The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units

Background: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people’s quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serio...

Full description

Bibliographic Details
Main Authors: Katia Furtado, Jaco Voorham, Paulo Infante, Anabela Afonso, Clara Morais, Pedro Lucas, Manuel Lopes
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Healthcare
Subjects:
Online Access:https://www.mdpi.com/2227-9032/11/12/1751
_version_ 1797594613106606080
author Katia Furtado
Jaco Voorham
Paulo Infante
Anabela Afonso
Clara Morais
Pedro Lucas
Manuel Lopes
author_facet Katia Furtado
Jaco Voorham
Paulo Infante
Anabela Afonso
Clara Morais
Pedro Lucas
Manuel Lopes
author_sort Katia Furtado
collection DOAJ
description Background: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people’s quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. Methods: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. Results: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 “Floating so that staffing is equalised among units” is strongly associated with a shorter PU healing time. Conclusion: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.
first_indexed 2024-03-11T02:24:46Z
format Article
id doaj.art-c7e2b754062648f99cd5e8ce0371991b
institution Directory Open Access Journal
issn 2227-9032
language English
last_indexed 2024-03-11T02:24:46Z
publishDate 2023-06-01
publisher MDPI AG
record_format Article
series Healthcare
spelling doaj.art-c7e2b754062648f99cd5e8ce0371991b2023-11-18T10:38:37ZengMDPI AGHealthcare2227-90322023-06-011112175110.3390/healthcare11121751The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care UnitsKatia Furtado0Jaco Voorham1Paulo Infante2Anabela Afonso3Clara Morais4Pedro Lucas5Manuel Lopes6Out Patient Department, Hospital of Portalegre, Unidade Local de Saúde do Norte Alentejano, 7300-312 Portalegre, PortugalDTIRS—Data to Insights Research Solutions, 1750-307 Lisboa, PortugalResearch Center in Mathematics and Applications (CIMA), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671 Évora, PortugalResearch Center in Mathematics and Applications (CIMA), Instituto de Investigação e Formação Avançada (IIFA), Universidade de Évora, 7000-671 Évora, PortugalAdministração Regional de Saúde do Alentejo, Largo do Jardim do Paraíso, nº 1, 7000-864 Évora, PortugalNursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1600-096 Lisbon, PortugalComprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-671 Évora, PortugalBackground: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people’s quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. Methods: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. Results: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 “Floating so that staffing is equalised among units” is strongly associated with a shorter PU healing time. Conclusion: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.https://www.mdpi.com/2227-9032/11/12/1751pressure ulcerslong-term carenursing homeswork environmentquality of carehealing rates
spellingShingle Katia Furtado
Jaco Voorham
Paulo Infante
Anabela Afonso
Clara Morais
Pedro Lucas
Manuel Lopes
The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units
Healthcare
pressure ulcers
long-term care
nursing homes
work environment
quality of care
healing rates
title The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units
title_full The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units
title_fullStr The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units
title_full_unstemmed The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units
title_short The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units
title_sort relationship between nursing practice environment and pressure ulcer care quality in portugal s long term care units
topic pressure ulcers
long-term care
nursing homes
work environment
quality of care
healing rates
url https://www.mdpi.com/2227-9032/11/12/1751
work_keys_str_mv AT katiafurtado therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT jacovoorham therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT pauloinfante therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT anabelaafonso therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT claramorais therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT pedrolucas therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT manuellopes therelationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT katiafurtado relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT jacovoorham relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT pauloinfante relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT anabelaafonso relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT claramorais relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT pedrolucas relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits
AT manuellopes relationshipbetweennursingpracticeenvironmentandpressureulcercarequalityinportugalslongtermcareunits