MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY

AND CHILDREN

NJOMBE INSTITUTE OF HEALTH AND ALLIED SCIENCES

RESEARCH PROPOSAL SUBMITTED IN PARTIAL FULFILLMENT OF THE

REQUIREMENTS FOR ORDINARY DIPLOMA IN NURSING AND MIDWIDERY
IN NJOMBE INSTITUTE OF HEALTH AND ALLIED SCIENCES.

TITLE

FACTORS CONTRIBUTING TO THE FAIRULE TOWARD BED SORE

PREVENTION AMONG NURSES WORKING AT KIFANYA HEALTH CENTRE

BY

ERICK J CHILAMULA, NS 0751/0076/2016

FEBRUARY,2022

Supervisor……………………………..

i
Contents
Declaration...........................................................................................................................................iii
Certification..........................................................................................................................................iv
Acknowledgement.................................................................................................................................v
List of Abbreviation/Acronyms.............................................................................................................vi
1.0. Introduction....................................................................................................................................1
1.1. Background of the study.............................................................................................................1
1.2. Problem statement.....................................................................................................................1
1.3. Research Objectives....................................................................................................................2
1.4. Research Questions....................................................................................................................2
1.5. Literature review........................................................................................................................2
1.6. Significance of the Study.............................................................................................................4
2.0. Materials and Methods..................................................................................................................5
2.1. Study setting...............................................................................................................................5
2.2. Study design...............................................................................................................................5
2.3. Study population........................................................................................................................5
2.4. Sample size and sampling procedure..........................................................................................5
2.5. Inclusion criteria.........................................................................................................................5
2.6. Research variables......................................................................................................................5
2.7. Data collection methods and Tools procedure...........................................................................6
2.8. Data Collection Procedure........................................................................................................10
2.9. Data Processing and analysis procedure...................................................................................10
2.10. Ethical considerations.............................................................................................................10
2.11. Dissemination of results.........................................................................................................11
References...........................................................................................................................................11
APPENDICES.........................................................................................................................................13
APPENDIX I: CODE BOOK.....................................................................................................................14
APPENDIX II: RESEARCH BUDGET........................................................................................................14
APPENDIX III: RESEARCH WORK PLAN.................................................................................................15
APPENDIX IV: QUESTIONNAIRE (ENGLISH VERSION)...........................................................................16
APPENDIX V: CONCENT FORM.............................................................................................................21
APPENDIX VI: REQUEST LETTER...........................................................................................................22

ii
Declaration
“I ……………………………………..declare that this proposal is my original ideas and that the
proposed research has not be presented or conducted elsewhere in a similar manner for
either award or as a research project”

Signature of the candidate Date

…………………………………….. …………………………….

iii
Certification
“The undersigned certifies that he/she has read the proposal and satisfied that this is the
original work of …………………………………. Who has registered for ordinary diploma in
nursing and midwifery (in service) programme at Njombe Institute of Health And Allied
sciences (NJIHAS)”

Signature of supervisor Date

……………………………………………….. ………………………………………

iv
Acknowledgement.
Firstly I would like to thank the almighty God for the life and health has been showing me
endlessly love as I was able to prepare this research proposal as one of the task to accomplish
my studies of diploma in nursing and midwifery practices. Also special thanks to my lovely
Father, Mother, sister and brothers for their tireless support as well as encouragement
throughout this study.

Special gratitude goes to the staff of Njombe institute of Health And Allied Sciences
(NJIHAS) particularly the principal madame Subby Yessaya and sir Baraka Righton for his
extensive support and endless encouragement in making sure that this work is completed
successful.

Lastly but not least. I would like to thank my classmates for their tireless encouragements,
support and advise to accomplish this proposal. May almighty God bless you.

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 List of Abbreviation/Acronyms.
KHC-Kifanya health centre

EN- Enrolled Nurse.

ICU-Intensive care Unit.

MoHWS- Ministry of Health and Social Welfare.

RN- Registered Nurse.

WHO- World Health Organization.

vi
 1.0. Introduction.

1.1. Background of the study

Bed sores is also known as pressure ulcers, other name for it includes pressure sores,
decubitus ulcers and tropical ulcers. Is Ischemic necrosis and ulceration of tissue overlying a
bony prominence which has been subjected to prolong pressure against an external object like
a bed, wheel chair, cast or splint (Stacey, 2004)

Bed sores is worldwide problem which affect patient’s quality of life and are associated with
an increase incidence of medical complication, infection and death (Voss 2002).

