Two for the Price of One: Reinforcing Student Learning While Enhancing Pressure Ulcer Care

Identification and implementation of preventive measures for those at risk for pressure ulcers is essential in the long-term care and rehabilitation settings.  Costs associated with pressure ulcers continue to grow and compromise the quality of life of individuals affected.  Some may result when those providing care do not understand the principles underlying skin and incontinence management or when staffing levels fall.  Student nurses can play a pivotal role in this process when education and training are reinforced.  This practice innovation included two objectives.  At the completion of the first school semester, nursing students would be able to identify measures to prevent skin breakdown.  They would also be able to explain two reasons why nursing documentation should include facts about skin assessment.  To accomplish these objectives, knowledge was reinforced throughout the semester.  First, students received classroom instruction on skin care and pressure ulcer prevention measures.  They learned about different methods for documenting care provided and the importance of each.  Then, with the use of simulation in the skill lab, nursing students practiced turning and repositioning patients while using specialty beds.  In the clinical setting, student nurses provided direct patient care for individuals with pressure ulcers and gave a verbal report to the nurse in charge.  Their nursing notes included a skin assessment and whether the resident had urinary or fecal incontinence.  Students spent one clinical day with the wound care nurse who assessed and treated those with skin impairments.  They also rotated with a physical therapist, occupational therapist, or speech therapist so that they would understand how the multidisciplinary team approach helped the rehabilitation client regain cognitive and motor ability while preventing complications such as skin breakdown.  As a dynamic practice innovation, student care and documentation reflected a growing knowledge about pressure ulcer management.