title: Knowledge and use of pressure ulcer preventive measures in nursing homes: a comparison of Dutch and German nursing staff.
abstract: OBJECTIVE
  To examine the knowledge and use of pressure ulcer preventive measures among nursing staff in Dutch and German nursing homes.
  
  
  BACKGROUND
  Studies in the Netherlands and Germany have shown a large discrepancy in pressure ulcer prevalence rates among nursing homes in both countries and concluded that some of this variance could be explained by differences in pressure ulcer prevention.
  
  
  METHODS
  A cross-sectional questionnaire survey nested in a prospective multicenter cohort study.
  
  
  METHODS
  A questionnaire was distributed to nursing staff employed in 10 Dutch nursing homes (n = 600) and 11 German nursing homes (n = 578). Data were collected in January 2009.
  
  
  RESULTS
  The response rate was 75·7% in the Netherlands (n = 454) and 48·4% in Germany (n = 283). Knowledge about useful pressure ulcer preventive measures was moderate in both countries, while nonuseful preventive measures were poorly known. On average, only 19·2% (the Netherlands) and 24·6% (Germany) of preventive measures were judged correctly as nonuseful. The same pattern could be seen with regard to the use of preventive measures, because nonuseful preventive measures were still commonly used according to the respondents.
  
  
  CONCLUSIONS
  The results indicate that the respondents' knowledge and use of pressure ulcer preventive measures could be improved in both countries, especially for nonuseful measures. Changes and improvements can be achieved by providing sufficient education and refresher courses for nurses and nursing assistants employed within Dutch and German nursing homes.
  
  
  CONCLUSIONS
  Recurring education about pressure ulcer prevention is required among nursing staff employed in Dutch and German nursing homes, particularly in relation to the use of ineffective and outdated preventive measures. Obstacles regarding the implementation of preventive measures should be addressed to achieve a change in practice.
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Meesterberends
authors.forename: Doris
authors.initials: D
authors.lastname: Wilborn
authors.forename: Christa
authors.initials: C
authors.lastname: Lohrmann
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
authors.forename: Ruud J G
authors.initials: RJ
authors.lastname: Halfens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009735:Nursing Homes; D009740:Nursing Staff; D003668:Pressure Ulcer / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D015995:Prevalence; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: clinical guidelines; nursing homes; pressure ulcers; research implementation; survey design