1. Master of Health Sciences (Specialist Nursing)

2.  The aim of the study was to explore the attitudes and knowledge of public health nurses’ (PHNs’) and community nurses’ toward pressure ulcer (PU) prevention and to ascertain if their attitudes and or knowledge is influenced by professional and or educational factors.

3.  PUs are considered a quality indicator (Pancorbo-Hidalgo et al 2007)  Mean point prevalence of PUs in Ireland was 16% ( 4-37%). (Moore et al 2013).  McDermott et al (2009) and Skerritt and Moore (2014) establish the prevalence of PUs in the community setting (PHN service only) at 4% and 0.04%.

4. IndividualSociety  Physical impact  Psychological impact  Social Impact  Financial impact  General health and consequences  Impact on others.  Cost of treating a PU Category 1= £1,214 Category 4=£14,108  90% of cost (Category 3 and 4), 96% of cost category 1 and 2 attributed to staff.  Dressings, equipment account for 3.3% of total costs.  PU treatment twice the cost of prevention.

5.  By 2030 estimated ¼ of Ireland’s population will be over 65 years of age (CSO, 2011)  75% of all PUs identified was in the over 65 year old ( Mc Dermott et al, 2009)  A role of the PHN is preventative rather than curative (Hanafin, 1997)  Emphasis on care delivery in the community moving away from acute sector ( DOHC, 2012)  Community nurse devote 100% time to wound care, PHNs dedicate 30%. 22% of all wounds PUs (Skerritt and Moore, 2014)  PHN service responsible for the clinical governance of the home support service.  95% of PUs are preventable (Botherton, 2012)

6.  Attitudes toward PU prevention- conflicting evidence.  PU prevention deemed as having a low priority.  The attitude of nurses was an independent factor for compliance with PU prevention guidelines ( OR=1.08, p=0.015) ( Beeckman et al, 2010, Demarre et al, 2011)

7.  Majority of studies that assessed nurses knowledge in PU prevention was ‘poor’ or ‘insufficient’.  The application of PU prevention knowledge into practice was significantly lower.  No studies to date explored to attitudes and knowledge of PHNs’ and community nurses toward PU prevention.

8. Methodology  Design-A cross-sectional descriptive survey  Sampling- census of 99  Data Collection Tool- APuP & PUKAT (Beeckman et al 2010)  Data Analysis- SPSS 21

9.  81 participated in the study  No correlation between total attitude score and demographics.  Over 90% (n=73)of participants-“satisfactory” positive attitude toward PU prevention.  16% (n= 13) of participants’ possessed an “unsatisfactory” attitude “Personal competency to prevent PU”  98.9% ( n=80) of participants’ possessed a “satisfactory” attitude in “ priority to prevent PUs”

10.  90%- “ satisfactory” knowledge  No statically significant correlations between total knowledge score and participants demographics.  Highest level knowledge in “ nutrition”- 98.8%  Lowest level of knowledge in “ preventative measures to reduce the duration of pressure/shear)

11.  Service provision- Tissue Viability Service  Education - Health care professional - Family and carers  Further Research

12. Thank You. Any Questions?