title: Pressure ulcer risk assessment and prevention: what difference does a risk scale make? A comparison between Norway and Ireland.
abstract: OBJECTIVE
  To explore similarities and differences in nurses' views on risk assessment practices and preventive care activities in a context where patients' risk of developing pressure ulcers is assessed using clinical judgment (Norway) and a context where patients' risk of developing pressure ulcers is assessed using a formal structured risk assessment combined with clinical judgement (Ireland).
  
  
  METHODS
  A descriptive, qualitative design was employed across two different care settings with a total of 14 health care workers, nine from Norway and five from Ireland.
  
  
  RESULTS
  Regardless of whether risk assessment was undertaken using clinical judgment or formal structured risk assessment, identified risk factors, at risk patients and appropriate preventive initiatives discussed by participant were similar across care settings. Furthermore, risk assessment did not necessarily result in the planning and implementation of appropriate pressure ulcer prevention initiatives. Thus, in this instance, use of a formal risk assessment tool does not seem to make any difference to the planning, initiation and evaluation of pressure ulcer prevention strategies.
  
  
  CONCLUSIONS
  Regardless of the method of risk assessment, patients at risk of developing pressure ulcers are detected, suggesting that the practice of risk assessment should be re-evaluated. Moreover, appropriate preventive interventions were described. However, the missing link between risk assessment and documented care planning is of concern and barriers to appropriate pressure ulcer documentation should be explored further.
  
  
  BACKGROUND
  This work is partly funded by a research grant from the Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare.
authors.affiliation: Assistant professor, Faculty of Health Sciences Buskerud and Vestfold University College Drammen, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Johansen
authors.forename: Z
authors.initials: Z
authors.lastname: Moore
authors.forename: M
authors.initials: M
authors.lastname: van Etten
authors.forename: H
authors.initials: H
authors.lastname: Strapp
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D036301:Qualitative Research; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: Ireland; Norway; focus group; pressure ulcer; prevention; risk assessment