'There should be proper training': Healthcare Support Workers reflect on their experiences of pressure ulcer prevention – a qualitative exploratory study

Aim: To examine healthcare support workers’ experiences of and roles in pressure ulcer prevention.

Background: Pressure ulcers cause personal suffering and represent a serious burden to health and social care systems. With rapid growth of aging population, healthcare workforce models project greater reliance on advanced nursing roles and concomitantly nursing support roles. Healthcare support workers are now an expanding group of nursing team who are increasingly responsible for pressure ulcer prevention. Little is known about their experiences, what roles they assume in pressure ulcer prevention or what their training needs may be.

Design: A focus group study conducted in the U.K. between March and June 2021.

Method: Four focus groups conducted online with 14 healthcare support workers working in different clinical settings. The focus groups explored healthcare support workers’ experiences and views about pressure ulcer prevention. Data were analysed using thematic analysis.

Findings: 14 participants included 3 trainee Nursing Associates (2 acute, 1 community) and 1 Nursing Associate from acute settings, remaining 10 Healthcare Assistants from acute (4), community (2), domiciliary care (3), and mental health (1). The findings show that: 1) Healthcare support workers are showed high motivation towards pressure ulcer prevention; 2) A lack of knowledge, skills, resources and structured training alongside poor working conditions and patients’ resistance was considered to prevent effective pressure ulcer care; 3) Good communication and multi-disciplinary team work together with appropriate training can facilitate good pressure ulcer care; 4) Pressure ulcer care might be improved by training, and more support from specialist tissue viability nurses.

Conclusion: Healthcare support workers’ experiences of and roles in pressure ulcer prevention is under investigated. With increased responsibility for bedside care including pressure ulcer prevention being devolved worldwide to healthcare support workers, a review of education on pressure ulcers prevention nationally at all levels of the nursing team is required.