireland and (ii) risk factors for their development. METHODS Eight teams of one doctor and one nurse visited 672 adult patients over a 2-day period in three teaching hospitals. Each patient was examined and pressure ulcers graded with the European Pressure Ulcer Advisory Panel system. Mental test score, Barthel index, type of support surface, length of stay, documentation of risk assessment and serum albumin were recorded. RESULTS Point-prevalence of pressure ulceration was 18.5%. Seventy-seven percent of pressure ulcers were hospital-acquired, 49% grade 1, 37% grade 2, 11% grade 3 and 3% grade 4. Reduced mobility, urinary incontinence, cognitive impairment, low serum albumin and length of stay were significantly associated with pressure ulcers. Multivariate logistic regression analysis found reduced mobility (odds ratio 8.84; 95% CI 5.04-15.48, p<0.0001) and length of stay (odds ratio 1.02; 95% CI 1.01-1.02, p<0.0001) to be predictive of the presence of pressure ulcers. Age, gender and risk assessment documentation were not associated with pressure ulcers. Sixty-five percent of patients with pressure ulcers were positioned on appropriate support surfaces. DISCUSSION Point-prevalence of pressure ulceration was 18.5%, similar to international data. Regular audit of prevalence, prevention and management strategies may raise awareness, influence resource allocation and ultimately improve patient care.

The effectiveness of the lecturer practitioner role in clinical practice: An Irish perspective

BACKGROUND Demands within academia such as teaching, publishing, research activity and generating grant income can make it difficult for nurse educators to protect time for clinical practice. In an effort to overcome this problem lecturer practitioner posts have been introduced with designated responsibilities in both clinical and educational settings. METHODS Using a mixed method descriptive methodology student nurses and registered nurses completed a modified questionnaire to examine the impact of lecturer practitioners (LPs) in clinical practice. Focus groups were also conducted with lecturer practitioners themselves. RESULTS The results identified that by having a clinical remit, LPs forged good relationships with student nurses and registered nurses in clinical practice, who considered the LP as being a learning resource with realistic expectations of the clinical environment. DISCUSSION The results provide further evidence to support the continuation of nurse educators in clinical practice for their own development, their students and registered nurses.

The Irish national stroke awareness campaign: a stroke of success?

INTRODUCTION Mass media campaigns are widely used to expose large populations to health-risk behaviour messages through routine uses of media. The Act F.A.S.T stroke campaign, which highlights the symptoms of stroke, has been endorsed globally. The aim of this study was to identify the influence of the campaign on the general public in Ireland. METHODS Descriptive pre and post comparative study design was conducted. Phase one was conducted in April 2010 prior to the campaign. Data were collected on a cross-section of the public (n=1925) to obtain baseline information on stroke warning signs. Phase two involved collecting data from participants (n=688) 18 months after the campaign launch. RESULTS The majority of participants from both phases were between 30 and 50 years of age. Results from phase two reported that 93% heard or saw the campaign yet only 37% could recall the campaign name or the slogan. Post the campaign over 80% recognized the warning signs of stroke. The increase in symptom recognition is evident from pre campaign to post campaign with an increase in knowledge across all the stroke symptoms. Post the campaign there was an increase of 54% of who stated that they would go straight to hospital for stroke symptoms. CONCLUSION Findings suggest the campaign was well executed given the high percentage of participants recall and the increase in the recognition of stroke symptoms. However, the influence of the campaign in changing behaviour was not as evident. Further research is needed to examine factors that influence behaviour when a stroke strikes.