title: Pressure ulcer prevention in nursing homes: nurse descriptions of individual and organization level factors.
abstract: Sustaining pressure ulcer prevention (PUP) in nursing homes has been difficult to achieve. Implementation science researchers suggest that identification of individual staff and organizational factors influencing current practices is essential to the development of an effective and customized plan to implement practice changes in a specific setting. A mixed methods approach was used to describe nurses' perceptions of individual and organization-level factors influencing performance of PUP in two Veterans Health Administration (VHA) nursing homes prior to implementation of a national VHA initiative on Hospital Acquired Pressure Ulcers (HAPUs). Individual interviews of 16 nursing staff were conducted. Individual factors influencing practice were a personal sense of responsibility to Veterans and belief in the effectiveness and importance of preventive measures. Organizational factors were existence of cooperative practices between nursing assistants and licensed nurses in assessing risk; teamwork, communication, and a commitment to Veterans' well-being. Integration and reinforcement of such factors in the development and maintenance of customized plans of PUP initiatives is recommended.
authors.affiliation: Department of Veterans Affairs, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA. Electronic address: mary.dellefield@va.gov.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Dellefield
authors.affiliation: Department of Veterans Affairs, Center for Implementation Practice & Research Support (CIPRS), VA Greater Los Angeles Healthcare System, Sepulveda, CA, USA; Yo San University of Traditional Chinese Medicine, Los Angeles, CA, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Magnabosco
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration*; D009740:Nursing Staff; D003668:Pressure Ulcer / Q000517:prevention & control*
keywords: Clinical guidelines; Implementation; Nursing; Nursing home; Pressure ulcers