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Table 3 Nurses’ knowledge to pressures ulcer prevention (N = 212)

From: Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: a cross-sectional study design

Categories (Mean ± SD) Items Frequency of answers (%)
Etiology and development
1.67 ± 1.10
1. Which statement is correct?
a. Malnutrition causes pressure ulcers. 9 (4.2)
b. A lack of oxygen causes pressure ulcers. a 31 (14.6)
c. Moisture causes pressure ulcers. 159 (75)
d. I don’t’ know 13 (6.2)
2. Extremely thin patients are more at risk of developing a pressure ulcer than obese patients.
a. The contact area involved is small and thus the amount of pressure is higher. a 72 (34.0)
b. The pressure is less extensive because the body weight of those patients is lower than the body weight of obese patients. 26 (12.2)
c. The risk of developing a vascular disorder is higher for obese patients. This increases the risk of developing a pressure ulcer. 67 (31.6)
d. I don’t’ know 47 (22.2)
3. What happens when a patient, sitting in bed in a semi upright position (60-), slides down?
a. Pressure increases when the skin sticks to the surface. 41 (19.3)
b. Friction increases when the skin sticks to the surface. 99 (46.7)
c. Shearing increases when the skin sticks to the surface. a 62 (29.3)
d. I don’t’ know 10 (4.7)
4. Which statement is correct?
a. Soap can dehydrate skin and thus the risk of pressure ulcers is increased. 5 (2.4
b. Moisture from urine, feces, or wound drainage causes pressure ulcers. 160 (75.5)
c. Shear is the force that occurs when the body slides and the skin sticks to the surface. a 33 (15.5)
d. I don’t’ know 14 (6.6)
5. Which statement is correct?
a. Recent weight loss that has brought a patient below his/her ideal increases the risk of pressure ulcers. a 73 (34.4)
b. Very obese patients using medication that decreases the peripheral blood circulation are not at risk of developing pressure ulcers. 54 (25.5)
c. Poor nutrition and age have no impact on tissue tolerance when the patient has a normal weight. 40 (18.9)
d. I don’t’ know 45 (21.2)
6. There is NO relationship between pressure ulcer risk and
a. Age. 58 (27.4)
b. Dehydration. 48 (22.6)
c. Hypertension. a 83 (39.2)
d. I don’t’ know 23 (10.8)
Classification and Observation
2.12 ± 1.14
7. Which statement is correct?
a. A pressure ulcer extending down to the fascia is a grade 3 pressure ulcer. a 30 (14.2)
b. A pressure ulcer extending through the underlying fascia is a grade 3 pressure ulcer. 50 (23.6)
c. A grade 3 pressure ulcer is always preceded by a grade 2 pressure ulcer. 84 (39.6)
d. I don’t’ know 48 (22.6)
8. Which statement is correct?
a. A blister on a patient’s heel is always a pressure ulcer of grade 2. 9 (4.2)
b. All grades (1, 2, 3, and 4) of pressure ulcers involve loss of skin layers. 28 (13.2)
c. When necrosis occurs, it is a grade 3 or a grade 4 pressure ulcer. a 137 (64.6
d. I don’t’ know 38 (17.9)
9. Which statement is correct?
a. Friction or shear may occur when moving a patient in bed. a 81 (38.2)
b. A superficial lesion preceded by non-blanchable erythema is probably a friction lesion. 56 (26.4)
c. A kissing ulcer (coping lesion) is caused by pressure and shear. 49 (23.1)
d. I don’t’ know 26 (12.3)
10. In sitting position, pressure ulcers are most likely to develop on the:
a. Pelvic area, elbow, and heel. a 146 (68.9)
b. Knee, ankle, and hip. 23 (10.8)
c. Hip, shoulder, and heel. 36 (17.3)
d. I don’t’ know 7 (3.0)
11. Which statement is correct?
a. All patients at risk of pressure ulcers should have a systematic skin inspection once a week. 16 (7.6)
b. The skin of patients seated in a chair, who cannot move themselves, should be inspected every 2 to 3 h. 123 (58.0)
c. The heels of patients who lie on a pressure-redistributing surface should be observed minimum a day. a 56 (26.4)
d. I don’t’ know 17 (8.0)
Risk assessment
0.90 ± 0.62
12. Which statement is correct?
a. Risk assessment tools identify all high-risk patients in need of prevention. 51 (24.1)
b. The use of risk assessment scales reduces the cost of prevention. 32 (15.1)
c. A risk assessment scale may not accurately predict the risk of developing a pressure ulcer and should be combined with clinical judgment. a 92 (43.3)
d. I don’t’ know 37 (17.5)
