Effects of a Just-in-Time Educational Intervention Placed on Wound Dressing Packages: A Multicenter Randomized Controlled Trial

PURPOSE: Comparison of the effects of a just-in-time educational intervention (educational materials for dressing application attached to the manufacturer's dressing package) to traditional wound care education on reported confidence and dressing application in a simulated model.

SUBJECTS AND SETTINGS: Nurses from a variety of backgrounds were recruited for this study. The nurses possessed all levels of education ranging from LPN to MSN, including novice nurses with no limit to years of experience. Exclusion criteria included nurses who spent less than 50% of their time in direct patient care and nurses with advanced wound care training and/or certification. Study settings included community-based acute care facilities, critical access hospitals, ECFs, LTACHs, and home care agencies.

METHODS: Participants were randomly allocated to control or intervention groups. Each participant completed a dressing confidence assessment tool, and then asked to apply the dressing to a wound model under the observation of an investigator who scored the accuracy of dressing application according to established criteria.

RESULTS: None of the 139 nurses who received traditional dressing packaging were able to apply the dressing to a wound model correctly. However, 88% of the nurses who received the package with the educational guide attached to it were able to apply the dressing to a wound model correctly ([Χ² = 107.22, df = 1, P = .0001). Nurses who received the dressing package with the attached educational guide agreed that this feature gave them confidence to correctly apply the dressing (88%), while no nurse agreed that the traditional package gave him or her the confidence to apply the dressing correctly (Χ² = 147.47, df = 4, P < .0001).

CONCLUSIONS: A just-in-time education intervention improved nurses' confidence when applying an unfamiliar dressing and accuracy of application when applying the dressing to a simulated model compared to traditional wound care education.