Patients experiencing decreased mobility sensory perception, poor nutrition, friction and
shears can therefore be at risk for pressure ulcer development (WHO, 2006)

Development of bed sores affect patient quality of life and are associated with an increase
length of hospitalization and incidences of medical complications, Infection and health
problem to patients admitted at KHC

Bed sores is a problem which has been reported by KHC to increase yearly. Nursing action
and prevention of bed sores should be consistently given consideration in daily routine.

Due to increased number of bed sores to patients admitted at KIFANYA HEALTH CENTRE,
the current study aim to find and evaluate the attitude and practice of nurses toward
prevention of bed sores.

This will help to find out or evaluate nurses and provide information which will be a useful
guide on measures to be taken in the units to reduce and treat bed sores.

1.2. Problem statement

Development of bed sores affect patient quality of life and are associated with an increase
length of hospitalization and incidences of Infection, and medical complications to patients
admitted at KHC.

Bed sore is the problem which has been reported to increase yearly among patients admitted
in ICU, Medical ward as well as pediatric ward for all ages and sex. Nursing action and
application of bed sores prevention should be consistently given consideration in daily
routine.

1
There is a National Efforts through Ministry of Health, Community Development, Gender,
Elderly and Children in Tanzania to prevent bed sores development by implementing
prevention program, the implementation is poor due to lack of resources and shortage of
staffs especially nurses and other health personnel’s (MoHSW, 2011).

So the purpose of this study is to “Determine attitude and practice of nurses toward
prevention of bed sores on patient care”, this will help to find out or evaluate nurses and
provide information which will be a useful guide on measures to be taken in the units to
improve quality of care to patients and reduce and treat bed sores.

1.3. Research Objectives

1.3.1. Broad Objective

1. To determine factors lead to the failure on prevention of bed sores at KHC.

1. 3. 2. Specific Objectives

1. To establish demographic data among nurses working at Kifanya health centre.

2. To assess the attitude of nurses having on prevention of bed sores

3. To assess practice of nurses on prevention of bed sores.

1.4. Research Questions

1.4.1. Broad research question

1. What are the factors which lead to the failure on prevention of bed sores at KHC.

1.4.2. Specific research questions

1. What are the demographic characteristics among nurses at Kifanya health centre (KHC)
that might influence on prevention of bed sores?

2. What attitude do nurses have toward on prevention of bed sores to patients?

3. How nurses practice on prevention of bed sores to patients?

1.5. Literature review.

Worldwide more than one million individual develop bedsores annually. Bed sores remain a
significant health care problem particularly among older person who are deliberated and
person with immobility. Further patients who need major surgery have a multiple risks factor,
many of which become exacerbated with surgery. Factors such as length of time on operating
table, restricted movement an assault of skin integrity such as shear and friction also
contribute to skin damage (WHO, 2006).

2
Prevalence of bedsores in East Africa is seen most frequently in patients who have
diminished or absent sensation or are emanated, paralyzed or otherwise bed ridden. Any
patient experiencing decreased morbidity decreases sensory perception, feces or urinary
incontinence or poor nutrition can be therefore being at risk of bed sores development.
Tissue over the sacrum, Ischia, greater trochanter external and heels are especially susceptible
but other sites may be involved depending on the patient’s position (Scand 2001).

Although evidence based guidelines for the prevention of pressure ulcers have been
developed extensively and have been supported globally, the problem is still widely spread in
health care facility around the world (Kaddourah et al, 2016)

Bed sores remain one of the major health problems around the world. For every 1000000
patients who developed Bed sores 65000 died from complications which presents a major
health challenge worldwide (soban et al, 2011). And also an 80% increase in the number of
patients who were hospitalized from the year 1993 to 2006, which lead to Bed sores
occurrence(Macgregor L,2009)

As revealed, Bed sores is common in high and middle income countries but it is rarely
researched in low income countries a prevalence of 12.7% was reported in Brazil (Chacon et
al,2009 ), 10% in Turkey (Ina DG & Oztunc G, 2012 ), A higher prevalence of 47.6% in
Thailand (suttipong C, Sindhu S.(2012) and 16% in Ethiopia (Gedamu et al,2014). Also
studies on health professional knowledge in Uganda (Mwebaza et al, 2014) and Ethiopia
(Dilie A, & Mengistu D, 2015)

Moreover, researchers identified variety of factors that influence the occurrence of Bed sores
including friction/shear, moisture sensory perception, immobility, the position of the patient,
and length of hospital stay, nutritional status of the patient, age and use of medical reliving
devices(Gedamu et al,2014 ),(Nuru N, 2015),(Bergstorm et al,1987)

The answers to reduce the prevalence of bed sores lies not in implementing any one strategy,
but in providing an institutional wide prevention program, Common guideline for preventing
bedsores (Bed sores) is identification of patients at risk at the hospitals ( Stacey 2004).

Bed sores are significant clinical concerns across the health care continuum. It is estimated
that 1.3 to 3 million adults have bedsores that have an impact on clinical function and
economic outcomes (Needleman, 2001).

3
Bed sores affect patients quality of life associated with an increase incidence of medical
complication, infection and death. Every year an estimate 60,000 people die from
complication related to bed sores (Vos, 2000).

Pressure sores remains a significant health care problem particular among older person who
are deliberated and person with immobility. Further patients who need major surgery have a
multiple risks factor many of which become exacerbated with surgery. Factors such as length
of time on operating table restricted movement an assault of skin integrity such as shear and
friction also contributes to skin damage (WHO, 2006)

The previous study of 2018 done in Ethiopia recommends that to establish a better system to
early identification of risk factors toward the occurrence of Bed sores and implementation of
different tools like guideline on how to handle patients on Bed sores as well as for researcher
to conduct studies on factors of Bed sores for hospitalized patients (Bereded et al, 2018)

Therefore, assessing the factors contributing to the failure of bed sores prevention at Kifanya
health centre is essential so as to improve health quality of the patients

1.6. Significance of the Study

Improving health status of individual is the main aim of millennium development goal. One
way of achieving this is to make sure anything that can prevent development of bed sores
should be given a greater consideration. In KHC patient’s susceptible development of bed
sores has been increasing yearly. Since bedsores is a problem in KHC, Contributed by
various factors. It’s unknown how the nurses perceive the contributing factors. In the current
study it focuses to assess nurses’ attitude and practice toward bed sore prevention. The result
that will be generated from this study will serve as a baseline for intervention on bed sores
prevention.

2.0. Materials and Methods.

2.1. Study setting

This study will be done at Kifanya health centre at Kifanya village. Kifanya health centre is
the Government health centre located in Njombe region with having 6 staffs, 2 RN, 1 EN,2
CLINICAL OFFICERS and 1 Data cracker. It serves the resident near and far away from
Kifanya by providing both in patient care (IPD-Care) and outpatient care (OPD-Care) as well
as Reproductive and child health clinic (RCH-Clinic)

4
 2.2. Study design
The study design will be hospital based cross sectional study design.

2.3. Study population

The target population is all nurses (EN & RN) working at Kifanya health centre (KHC)
Nurses of all ages, and sex.
2.4. Sample size and sampling procedure
Simple random procedure will be done to nurses working at KHC. The researcher will write
number in small piece of papers. The written papers with number will be put in the box and
ENs and RNs will pick one number at a time up to the required number of 30. Then
questionnaire will be given to those whose numbers were picked to represent the study
population.

2.5. Inclusion criteria

All nurses with all ages, sex, and all ranks as ENs and RNs who will be willing to participate
in the study.

2.6. Research variables

Table 2.6.1.In this study there are eight variables, in which two variables are Numerical and
seven variables are categorical variables. Numerical variables are Age and Number of years
in service. Categorical variables are Sex, Education level, Type of nursing title, Number of
years in service, Area of practice, Level of Attitude, Level of practice as shown in table
below:

Objectives Variables Measurement

Indicator Scale
1.To establish demographic Age
data
Sex
Education level
Type of nursing title
Number of years in
service
Area of practice
2. To assess the attitude of Level of attitude Positive 2
nurses having on prevention Negative 1
of bed sores.

3. To assess practice of - Level of practice Good practice 2

Bad practice 1
nurses on prevention of bed

5
sores

Source: field survey, 2020

2.7. Data collection methods and Tools procedure

Table 2.7.1.Administering of questionnaire will be used to mobilize data. Self administered
questionnaire consisting of 30 questions will be answered by participants who will be willing
to participate in the study. The data collection tool is divided into three sections including
Section (A) Demographic questionnaire consisting of seven (6) questions, Section (B)
Nurses attitude toward bed sore prevention questionnaire consisting of eighteen (12)
questions, Section (C) Nurses Practice toward bed sore prevention questionnaire consisting
of sixteen (12) questions.

Research Variables source of Data collection data collection

objectives data tools questions
1.To establish Age Primary Self administered 1. What is your age?
demographic source Questionnaire
data
Sex Primary Self administered 2. What is your sex?
source Questionnaire
Education Primary Self administered 3. What is your level
source Questionnaire of education?
level
Type of Primary Self administered 4. What is your
source Questionnaire nursing title?
nursing title
Number of Primary Self administered 5. How long have
years in source Questionnaire
you employed as a
service
permanent staff nurse
in your hospital?

Area of Primary Self administered 6. What is your area

practice source Questionnaire of practice?
2. To assess the -Level of Primary Self administered 1. Most risk factors
attitude of attitude source Questionnaire
of bed sores can be
nurses having on (statement)
prevention of avoided
bed sores.
2. Prevention of risk
factors for bed sore is
time consuming for

6
 me to carry out.
3. The incidence of
bed sore should be
0% in my ward
4. In my opinion,
Nurses can
independently
provide nursing care
to prevent bed sores
5. I am aware of
appropriate
assessment
procedure for bed
sore formation
6. Patient who at
risks for bed sore
development should
be assessed at the
first day of
admission
7. All data about bed
sore should be
documented at the
time of assessment
and reassessment
8. Bed sores should
be an important
indicator for quality
of nursing care
9. Patients who are at
risks of bed sore
development should
be cared by standard

7
 nursing care to
prevent bed sores
10. Patients should
be cleansed
immediately after
soiled
11. I am not
interested to move
patient from one side
to another side of the
bed by lifting up
her/him out of the
bed
12. I value that
joining educational
training on bed sore
prevention is
important to my
practice
3. To assess Level of Primary Self administered 1. I observe how
practice source Questionnaire
practice of other nurses risk
(statement)
nurses on factors of bed sores
prevention of development
bed sores 2. I identify common
contributing factors
for bed sore
development by
periodic assessment
of patients skin
3. I do skin
assessment that is
guided by standard
nursing care

8
 available in my ward.
4. I document all
data related to bed
sore assessment
5. I place the pillow
under the patient’s
legs to prevent bed
sore.
6. I pay more
attention to pressure
points during
cleansing of patients
skin
7. I provide and
monitor protein diet
foods to
malnourished patient
who is bedridden
8. I avoid dragging
the patient during
repositioning
9. I turn patients
position every two
hourly
10. I put pillows
under patient legs
from mid cuff to
ankle in order to
keep heels off the
bed
11. I always attend
seminars for bed
sores prevention

9
 12. I give advice to
patient or care giver
regarding bed sore
preventive care
before discharge the
patient from hospital
Source: field survey, 2020

2.8. Data Collection Procedure

In this study administered questionnaire will be given to each participant who will be willing
to participate so that each will answer the questions according to instruction given for each
question then latter on they will give them back to the researcher.

2.9. Data Processing and analysis procedure

Each day data will be received counter checked for appropriate accuracy and completeness
and consistence with other fact gathered to detest errors and to correct them. All data will be
sorted and manually calculated scientifically and summarized in the form of tables.

2.10. Ethical considerations

The researcher will get an introduction letter from the principal of the institute, permission to
conduct a study will be obtained from medical officer in charge of KHC, Hospital matron and
the nurse in charge of the ICU will be informed. The respondents will be informed the
purpose of the study and benefits. The respondents will write number instead of names in
Questionnaires for confidentiality purpose and data collection will be secured confidentially.

2.11. Dissemination of results

The study will be disseminated to Njombe Institute of Health And Allied Sciences (NJIHAS)
for record keeping and to the medical Officer Incharge of KHC for action taking and record
keeping.

References
Bereded, D. T. (2018). Prevalence and risk factors of pressure ulcer in hospitalized adult
patients; a single center study from Ethiopia. BMC Research Notes; 2018; 11;847. Published
online 2018 Nov 29. doi: 10.1186/s13104-018-3948-7 [Wiley Online Library] .

Bergstorm N, B. B. (1987). The Braden scale for Predicting Pressure sore Risk. Nursing
Research.1987 july-Aug; 36(4):205_10.[PubMed][Ref list] .

10
Dilie A, M. D. (2015). Assessment of Nurse's knowledge, attitude and perceived barriers to
expressed pressure ulcer prevention practice in Addis Ababa government hospitals, Addis
Ababa, Ethiopia, 2015.. [Cross Ref][Google Scholar]. Adv Nurs .

Gadamu H, H. M. (2014). Prevarence and associated factorsof pressure ulcer among

hospitalized patients at Fallegehiwot referral Hospital, Bahie Dar, Ethiopia. Adv
Nurs.2014;2014:1-8, doi: 10.1155/2014/767358. [Cross Ref][Google Scholar][Ref list] .

Inna DG, O. G. (2012). Pressure ulcer prevalence in Turkey; a sample from university
hospital. J wound Ostomy Continency Nursing, 2012 July-Aug; 39(4):409-13 [PubMed][Ref
list] .

Kaddourah B, A. K. (2016). Atittude of health professionals toward bed sore. BMC Article ,
2.

L, M. (2009). International guidelines, Pressure sore prevention: prevalence and incidence

in context. A consensus document. London: MEP Ltd: 2009.[Google Scholar][Ref list]. Wiley
Online Library.

Mohsw. (2011). [HTML]jamanetwork.com/002_06_1212 .

Mwebaza I, K. G. (2014). Nurse's knowledge, practices and barriers in care of patients with
pressure ulcer in Ugandan teaching hospital. Nurs Res Pract , 2014():973602.[PubMed][Ref
list].

Needleman. (2001). Surgical disorders,www.health .wa.gou.safety and quality

programmes/pressure ulcers.cfm.

Nuru N, Z. F. (2015). knowledge and practice of nurses toward prevention of pressure ulcer
and associated factors in Gondar University Hospital, Northwest Ethiopia. BMC Nursing
2015,[PubMed][Ref list] .

Sittipong C, S. S. (2012). Predicting factors of pressure ulcers in older Thai stroke patients
living in urban communities. J Clin Nurs.2012 Feb; 21(3-4):372-9 [MedPub][Ref list] .

Sobaan LM, H. S. (2011). Preventing pressure ulcersin hospitals: A systematic review of

nurse-focused quality improvement interventions. . Jt Comm J Qual Patient Saf, 2011 Jun;
37(6):245-52 [PubMed][Ref list] .

Stacey. (2004). Nurses knowledge toward pressure ulcers prevention. [MedPub][Ref list] .

Voss. (2012). Complications related to bed sores. (2002). wiley Online Library .

Voss. (2000). bed sores management and the importance of nutrition in measure nursing.
Wiley Online Library[PubMed][Ref list] .

WHO. (2006). [HTML] jamanetwork.com .

11
12
APPENDICES

13
 APPENDIX I: CODE BOOK
Variable Coding
Sex Male =2
Female=1
Education level
Diploma in nursing=2
Certificate in nursing=1
Type of nursing title RN=2
EN=1
Number of years in service Highly experienced-1-4 years =3
Moderate experienced-5-10 years =2
Mild experienced-1-4 years=mild
experienced =1

Area of practice ICU=3

Surgical ward=2
Medical ward=1
Level of attitude Good attitude = 2
Poor attitude =1
Level of practice Good practice =2
Bad practice =1

APPENDIX II: RESEARCH BUDGET

SN DESCRIPTION TERM PRICE MULTIPLYING TOTAL
FACTOR AMOUNT
1 STATIONARIES
Ruled paper 1 Rim 12,000/=@ 12,000 x 1

Duplicating paper 1 Rim 8,000/=@ 10,000 x 1

Typing expenses 3 books 15,000/=@ 15,000 x 3
Writing pens 5pens 400/=@ 400 x 5
Ruler 1 pc 500/=@ 500 x 1
Pencil 2 pencils 200@ 200 x2

2. TRANSPORT 5000/= 5000/=x4 20000/=

TOTAL 89000/=

14
 APPENDIX III: RESEARCH WORK PLAN
ACTIVIES 5 days 1 day 4 days 8 days 3 days
Writing research
proposal
Presenting
research proposal
Data collecting

Data analysis and

Report writing
Report submitting

15
APPENDIX IV: QUESTIONNAIRE (ENGLISH VERSION)

Questionnaire for assessment of nurse’s attitude and practice toward bed sore
prevention

Introduction: this tool is divided into three sections. Section [A] is related to your personal
data. Section [B] is about your attitude toward bed sore prevention. Section [C] related to
your practice toward bed sore prevention. Your answers will be used as a baseline for
improvement of quality nursing care to patients.

SECTION A: Demographic Questionnaire

Instruction: please fill in the blank space or tick mark [√] for your answer in the bracket as
indicated

1. What is your age?

My age is (write your age in numbers) ……………years.