13. Which statement is correct?
a. The risk of pressure ulcer development should be assessed daily in all nursing home patients. 17 (8.0)
b. Absorbing pads should be placed under the patient to minimize the risk of pressure ulcer development. 77 (36.3)
c. c. A patient with a history of pressure ulcers runs a higher risk of developing new pressure ulcers. a 97 (45.8)
d. I don’t know 21 (9.9)
Nutrition
2.65 ± 0.87
14. Which statement is correct?
a. Malnutrition causes pressure ulcers. 35 (16.5)
b. The use of nutritional supplements can replace expensive preventive measures. 24 (11.4)
c. Optimizing nutrition can improve the patients’ general physical condition that may contribute to a reduction of the risk of pressure ulcers. a 133 (62.7)
d. I don’t’ know 20 (9.4)
Preventive measures to reduce the amount of pressure
2.48 ± 1.32
15. The sitting position with the lowest contact pressure between the body and the seat is
a. An upright sitting position, with both feet resting on a footrest. 36 (17.0)
b. An upright sitting position, with both feet resting on the floor. 77 (36.3)
c. A backward sitting position, with both legs resting on a footrest. a 67 (31.6)
d. I don’t’ know 32 (15.1)
16. Which repositioning scheme reduces pressure ulcer risk the most?
a. Supine position---side 90 lateral position---supine position---90 lateral position---supine position 62 (29.2)
b. Supine position---side 30 lateral position---side 30 lateral position---supine position. a 70 (33.0)
c. Supine position---side 30 lateral position---sitting position---30 lateral position---supine position 49 (23.2)
d. I don’t’ know 31 (14.6)
  17. Which statement is correct?
a. Patients who are able to change position while sitting should be taught to shift their weight minimum every 60 min while sitting in a chair. 29 (42.1)
b. In a side-lying position, the patient should be at a 90 degree- angle with the bed. 125 (19.8)
c. Shearing forces affect a patient’s sacrum maximally when the head of the bed is positioned at 30 degrees. a 31 (20.8)
d. I don’t’ know 27 (17.4)
18. If a patient is sliding down in a chair, the magnitude of pressure at the seat can be reduced the most by
a. A thick air cushion. a 92 (43.4)
b. A donut-shaped foam cushion. 97 (45.8)
c. A gel cushion. 14 (6.6)
d. I don’t’ know 9 (4.2)
19. For a patient at risk of developing a pressure ulcer, a viscoelastic foam mattress
a. Reduces the pressure sufficiently and does not need to be combined with repositioning. 29 (13.7)
b. Has to be combined with repositioning every 2 h.a 125 (59.0)
c. Has to be combined with repositioning every 4 h. 31 (14.6)
d. I don’t’ know 27 (12.7)
20. A disadvantage of a water mattress is
a. Shear at the buttocks increases. 49 (23.1)
b. Pressure at the heels increases. 44 (20.8)
c. Spontaneous small body movements are reduced. a 69 (32.5)
d. I don’t’ know 50 (23.6)
21. When a patient is lying on a pressure-reducing foam mattress,
a. Elevation of the heels is not necessary. 29 (13.7)
b. Elevation of the heels is important. a 62 (29.3)
c. He/she should be checked for “bottoming out” at least twice a day. 94 (44.3)
d. I don’t’ know 27 (12.7)
Preventive measures to reduce the duration of pressure
1.49 ± 0.92
22. Repositioning is an accurate preventive method because
a. The magnitude of pressure and shear will be reduced. 50 (23.6)
b. The amount and the duration of pressure and shear will be reduced. 99 (46.7)
c. The duration of pressure and shear will be reduced. a 36 (17.0)
d. I don’t’ know 27 (12.7)
23. Fewer patients will develop a pressure ulcer if
a. Food supplements are provided. 22 (10.4)
b. The areas at risk are massaged. 121 (57.1)
c. Patients are mobilized. a 34 (16.0)
d. I don’t’ know 35 (16.5)
24. Which statement is correct?
a. Patients at risk lying on a non-pressure-reducing foam mattress should be repositioned every 2 h.a 69 (32.5)
b. Patients at risk lying on an alternating air mattress should be repositioned every 4 h. 58 (27.4)
c. Patients at risk lying on viscoelastic mattress should be repositioned every 2 h. 56 (26.4)
d. I don’t’ know 29 (13.7)
  25. When a patient is lying on an alternating air mattress, the prevention of heel pressure ulcers includes
a. No specific preventive measures. 11 (5.2)
b. A pressure-reducing cushion under the heels. 83 (39.2)
c. A cushion under the lower legs elevating the heels. a 94 (44.3)
d. I don’t’ know 24 (11.3)
26. If a bedridden patient cannot be repositioned, the most appropriate pressure ulcer prevention is
a. A pressure-redistributing foam mattress. 55 (25.9)
b. An alternating-pressure air mattress. a 83 (39.2)
c. Local treatment of the risk areas with zinc oxide paste. 49 (23.1)
d. I don’t’ know 25 (11.8)
  1. a Indicates correct answers for each question
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