Original Article Patients’ Perceptions of a Pressure Ulcer Prevention Care Bundle in Hospital: A Qualitative Descriptive Study to Guide Evidence-Based Practice Shelley Roberts, PhD • Marianne Wallis, PhD • Elizabeth McInnes, PhD • Tracey Bucknall, PhD • Merrilyn Banks, PhD • Lauren Ball, PhD • Wendy Chaboyer, PhD Keywords care bundle, patient-centered care, patient participation, pressure injury prevention, pressure ulcer prevention ABSTRACT Background: Pressure ulcers place a signiﬁcant burden on patients and hospitals. Our team developed and tested a pressure ulcer prevention care bundle (PUPCB) in a cluster randomized trial. As part of the process evaluation conducted alongside the trial, we explored patients’ perceptions of the intervention. Aims: To identify patients’ perceptions and experiences of a PUPCB in hospital. Methods: This qualitative descriptive study explored the perceptions of a subset of patients who participated in a trial testing the PUPCB across four intervention hospitals. A trained interviewer conducted semistructured interviews, which were digitally recorded, transcribed, and analyzed using thematic analysis. Findings: Nineteen patients were interviewed across the four hospitals. Three main themes emerged: (a) importance of personal contact in PUPCB delivery; (b) understanding pressure ulcer prevention (PUP) enhances participation; and (c) individual factors impact patients’ engagement in PUP. Discussion: The extent to which patients adopted the intervention appeared to be inﬂuenced by the complexity of education materials, compatibility with patients’ existing knowledge and beliefs, and perceived advantage of the intervention; ability for human interaction; and patient- related facilitators and barriers to participating in PUP care. Linking Evidence to Action: This study found patients accepted a PUPCB that encouraged participation in care, particularly as it involved personal and positive interactions with nurses and provision of information that was easy to understand and resonated with patients. BACKGROUND Pressure ulcers (PUs) are a signiﬁcant problem in the clini- cal setting. PUs cause severe physical, social, and psycholog- ical problems for patients, including pain, reduced mobility and functional ability, restricted daily and social life activities, mood changes and emotional problems, and poor self-image (Gorecki et al., 2009; Gorecki, Closs, Nixon, & Briggs, 2011). For hospitals, PUs cause substantial economic burden through longer length of stay, high treatment costs (Graves & Zheng, 2014; Nguyen, Chaboyer, & Whitty, 2015), and ﬁnancial penal- ties to institutions (Queensland Government & Queensland Health, 2012). Pressure ulcer prevention (PUP) is therefore a national and international priority for healthcare organiza- tions (Australian Commission on Safety and Quality in Health Care, 2011; European Pressure Ulcer Advisory Panel, National Pressure Ulcer Advisory Panel, & Pan Paciﬁc Pressure Injury Alliance, 2014). Our team recently developed a pressure ulcer prevention care bundle (PUPCB; Chaboyer et al., 2015) and tested its ef- fectiveness and cost effectiveness in a cluster randomized trial (the INTroducing A Care bundle To prevent pressure injury [INTACT] trial) in eight Australian hospitals (Chaboyer et al., 2016). The PUPCB promoted patient participation in PUP care and was delivered to both patients and nurses. Patients received PUP education with a brochure, poster, and DVD, which con- tained three messages: (a) keep moving, (b) look after your skin, and (c) eat a healthy diet. While a signiﬁcant reduction in hospital-acquired PUs was seen in intervention patients at the cluster level, the difference was not statistically signiﬁcant at the individual patient level when adjusted for covariates and Worldviews on Evidence-Based Nursing, 2017; 00:0, 1–9. 1 C  2017 Sigma Theta Tau International