ORIGINAL ARTICLE
Pediatric skin care: What do nurses really know?
Jennifer Drake, Wendi S. Redfern, Eileen Sherburne, Melodee L. Nugent, and Pippa Simpson
Jennifer Drake, RN, MS, CPN, is a Nurse and Clinical Nursing Instructor, Neuroscience Unit; Wendi S. Redfern, MSN, RN, CCRN, is an Advanced Practice
Nurse, Department of Advanced Practice Nursing, Children’s Hospital of Wisconsin; Eileen Sherburne, MS, ACNS-BC, FNP-BC, CRRN, WCC, is an Advanced
Practice Nurse, Department of Advanced Practice Nursing, Children’s Hospital of Wisconsin; Melodee L. Nugent, MA, is a Pediatric Biostatistician; and
Pippa Simpson, PhD, is a Section Chief Director, Professor—Pediatrics, Quantitative Health Sciences, Children’s Research Institute, Medical College of
Wisconsin, Milwaukee, Wisconsin, USA
Search terms
Attitude, barrier, behavior, belief,
evidence-based practice, facilitator, knowledge,
nursing, pediatrics, perception, practice,
pressure sore, pressure ulcer, prevention,
research utilization, skin care, skin integrity.
Author contact
wredfern@chw.org, with a copy to the Editor:
roxie.foster@ucdener.edu
Acknowledgements
This project was supported by the Sophie
Schroeder Endowment Fund. The authors wish
to thank Shelly Malin PhD, RN, NEA-BC, Karen
Gralton, RN, MS, PCNS-BC, Children’s Research
Institute, and Children’s Hospital of Wisconsin
Nursing Research Council for their advice and
encouragement.
Disclosure: The authors report no actual or
potential conflicts of interest. This research was
funded in part by Sophie Schroeder Endowment
Fund.
First Received October 12, 2011; Revision
received March 8, 2012; Accepted for
publication June 23, 2012.
doi: 10.1111/j.1744-6155.2012.00342.x
Abstract
Purpose. The purpose of this study was to explore pediatric nurses’ knowl-
edge of pressure ulcer prevention, investigate their beliefs and practices,
and identify the barriers and facilitators to providing evidence-based pres-
sure ulcer preventive practices.
Design and Methods. An exploratory, descriptive, and cross-sectional
survey was taken of registered nurses in a freestanding children’s hospital.
Results. Nurses have adequate knowledge of general pressure ulcer pre-
vention; however, they struggle with individualization. Further, analysis
revealed that nursing knowledge did not always correlate with nursing
practice.
Practice Implications. Nurses require education on individualized inter-
ventions and access to user-friendly, interactive, and comprehensive
resources, including unit-based champions and order sets.
From local to national organizations, private and
public, pressure ulcer prevention is a priority for insti-
tutional goals. Despite these efforts, pressure ulcers
remain a significant threat for hospitalized and
immobilized populations. While often seen as an
issue of the elderly and in the nursing home setting,
pressure ulcers also adversely affect infants and
children and remain a major concern in pediatric
inpatient facilities with prevalence in pediatric
patients ranging from 1.6% to 27.7% (McLane,
Bookout, McCord, McCain, & Jefferson, 2004;
Noonan, Quigley, & Curley, 2006; Schindler et al.,
2007; Schluer, Cignacco, Muller, & Halfens, 2009),
resulting in pain, infection, disfigurement, altered
body image, and mortality, as well as increased costs,
length of stay, and litigation (Baharestani & Ratliff,
2007). In the past, pressure ulcers in children were
not recognized as an issue; as the industry has become
more knowledgeable through research, national
patient safety goals, and certifying bodies (i.e., Med-
icaid reimbursement, Magnet recognition, and Joint
Commission), it has become apparent in the last
decade that the issue of pressure ulcer prevention
needs to be addressed in the pediatric setting.
Journal for Specialists in Pediatric Nursing
329 Journal for Specialists in Pediatric Nursing 17 (2012) 329–338
© 2012, Wiley Periodicals, Inc.