Objective

The objective of this study was to decrease the number of patients developing pressure ulcers.  Research on wound management has multiplied in the last years.  These advances frequently have not reached the bedside nurse, and wound prevention and treatment have remained a low priority in patient care.  Nor are nurses competent to care for these complicated chronically ill patients (Kennedy & Arundel, 1998).  With so much national attention, why are nurses, still confused about wounds? Are our nurses being taught the gold standard in prevention and wound care?  This disparity can be attributed to the lack of minimum competencies for nurses in pressure ulcer treatment and prevention. 

Sample

          The setting was an urban, acute care teaching facility in the Midwest.  Licensed nurses from two Medical / Surgical units and one Intensive care unit were asked to participate in the project.  These units were chosen because of their participation in NDNQI data collection on hospital acquired pressure ulcers.  

Method

          Utilizing a tool developed based on the NPUAP competency based curriculum for pressure ulcer prevention the nurses were given a multiple choice questionnaire.  The questionnaire evaluated their knowledge of wound and patient assessment, wound bed management and systemic factors affecting wound healing.  It was completed anonymously and returned to the investigators in sealed pre-labeled envelopes.

Results

          Despite having a comprehensive wound team, incidence rates range between three and eight percent per year at our facility.  Assessment of nursing’s wound care knowledge and skills assisted in development of a formal education plan to  improve the quality care we provide to our patients in decreasing pressure ulcer prevention.

Conclusions

          Through proper teaching, sharing of critical thinking, reasoning and accurate skills performance instruction, the novice nurse can become the expert nurse.  Benner’s theory depicting the progression of the nurse as he or she moves along the knowledge continuum was utilized in our project.  If the gold standard of wound care is taught appropriately, the nurse should advance from the novice phase to hopefully, the competency phase.    As the nurse continues to practice more advanced wound care, he or she will continue along the pathway to expertise.  If the gold standard is not taught, nurses will linger in the novice and advanced beginner phase.

Implications

           Nurses want to provide appropriate quality care to their patients.  Patients deserve a qualified competent nurse to assess and provide appropriate interventions to prevent pressure ulcers.  Through comprehensive education our nurses are able to provide gold standard care to their patients. This poster presentation will display what competency data has been collected and the education plan to decrease the number of pressure ulcers.