Can Educating Certified Nursing Assistants (CNAs) in a Nursing Home Reduce In-house Pressure Ulcer Development?

Objective: To determine if educating CNAs in pressure ulcer prevention techniques can reduce pressure ulcer incidence in a long-term care facility.

 Methods: A pretest/posttest design was utilized for this study to measure the effectiveness of an evidence-based educational intervention utilizing the National Pressure Ulcer Advisory Panel (NPUAP) guidelines for pressure ulcer identification and prevention. Pressure ulcer incidence was recorded three months pre-intervention and will be recorded three months post-intervention from monthly quality assurance reports (this study is in progress and will be completed Jan. 2014).

CNAs were invited to participate in the research study and consent was obtained. Demographics were gathered from the CNAs. The CNAs were presented with a pre-test regarding pressure ulcer prevention knowledge. An evidence-based educational intervention was presented via PowerPoint lecture to the CNAs. The CNAs were required to attend this training as a QI initiative, but study participation was voluntary. During the study period, CNAs will complete daily electronic charting on turning and repositioning in the bed, repositioning in the chair and daily skin checks. The CNAs also will report any skin breakdown to the charge nurse and document via skin check report sheets. Data will be collected three months post-intervention regarding pressure ulcer incidence (Feb., 2014). The CNAs will take the post-test three months after the evidence-based educational intervention and scores will be compared (Feb., 2014).

Statistical analysis: A pretest-posttest analysis will be conducted using the t-test comparing the scores of the two tests. The average score of the number of pressure ulcers per stage will be compared pre-intervention and post-intervention using a t-test comparison. A line graph will be utilized to identify prevailing trends. Descriptive data will be provided on the following information: years of experience – mean and standard deviation, educational background – percentage distribution, C.N.A. training – frequency distribution, turning and repositioning reporting skin breakdown. A statistician has been consulted.