Implementering af trykskadeforebyggelse. En effekt- og procesevaluering med fokus på fremmende og haemmende faktorer
Sammanfattning
Background: Studies on implementation processes point out the importance of multifactorial
efforts to achieve success. This article describes and discusses results from an effect
and process evaluation of implementing guidelines to prevent pressure injuries. Aim: To
evaluate the effect of the implementation with focus on incidence of pressure injuries and
pressure injury preventive activities. Degree of success is understood with inspiration from
Alison Kitson’s conceptual framework. Method: A cohort study. Quantitative data: Patient
records, direct observation of the patient and use of pressure injury facilities. Qualitative
data: Semi-structured focus group interviews. Analysis: Chi2-test, Fischer’s Exact test orsimple proportion
and a hermeneutic approach inspired by Alison Kitson. Results: Incidence
of pressure injuries was reduced. Promoting factors: Organisational – and management
recognition, responsiveness to change, interdisciplinarity, visual leadership, a multifaceted
learning approach and accessible discussion partners. Restraining factors:
Challenges of standard practices, bad timing of project process and educational setting.
Conclusion: Incidence of pressure injuries was reduced. The causes of success were recognition
of evidence on management- and clinician levels, positive attitudes, practically oriented
guidelines, high levels of motivation, receptiveness to change, interdisciplinarity, and
a multifaceted approach towards learning and facilitators.