title: Nurse Managers' prerequisite for nursing development: a survey on pressure ulcers and contextual factors in hospital organizations.
abstract: OBJECTIVE
  To describe and compare pressure ulcer prevalence in two county councils and concurrently explore Nurse Managers' perspective of contextual factors in a hospital organization.
  
  
  BACKGROUND
  Despite good knowledge about risk factors and prevention of pressure ulcers, the prevalence of pressure ulcers remains high. Nurse Managers' have a key role in implementing evidence-based practice.
  
  
  METHODS
  The present study included five hospitals in two Swedish county councils: county council A (non-university setting) and county council B (university setting). A pressure ulcer prevalence study was conducted according to the methodology developed by the European Pressure Ulcer Advisory Panel. The Nurse Managers' answered a (27-item) questionnaire on contextual factors.
  
  
  RESULTS
  County council B had significantly less pressure ulcers grade (2-4) (7.7%) than county council A (11.3%). The Nurse Managers' assessed only two out of the 27 general contextual items significantly differently. Some significant differences were observed in ward organization.
  
  
  CONCLUSIONS
  In county council B, the Nurse Managers' seemed more aware of prevention strategies compared with Nurse Managers' in county council A. The Nurse Managers' should take more responsibility to develop the prerequisite for quality improvement in nursing.
  
  
  CONCLUSIONS
  Nursing outcomes (e.g. pressure ulcers) should be incorporated into national quality registries for benchmarking and Nurse Managers' competence in evidence-based practice and research methodology increased.
authors.affiliation: Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden. lena.gunningberg@pubcare.uu.se
authors.forename: Lena
authors.initials: L
authors.lastname: Gunningberg
authors.forename: Lars
authors.initials: L
authors.lastname: Brudin
authors.forename: Ewa
authors.initials: E
authors.lastname: Idvall
mesh_terms: D000328:Adult; D000368:Aged; D055318:Evidence-Based Nursing; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D009745:Nursing, Supervisory; D003668:Pressure Ulcer / Q000453:epidemiology / Q000451:nursing* / Q000517:prevention & control; D015995:Prevalence; D058996:Quality Improvement; D011787:Quality of Health Care; D012307:Risk Factors; D012931:Social Environment; D013192:Staff Development; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology