EFFECTIVENESS OF NURSING INTERVENTIONS IN THE PREVENTION AND TREATMENT OF PRESSURE ULCERS AMONG BEDRIDDEN PATIENTS IN OKWE GENERAL HOSPITAL, ASABA, DELTA STATE

TOPIC:  EFFECTIVENESS OF NURSING INTERVENTIONS IN THE PREVENTION AND TREATMENT OF PRESSURE ULCERS AMONG BEDRIDDEN PATIENTS IN OKWE GENERAL HOSPITAL, ASABA, DELTA STATE

THIS TOPIC IS ALSO SUITABLE FOR:
1-Department of Nursing Science
2-Department of Public Health
3-Department of Community Health
This research material contains:
1-Chapter One to Five
2-Recent References/citations
3-Tables/Charts/Graphs in Chapter Four
4-Accurate Data Analysis
5-Table of Contents
6-Questionnare

ABSTRACT
This study was carried out to examine the effectiveness of nursing interventions in the prevention and treatment of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, Delta State. The study was specifically carried out to determine the effectiveness of pressure ulcer risk assessment and early identification by nurses in reducing the occurrence and severity of pressure ulcers among bedridden patients in Okwe General Hospital, examine the effectiveness of routine patient repositioning in the prevention and treatment of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, evaluate the effectiveness of wound care management practices in promoting the healing of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, and assess the effectiveness of patient and caregiver education provided by nurses in preventing pressure ulcers among bedridden patients in Okwe General Hospital, Asaba. The study employed the descriptive survey research design. A total population of 133 bedridden patients in Okwe General Hospital, Asaba was used for the study. A sample size of 100 respondents was initially determined using Taro Yamane formula, while 85 respondents were validated for the study using multi-stage sampling technique involving stratified and convenience sampling methods. Hence, questionnaire was used for data collection, while the data collected were analyzed using frequency tables, percentages, and mean scores. The hypotheses test was conducted using Pearson Chi-square statistical tool. From the responses obtained and analyzed, the findings revealed that pressure ulcer risk assessment and early identification by nurses have significant effect on reducing the occurrence and severity of pressure ulcers among bedridden patients in Okwe General Hospital at r = 0.648, t = 8.214, P = 0.013. The study also showed that routine patient repositioning has significant effect on the prevention and treatment of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba at r = 0.592, t = 6.701, P = 0.021. The study therefore recommends that nurses should conduct regular pressure ulcer risk assessments, ensure consistent patient repositioning, adopt effective wound care management practices, and provide continuous education to patients and caregivers for improved pressure ulcer prevention and treatment outcomes.
Keywords: Nursing Interventions, Pressure Ulcers, Bedridden Patients, Wound Care Management, Patient Repositioning.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background to the Study
Healthcare is an integral part of human development as it contributes to longevity, which improves the quality of life and restores physical, psychological and social health. Patient-centredness, evidence-basedness, and quality-oriented delivery of healthcare services to the diverse healthcare needs of those needing acute and long term healthcare has become a growing concern in all healthcare systems today. The quest for excellence in healthcare has, therefore, altered the role of healthcare professionals, especially nurses, which include a wide range of clinical activities such as health promotion, disease prevention, therapeutic care, rehabilitation and palliative care. The delivery of healthcare was gradually maturing towards integrating care and focusing on patient safety and evidence-based practice for better clinical outcomes, according to Ahmed et al. (2022). Likewise, Hassan and Noor (2021) claimed that coordinated multidisciplinary working that improved continuity and quality of care was essential to effective healthcare systems. Oliveira et al. (2021) also reported that the quality of health services has been improved over time, by establishing standardized clinical protocols, holding the professional to account and by keeping quality improvement efforts going. These developments have strengthened the need for nursing practice as an integral part to comprehensive and holistic healthcare services.
In this changing health care setting, nursing has come to be a science-based and professionally regulated profession which emphasizes the physiological, psychological, emotional and social needs of patients and the systematic application of clinical interventions. Nursing interventions are described as deliberate, evidence based, interventions initiated by the nurses to prevent disease, alleviate suffering, improve recovery and maximize patient health outcomes. These include: Comprehensively assessing the patient; regularly monitoring the patient's condition; managing the patient's skin integrity; providing nutritional support; educating patients; providing wound care; preventing infection in patients; and positioning patients for therapy. According to Gedamu et al. (2021), nursing interventions had been activities that had been planned and carried out in an organized way to achieve predetermined outcomes for patients based on individual care planning. Similarly, Iblasi et al. (2022) reported that suitable nursing interventions were able to significantly improve patient security and minimize the occurrence of preventable complications linked to extended hospital stays. Eirinidou et al. (2023) also continued to assert that nursing interventions' effectiveness had largely been contingent upon the nurses' clinical competence, following established protocols, and continually evaluating patients' responses to nursing care. Castelino et al. (2024) also noted that evidence-based nursing practices had significantly contributed to improving healthcare quality, and enabled a more personalized and patient-centered approach to clinical care in diverse healthcare environments.
A major category of patients requiring extensive nursing interventions comprises bedridden individuals, whose dependence on continuous nursing care necessitates meticulous clinical attention throughout hospitalization. A bedridden patient is a person who is medically unfit or physically handicapped, recovering from a surgical procedure or suffering from a chronic disease and are unable to move around on their own and has to be kept in bed and supervised by a professional. Prevention and treatment of pressure ulcers is one of the basic tasks of a nurse in caring for such patients. Pressure ulcers are localized injuries of the skin and underlying tissues that result primarily from pressure acting on the body, the most common sites are over bony prominences, and caused by sustained pressure or pressure in combination with shear or friction. Ehwarieme et al., (2024) found that effective prevention of the pressure ulcers had included systematic nursing interventions such as to change position, comprehensive skin assessment, pressure redistribution, control of moisture, and nutritional optimization. Kandula (2025) also noted that the treatment of pressure ulcers had incorporated evidence-based wound management, prevention of infection, choosing the right dressing, and constant clinical evaluation to facilitate wound healing. Moreover, Saleh et al. (2026) reported that systematic nursing care had significantly reduced healing as it related to bedridden patients, and Gbadamosi et al. (2026) argued that following the standard nursing procedure had significantly improved the prevention and care of PUs in hospitals.
General hospitals play a vital role as an integral part of health services delivery as they offer health services of all nature to patients of all dependency levels. In these institutions, the role of nursing interventions becomes more meaningful because during hospitalization of the patients the constant surveillance and individualized care of the patient is important. Okwe General Hospital in Asaba, Delta State, is an example of a health care facility where nurses are expected to have different clinical roles with the goal of maintaining the physiological integrity of patients, preventing complications and enabling optimum recovery. The hospital setting is an ideal place to consider implementation of evidence-based nursing interventions for prevention and treatment of pressure ulcers in bedridden patients receiving routine hospital care. According to Ahmed et al. (2022), evidence-based nursing practice (EBP) had become more and more important for healthcare institutions to help them enhance patients' outcomes and the quality of healthcare. Similarly, Castelino et al. (2024) found that since the beginning of the program, the institutional commitment to professional nursing standards had enhanced the implementation of preventive and therapeutic interventions in the clinical environment. Hence the study of how effective nursing interventions are in preventing and managing pressure ulcers in bed ridden patients at Okwe General Hospital, Asaba, Delta State will enlighten us on the current nursing practice and support the development of evidence-based nursing practice.

1.2 Statement of the Problem
Prevention and treatment of pressure ulcers are fundamental aspects of quality nursing care and serve as an indicator of the quality of patient management in health care settings and of the effectiveness of evidence-based clinical practice. The nursing interventions necessary to prevent skin breakdown, promote healing and achieve positive health outcomes in bedridden patients should be ongoing and individualized throughout the hospitalization. The ideal healthcare setting is where preventive and therapeutic nursing interventions are always undertaken according to best practice guidelines, so that a patient will always recover as well as possible and avoidable complications are minimised. According to Ahmed et al. (2022), there was evidence that EBPN had improved patients' outcomes due to delivery of care in a systematic manner. Likewise, Castelino et al. (2024) noted that professional nursing practice had reinforced the quality and uniformity of the preventive and therapeutic practices implemented in the various hospital wards. This expectation highlights the need for regular assessment of the effectiveness of nursing interventions in a particular health care institution.
Evidence has indicated that despite the presence of known clinical guidelines for preventing and treating pressure ulcers there are differences in how and what nursing interventions are implemented and effective in preventing and treating pressure ulcers between healthcare facilities. From the current situation, it can be seen that the recommended practices like frequent turn, systematic skin evaluation, nutrition, proper cleaning of wound are accepted as necessary measures in the care of patients, but they might not be equally effective in different institutions, due to different nursing care. Ehwarieme et al. (2024) noted that when the pressure ulcers were prevented, it has been attributed to the consistency of comprehensive nursing interventions. Similarly, Kandula (2025) found that timely and evidence-based management of wounds with continuous monitoring of patients had been necessary for effective treatment outcomes. These variations have caused confusion on the effectiveness of nursing interventions in the prevention and treatment of bedridden patients for developing pressure ulcers in a particular hospital, thus the need for empirical research.
Although there have been studies that focused on the prevention and management of pressure ulcers as a result of nursing care, most of the evidence available has been for more general health care settings, and little was known about the efficacy of the nursing care within many of the general hospitals in Nigeria including the Okwe General Hospital, Asaba Delta State. Thus, there is an empirical gap in the knowledge regarding the implementation and effectiveness of nursing interventions, when it comes to prevention and treatment of pressure ulcers for the bedridden patients in this healthcare environment. The evaluation of nursing interventions on a continuous basis has continued to be crucial for enhancing healthcare quality and patient results(Saleh et al.,(2026). In the same vein, Gbadamosi et al. (2026) asserted that institutional audit of nursing practice had been an invaluable source of evidence to enhance evidence-based clinical decision-making. Hence, this study will attempt to close this gap in knowledge by assessing the effectiveness of nursing interventions to prevent and treat pressure ulcers in bed ridden patients in Okwe General Hospital, Asaba, Delta State to provide evidence that could guide enhancement of nursing practice and care.
1.3 Objectives of the study
The main objective of this study is to assess the effectiveness of nursing interventions in the prevention and treatment of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, Delta State.  The specific objectives are to: 
1.Determine the effectiveness of pressure ulcer risk assessment and early identification by nurses in reducing the occurrence and severity of pressure ulcers among bedridden patients in Okwe General Hospital.
2.Examine the effectiveness of routine patient repositioning in the prevention and treatment of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba.
3.Evaluate the effectiveness of wound care management practices in promoting the healing of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba.
4.Assess the effectiveness of patient and caregiver education provided by nurses in preventing pressure ulcers among bedridden patients in Okwe General Hospital, Asaba.
Other parts of chapter one include:
1.4 Research Questions
1.5 Hypotheses
1.6 Significance of Study
1.7 Scope of the Study 
1.8 Operational Definition of Terms 

CHAPTER TWO
REVIEW OF LITERATURE (Preview)
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of pressure ulcers, causes and risk factors of pressure ulcers, stages and complications of pressure ulcers, prevention and treatment of pressure ulcers, nursing interventions in the prevention and treatment of pressure ulcers, and challenges associated with pressure ulcer management among bedridden patients, etc.  The chapter is sub-grouped into the following major headings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Presented below is a snapshot of key areas of the study methodology, the full and detail chapter three methodology is contained in the instant download document.

Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises bedridden patients receiving treatment at Okwe General Hospital, Asaba, Delta State.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 100 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified, proportionate allocation, and convenience sampling to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses. Inferential statistics, such as Pearson Chi-square, were used to test the hypotheses.
Full outline for chapter three;
3.1 Research Design
3.2 Research Setting
3.3 Target Population
3.4 Sample Size
3.5 Sampling Technique
3.6 Instruments For Data Collection
3.7 Validity and Reliability of Instrument
3.8 Pilot Study
3.9 Method of Data Collection
3.10 Method Of Data Analysis
3.11 Ethical considerations

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables and charts. Based on the results obtained from the analysis, the following major findings were made:

i. The study found that pressure ulcer risk assessment and early identification by nurses are effective in reducing the occurrence and severity of pressure ulcers among bedridden patients in Okwe General Hospital, as evidenced by the fact that 53.0% of respondents agreed that nurses regularly assess patients for pressure ulcer risks, 54.1% agreed that early identification reduces pressure ulcer severity, and 52.9% agreed that regular monitoring helps prevent pressure ulcer occurrence. The corresponding hypothesis test further showed a correlation coefficient (r) of 0.648, t-value of 8.214, and p-value of 0.013 (p < 0.05), leading to the rejection of the null hypothesis.

ii. The study found that routine patient repositioning is effective in the prevention and treatment of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, as evidenced by the fact that 53.0% of respondents agreed that routine repositioning reduces pressure ulcer occurrence, 49.4% agreed that consistent repositioning enhances comfort and supports recovery, and 52.9% agreed that proper repositioning contributes positively to pressure ulcer prevention and treatment. The corresponding hypothesis test further showed a correlation coefficient (r) of 0.592, t-value of 6.701, and p-value of 0.021 (p < 0.05), leading to the rejection of the null hypothesis.

iii. The study found that wound care management practices are effective in promoting the healing of pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, as evidenced by the fact that 50.6% of respondents agreed that proper wound care management promotes faster healing, 50.6% agreed that regular wound assessment improves healing outcomes, and 49.4% agreed that effective wound cleaning and dressing help prevent infections. The corresponding hypothesis test result was not presented in the supplied analysis.

iv. The study found that patient and caregiver education provided by nurses is effective in preventing pressure ulcers among bedridden patients in Okwe General Hospital, Asaba, as evidenced by the fact that 50.6% of respondents agreed that nurses' education helps patients and caregivers understand prevention strategies, 50.6% agreed that adequate education improves participation in pressure ulcer prevention, and 50.6% agreed that continuous education and guidance support better prevention outcomes. The corresponding hypothesis test result was not presented in the supplied analysis.

CHAPTER FIVE: DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings  
5.2 Implication of the Findings
5.3 Limitations of the Study
5.4 Summary 
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies
Reference
Appendix

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