Abstract: Our Educators Have Pressure Ulcers! Unexpected Simulation to Achieve a Tipping Point in Pressure Ulcer Education (45th Annual Conference (June 22-26, 2013 ))

Meredith Overstreet, BSN, RN, CEN, Sentara Martha Jefferson Hospital, Wound & Ostomy Clinical Educator, Charlottesville, VA, Lisa Carmines, MSN, RN, CPN, Sentara Martha Jefferson Hospital, Pediatric Nurse Educator, Charlottesville, VA, Whitney Digney, MEd, RN, Sentara Martha Jefferson Hospital, Clinical Educator, Charlottesville, VA, Jennifer Gaines, BSN, RN, Sentara Martha Jefferson Hospital, Simulation Center Coordinator, Charlottesville, VA and Susan Winslow, MSN, RN, NEA-BC, APHN-BC, Sentara Martha Jefferson Hospital, Director of Nursing Education, Charlottesville, VA

Topic: At our institution, stage II pressure ulcers account for the majority of our hospital-acquired pressure ulcers. However, analysis of documented stage II pressure ulcers by our wound nurse revealed that injuries such as incontinence-associated dermatitis, skin tears, and friction injuries were commonly misclassified as stage II pressure ulcers. Clinicians need to be competent in appropriately identifying and staging pressure ulcers. Staff who are engaged by a teaching modality retain more information than those who are merely present at an educational offering, and are more likely to carry change back to the bedside.

Purpose: The purpose of this abstract is to describe an innovative strategy for improving clinicians’ ability to identify and classify pressure ulcers.

Objectives: Using adult learning principles and simulation, educators developed an experiential learning environment, executing a hospital-wide educational initiative. This initiative targeted pressure ulcer prevention, identification, and improved staging in response to practice and documentation discrepancies. Clinical educators conducted a live simulation in which educators, acting as patients, wore garments affixed with iron-on representations of actual pressure ulcers. The garments were worn so that the ulcers were situated over key pressure points, and were “discovered” by participants during a simulated patient care experience.

Outcomes: Seventy-three percent of clinical staff attended the live session, in addition to a segment of staff who were not required to attend. Staff verbalized increased comfort with identification and staging of pressure ulcers. In the quarter following the initiative, real-time assessments by the wound nurse showed improved classification and documentation of pressure ulcers by clinicians; our hospital also achieved a score of zero hospital-acquired pressure ulcers on the NDNQI® Pressure Ulcer Prevalence Survey.

1565 Our Educators Have Pressure Ulcers! Unexpected Simulation to Achieve a Tipping Point in Pressure Ulcer Education