Abstract
High dependency levels and complex care needs increase pressure injury risk for older adults in aged residential care, with devastating consequences for their health and well-being. The prevention of pressure injuries requires comprehensive and skilled care mainly provided by registered nurses and health care assistants. Despite high prevalence of pressure injuries, there is a lack of evidence on their prevention in aged residential care settings in Aotearoa New Zealand. This single case study aimed to identify factors affecting pressure injury prevention in aged residential care. The perceptions of 10 staff from two aged care facilities in Aotearoa New Zealand were obtained from individual interviews along with relevant policy and practice documents. Data were analysed using triangulation and pattern matching. Three themes were identified: 1) staffing; 2) leadership, teamwork, and communication; and 3) assessment and early intervention. Participants were committed to preventing pressure injuries despite the complex, high care needs of residents and challenging contextual factors. The findings contest the notion that pressure injuries occur solely from poor quality care. The association between increasingly difficult work conditions and pressure injury prevalence should be addressed by policy makers. Support and empowerment of health care assistants to take a proactive role in pressure injury prevention could improve outcomes for residents in aged residential care settings. Nurse leaders should continue to advocate for a skilled and knowledgeable nursing workforce and mandated safe staffing levels.