Expert interview: How to get the support of hospital executives for pressure injury prevention interventions

Our discussion covered who to speak to, how to choose criteria for your interventions and audits and how to collect and present data.

A note on terminology: ‘pressure ulcers’, ‘pressure injuries’, ‘pressure sores’ or ‘bed sores’ are all commonly used terms. We use ‘pressure injuries’ throughout this article to include all the above.

Starting a conversation about pressure injury prevention

There are clear international guidelines on pressure injury prevention, but putting them into practice can depend on the ability of clinicians to persuade hospital executives of the value of specific interventions.
 
As Michelle points out, the first challenge is deciding who to speak to. For a junior clinician, the first conversation may be with their immediate manager; others may be able to go straight to the director of nursing. It’s about getting the idea in front of someone relatively senior who has clinical knowledge.

Whoever you speak to, it’s important to provide some evidence of the need for the intervention you want to deliver. Andrea suggests the types of data that are most relevant. 

It’s also important to consider factors such as the care quality outcome, the cost, the ease (to clinicians) of delivering the proposed intervention, and so on.

Before you propose a pressure injury prevention programme, should ensure that it is auditable, so results can be evaluated.

How to choose criteria to help select and/or audit pressure injury interventions

Michelle suggests a process by which to choose pressure injury interventions, beginning by looking at any audits the hospital currently conducts. 

Andrea similarly stresses the need to select data the hospital already generates, if possible, to communicate the need for change and later to demonstrate the effects of an intervention.

The importance of a root cause analysis

To supplement this data, Michelle stresses the value of a root cause analysis when deciding how to address a problem such as the incidence of pressure injuries. This means bringing a holistic view of the problem and the person affected by it into the conversation at an early stage, as this may also be important in deciding the most appropriate next steps.

Watch the interview with Dr Michelle Barakat–Johnson

Dr Michelle Barakat–Johnson, Clinical Lead and Nurse Manager Skin Integrity, Sydney Local, Australia

Watch the interview with Andrea Pokorná

Andrea Pokorná, Full Professor of Nursing, Masaryk University, Czech Republic