title: Successful factors to prevent pressure ulcers - an interview study.
abstract: OBJECTIVE
  To explore successful factors to prevent pressure ulcers in hospital settings.
  
  
  BACKGROUND
  Pressure ulcer prevalence has been recognised as a quality indicator for both patient safety and quality of care in hospital and community settings. Most pressure ulcer can be prevented if effective measures are implemented and evaluated. The Swedish Association of Local Authorities and Regions initiated nationwide pressure ulcer prevalence studies in 2011. In 2014, after four years of measurement, the prevalence was still unacceptably high on a national level. The mean prevalence of pressure ulcer in the spring of 2014 was 14% in hospital settings with a range from 2·7-36·4%.
  
  
  METHODS
  Qualitative semistructured interviews were conducted.
  
  
  METHODS
  A qualitative content analysis, in addition to Promoting Action on Research Implementation in Health Services frameworks, was used in the analysis of the data text. Individual interviews and focus groups were used to create opportunities for both individual responses and group interactions. The study was conducted at six hospitals during the fall of 2014.
  
  
  RESULTS
  Three main categories were identified as successful factors to prevent pressure ulcer in hospitals: creating a good organisation, maintaining persistent awareness and realising the benefits for patients.
  
  
  CONCLUSIONS
  The goal for all healthcare personnel must be delivering high-quality, sustainable care to patients. Prevention of pressure ulcer is crucial in this work. It seems to be easier for small hospitals (with a low number of units/beds) to develop and sustain an effective organisation in prevention work.
  
  
  CONCLUSIONS
  The nurse managers' attitude and engagement are crucial to enable the personnel to work actively with pressure ulcer prevention. Strategies are proposed to advance clinical leadership, knowledge, skills and abilities for the crucial implementation of pressure ulcer prevention.
authors.affiliation: Skåne University Hospital, Lund, Sweden.
authors.forename: Ami
authors.initials: A
authors.lastname: Hommel
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University and Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Gunningberg
authors.affiliation: Faculty of Health and Society, Malmö University and Skane University Hospital, Malmö, Sweden.
authors.forename: Ewa
authors.initials: E
authors.lastname: Idvall
authors.affiliation: Department of Health Sciences, Karlstad University, Karlstad, Sweden.|County Council of Värmland, Karlstad, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Bååth
mesh_terms: D000328:Adult; D005260:Female; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D057184:Practice Patterns, Nurses'; D003668:Pressure Ulcer / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D017592:Skin Care; D013548:Sweden / Q000453:epidemiology
keywords: evidence-based practice; leadership; nurse's responsibilities; pressure ulcer; qualitative study; quality and safety; work organisation