Role understanding of the interprofessional team in promoting movement for pressure ulcer prevention: An ethnographic study

Background

Interprofessional movement promotion is a key measure for preventing pressure ulcers. Although international guidelines emphasize the importance of interprofessional collaboration, it remains unclear what specific roles different professional groups assume in movement promotion and how they collaborate in clinical practice. Therefore, this study aimed to investigate the implementation of interprofessional movement promotion as well as the understanding, roles, and expectations of the involved healthcare professionals.

Methods

As part of qualitative rapid ethnography, we observed the clinical practice of pressure ulcer prevention in an acute care hospital by using an observation guide, informal interviews, field notes, and memos. Using purposive sampling, we included patients at risk of pressure ulcers and the health professionals caring for them, including nurses, physiotherapists, and physicians. The data analysis was based on interpretive description.

Results

We observed 8 patients at risk of decubitus ulcers with relatives and 52 professionals from nursing, physiotherapy, and the medical profession during 30 observation sequences and a total of 80 h. We found uncertainties in the understanding of roles, responsibility for managing and controlling the process of movement promotion, and the involvement of patients and relatives. The involved professionals are convinced of the importance of interprofessional collaboration, but we did not observe corresponding implementation in practice.

Conclusion

The implementation of interprofessional movement promotion for pressure ulcer prevention in acute-care hospitals requires a binding, cross-hospital concept that defines the team composition, roles, and suitable communication channels to promote exchange.