الفهرس 
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Abstract
Summary
Medical devices are essential tools for managing critically ill patients in intensive care units (ICUs). However, prolonged use of medical devices on the skin can lead to pressure injuries or pressure ulcers, which can have serious consequences for the patient’s health outcomes. Pressure injuries in critical care units are commonly associated with the use of devices such as mechanical ventilation, continuous positive airway pressure (CPAP) machines, and intravenous catheters. These medical devices increase the pressure on the skin, leading to tissue damage and the development of pressure injuries (Setchell et al., 2023).
Nurses play a significant role and responsibility to prevent pressure injuries in critically ill patients, and this prevention is considered an essential part of nursing care. Factors such as workload and a lack of knowledge may effect of pressure injury prevention. Most nurses were able to identify medical devices that may cause pressure injuries and suggest ways to prevent them. However, there was a lack of awareness among some nurses about the implications of placing medical devices in close contact with the skin. there is likely to be a disparity in this data because of different exposure to MDRPI (Tan et al., 2020).
Furthermore, nurses’ attitudes towards pressure injuries are significantly correlated with the implementation of adequate prevention measures. to reduce MDRPI occurrences, hospital-directed and evidence-based protocols must be followed., positive attitudes alone are not enough to ensure that practice change takes place, as behavioral change is complex. A mindset focused on pressure injury prevention should be strived for. Changes in understanding will lead to changes inaction, through nurses’ individual actions and through feedback on pressure injury prevention (Kim et al., 2019).
Aim of the Study:
This study aims to:
The study aims to explore factors affecting medical devices related pressure injuries in intensive care units through:
1- Assess nurses’ factors affecting the occurrence of medical devices related pressure injuries.
2- Assess patient factors affecting the occurrence of medical device related pressure injuries.
3- Assess medical devices factors affecting the occurrence of medical devise related pressure Injuries.
Research question:
This study will be conducted for answering the following question:
1- What are the nurses’ factors affecting the occurrence of Medical Device Related Pressure Injuries in intensive care units?
2- What are the patients’ factors affecting the occurrence of Medical Device Related Pressure Injuries in Intensive care units?
3- What are the medical devices factors affecting the occurrence of Medical Device Related Pressure Injuries in intensive care units?
Subject and Methods:
Research design:
A descriptive exploratory design was conducted to achieve the aim of this study.
(A)- Setting:
This study was conducted at (El-Demerdash hospital) in tow intensive care units and Cardiac Intensive Care Unit, which is affiliated with Ain Shams University, Cairo-Egypt.
(B)- Sample:
A convenience sample of all available nurses (No=50 nurses) (157) purposive patient with inclusion criteria from medical ICU and cardiac CCU at Ain Shams university hospital.
(C)-Subject:
This study included a convenient sample of all available nurses’ withy total number of 50 nurses 30 of them were nurses in medical ICU and 20 of them were nurses in CCU in which the study was conducted, and 157 patients from both ICUs.
(D)- Tools of data collection:
Five tools were used to collect the data as follows:
Self-administrated questionnaire
It was developed by the investigator after reviewing the related national and international literature, it was written in simple Arabic language to suit nurses` level of understanding, the investigator developed it to assess nurses’ knowledge.
The first part: It included demographic characteristics of nurses under study and developed by the investigator it was used to assess (age, gender, education, years of experience, and their attainment pervious training
The second part: It was adapted from (Sönmez & Bahar, 2022: Kaçmaz et al.,2023:Nan et al.,2023).) and modified by the investigator.
Nurses practice observational checklist
The first part: It included general practice (protective strategies to avoid the MDRPIs).
The second part: It included preventive care of 5 medical devices.
Nurses Attitude Likert Scale
Patient Assessment Record
The first part: It included patient demographic characteristics.
The second part: It included patient medical record.
Medical device related pressure injuries
The first part: It included characteristics of MDRPIs record.
The second part: Number of devices connected to the patient.
Results
The study revealed that 46% of nursing professionals fall within the age range of 25 to less than 30 years old, and they possess less than 3 years of experience. Concerning gender, 68% were females, 58% of the study participants were nursing institute graduates, and 88% of them had not attended any training courses. Furthermore, the results indicated that 36% of the sample had unsatisfactory knowledge about the factors influencing the occurrence of medical device-related pressure injuries. Regarding the nursing professionals’ skills in preventing medical device-related pressure injuries, the results showed that 68% of the sample lacked competence. Additionally, 56.00% of the nursing professionals under study exhibited negative attitudes towards their role in preventing medical device-related pressure injuries. The study demonstrated a statistically significant relationship between nurses’ knowledge of the factors affecting medical device-related pressure injuries and their education level, attendance of training courses, as well as a relationship between years of experience and age. Importantly, the study established a highly significant correlation between the nurses’ overall knowledge and their practice. Regarding the patients within the research sample, the study established that 57.3% of the patients were in the age range of 35-50 years, 57.9% were female, and concerning monthly income, 73.2% of the sample had insufficient income. Moreover, 49% of the patients had extended their stay in care for more than 15 days.
Conclusion
Based on this study, it was found that most nursing professionals possess inadequate knowledge and skills regarding the factors individually affecting pressure injuries resulting from medical device-related pressure. Additionally, the majority of them exhibit negative behaviors and attitudes concerning their role in preventing pressure injuries related to medical device pressure in intensive care units. Furthermore, a statistically significant relationship was observed between the knowledge and skills of the nursing professionals.
Recommendation
1. The educational training program for nurses in the ICU should be improved to enhance their performance and prevent MDRPIs.
2. A booklet containing clear guidelines in Arabic and English should be provided to assist nurses in caring for patients with medical devices.
3. Further research is needed to assess the impact of the educational training program on nurses’ performance and patient outcomes.
4. It is recommended to replicate the study on a larger scale, involving different hospitals, to generalize the findings. Additionally, the importance of conducting Inservice training programs should be emphasized.