Integrating Evidence-Based Clinical Framework in the Prevention of Pressure Ulcers Among Orthopedic Patients: How Responsive Are Nurses in Sub-Saharan African Countries? A Scoping Review

Abstract

Background: Pressure ulcers are a significant concern in healthcare, particularly among orthopedic patients who are often immobile due to surgeries or trauma. In sub-Saharan Africa, the integration of evidence-based clinical frameworks for the prevention of pressure ulcers faces unique challenges, including limited resources and inadequate training.

Method: This scoping review explores the responsiveness of nurses in Sub-Saharan Africa in implementing evidence-based practices to prevent pressure ulcers in orthopedic patients.

A comprehensive search of databases including PubMed, CINAHL, Google Scholar, African Journals Online, and Medline yielded 4 relevant studies published from 2019 to 2024.

Results: The review highlights the current state of knowledge as barriers to effective practice and the impact of cultural and systemic factors on nursing responses to evidence-based guidelines.  Findings also suggest gaps in training and resource constraints to hinder full implementation, with 67% of surveyed nurses acknowledging the significance of regular patient repositioning, but only 35% consistently practiced it due to high patient-to-nurse ratios and poor staffing levels.

Conclusions: Recommendations include strategies for enhancing nursing education, improving resource allocation, and fostering an environment that supports evidence-based practice to ultimately improve patient outcomes in this vulnerable population.