![[ Visit WOCN Website ]](images/banner.jpg)
In order decrease the incidence of pu complications; our institution has initiated a medical educational program focused on PU prevention and treatment. Integral to this education is early detection and accurate staging. In order to assess the efficacy of this program we are studying whether PU detection and staging accuracy rates improve after educational intervention. Baseline PU detection and staging accuracy rates were determined. As it is neither ethical, nor practical to use actual patients for this determination, standardized patients were moulaged with ulcers. To our knowledge, no studies have ever been performed using moulaged patients to assess competency in pressure ulcer detection.
Methods
Medical student volunteers were used as standardized patients and were moulaged to have PU of varying stages. Ulcers were placed in easily identifiable locations. Patients were randomly assigned to participants. Participants were provided with a discharge summary describing a patient in the EDU with paraplegia, fever, chills and mental status changes who is receiving nasal oxygen. Participants were asked to examine the patient, record findings and write admission orders. Data were analyzed for PU detection, staging and whether orders were written to address the ulcers.
Results
Twenty five participants took part in this study. The ulcers were 9 calcaneal, 9 sacral, and 7 post-auricular. Seven ulcers were noted by participants and were charted correctly as PU. Two sacral ulcers were found incidentally while checking for CVA tenderness which could decrease detection to 20% (5/7). Only 14% (1/7), staged the ulcer, albeit inaccurately. Of 7 ulcers noted, only 3/7 requested wound consultation orders leaving 89% (22/25) of PU untreated.
Discussion
This pilot study indicates that prior to education, the detection rate of PU is extremely low (28%). Even if PU were detected, the staging accuracy was extremely low and wound care consults were rarely ordered