2. Sex

 Male [ ]

 Female [ ]

3. Education level

 Certificate [ ]

 Diploma [ ]

 Degree [ ]

4. Type of nursing title

 RN [ ]

 EN [ ]

 NO [ ]

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 5. How long have you employed as a permanent staff nurse in your hospital?

I have been employed as a permanent staff nurse for (write years in number)
…………years

6. What area of practice do you work in?

 Medical ward [ ]

 Surgical ward [ ]

 ICU [ ]

SECTION B: Nurse’s attitude of bed sores prevention questionnaire

Instruction: please read each statement carefully and tick ‘√’in the box that most closely
reflects your answer to the following questions. If you accidentally tick the incorrect box put
a ‘Ⅹ’ through the box and then put tick the correct box.

-if you are strongly agree with that particular statement, please tick ‘√’ in the box of “strongly
agree”

-if you are agree with that particular statement please put a tick ‘√’ in the box of “agree”

-if you are disagreeing with that particular statement, please put a tick ‘√’ in the box of
“disagree”

-if you are strongly disagreeing with that particular statement, please put a tick ‘√’ in the box
of “strongly disagree”

‘Strongly agree’ means you are strongly agree with the statement.

‘Agree’ means you are agree with the statement.

17
 ‘Disagree’ means you are not agree with the statement.

‘Strongly disagree’ means you are strongly disagree with the statement.

4=strongly agree, 3= agree, 2= disagree, 1= strongly disagree

NURSES
STATEMENT RATING
4 3 2 1
1 Most risk factors of bed sores can be avoided

2 Prevention of risk factors for bed sore is time consuming for me

to carry out.
3 The incidence of bed sore should be 0% in my ward

4 In my opinion, Nurses can independently provide nursing care to

prevent bed sores
5 I am aware of appropriate assessment procedure for bed sore
formation
6 Patient who at risks for bed sore development should be assessed
at the first day of admission
7 All data about bed sore should be documented at the time of
assessment and reassessment
8 Bed sores should be an important indicator for quality of nursing
care
9 Patients who are at risks of bed sore development should be cared
by standard nursing care to prevent bed sores
10 Patients should be cleansed immediately after soiled
11 I am not interested to move patient from one side to another side
of the bed by lifting up her/him out of the bed
12 I value that joining educational training on bed sore prevention is
important to my practice

18
SECTION C: Nurse’s practice of bed sores prevention questionnaire.

Instruction; please read each statement carefully and tick ‘√’ in the box that closely reflects
your answer to the following questions. If you accidentally tick the incorrect box put a ‘Ⅹ’
through the box and then put tick the correct box.

-if you do not practice at all in accordance with the statement, please tick ‘√’ in the box of “
never”

-if you practice very often in accordance with the statement, please put tick‘√’ in the box of
“sometimes”

-if you practice every time in accordance with the statement, please put tick ‘√’ in the box of
“always”

‘Never’ means you do not practice in accordance with the statement.

‘Sometimes’ means you practice very often in accordance with the statement.

‘Always’ means you practice every time in accordance with the statement.

No Nurses practice regarding bed sore prevention Always Sometime Never

s
1 I observe how other nurses risk factors of bed sores
development
2 I identify common contributing factors for bed sore
development by periodic assessment of patients skin
3 I do skin assessment that is guided by standard nursing
care available in my ward.
4 I document all data related to bed sore assessment
5 I place the pillow under the patient’s legs to prevent bed
sore.
6 I pay more attention to pressure points during cleansing
of patients skin
7 I provide and monitor protein diet foods to
malnourished patient who is bedridden
8 I avoid dragging the patient during repositioning

19
9 I turn patients position every two hourly
10 I put pillows under patient legs from mid cuff to ankle
in order to keep heels off the bed
11 I always attend seminars for bed sores prevention

12 I give advice to patient or care giver regarding bed sore

preventive care before discharge the patient from hospital

THANKS FOR YOUR COOPERATION

20
APPENDIX V: CONCENT FORM

NJOMBE INSTITUTE OF HEALTH AND ALLIED SCIENCES

ACADEMIC OFFICE

CONSENT FORM

I …………………………… agree to participate a research study.

I have read the information sheet and understood the purpose and nature of the study.

I am participating voluntarily.

I understand that I can withdraw from the study, without repercussions, at any time, whether

before it starts or while I am participating.

I understand that anonymity will be ensured in the write.

I understand that the data collected can be used for scientific publication.

Name: …………………………………

Signature: …………………………….. Date: ……………………….

Witnessed by: ........................................ Signature: …………………..

21
APPENDIX VI: REQUEST LETTER

22