Testing a Pressure Ulcer Knowledge Test

Purpose: We will describe the testing of a pressure ulcer (PU) knowledge test. This test is a revision of a pressure ulcer knowledge test which was developed over 20 years ago.

Methods: Initially, pressure ulcer research literature and guidelines from the last 5 years were examined for test item content. A table was made with existing and proposed test items and supporting content for each item. The initial PU test had 115 items; response options were true-false-don’t know. Testing was a cross-sectional, instrument testing design and was administered at a hospital association pressure ulcer educational program conference twice. At one conference, registered nurses (N=108) were randomly divided into two groups to take either the 60 Prevention/Risk and Staging items or the 55 Wound Description items. Analyses of these responses resulted in 72 items which were administered in total to a second cohort (second conference) of 98 nurses for reliability.

Results: Testing resulted in 27 items about Prevention/Risk, 25 items about Pressure Ulcer Staging, and 20 items about Wound Description. Cronbach’s alpha was .80 for the 72-item PU test.  Cronbach’s alpha values for the subscales were: Staging, .67; Wound Description, .64; and Prevention/Risk, .56. The mean correct scores were: Total, 80%; Prevention, 77%; Staging, 86%; and Wound Description, 77%. Nurses certified in wound care had significantly (p<.001) higher total test scores (87%) than those not certified (77.4%).

Conclusions: This PU test a good total reliability; the subscores reliabilities are lower and need further refinement. Continued use of the instrument may provide direction for determination of a passing cut-score. Because of worldwide requests, an updated pressure ulcer knowledge test is important in health care.