Pressure injury prevention practices in critical care settings: an evaluation of the Stop Pressure Injury Development and Eliminate Risk (SPIDER) project

OBJECTIVE: To assess the impact of an educational intervention on pressure injury (PI) prevention practices in critical care units in Saudi Arabia. METHOD: The study was conducted across three hospitals using a pre- and post-intervention approach, complemented by qualitative evaluation. It was structured into four phases, guided by the Knowledge to Action framework. The research involved collecting data on PI prevalence, surveying nurses about their knowledge and attitudes towards prevention practices, and implementing an educational intervention. Subsequently, phase 1 findings were re-evaluated. Qualitative interviews were conducted to identify barriers and facilitators to prevention practices, and to evaluate the study's effectiveness. RESULTS: Data were collected pre-intervention from 87 patients and 190 nurses. The initial PI prevalence rate was 60.9%, while the initial knowledge and attitude scores of nurses were 43.22% and 74.77%, respectively. A tailored group-based educational intervention engaged 294 nurses across all research sites. Post-intervention data were gathered from 94 patients and 195 nurses. The PI prevalence rate reduced significantly to 28.7%. Nurses' knowledge scores increased to 51.22%, and attitudes improved to 79.02%. Qualitative interviews with nine nurses identified three themes related to barriers and facilitators: 'Workforce and resource issues'; 'Training and preparedness' and 'Managing complex conditions'. The project's success was attributed to three themes: 'Delivering an adaptable and personalised intervention'; 'Impact of attention to detail' and 'Significance of contributing to positive change'. CONCLUSION: The findings of this research underscores the crucial role of nurses in preventing PIs in critical care units. Tailored group-based educational programmes have proved effective in reducing PI rates, bolstering nurses' knowledge and attitudes, and overcoming prevention barriers.