Competency of Champions of Skin Integrity (CSI) in Staging of Pressure Ulcers and Identification of Other Types of Wounds

Our facility identified a need to assure accurate classification of pressure and non-pressure ulcer wounds and accurate staging of pressure ulcers by Champion of Skin Integrity (CSI) nurses. Every bedded unit in our facility has a CSI, who acts as a resource nurse on their own unit/floor. One of the CSI's responsibilities is to participate in the quarterly NDNQI Prevalence Study. All RNs in our facility have an annual requirement to complete NDNQI modules 1 and 2, Pressure Ulcer Prevention video, and take the test on our Healthstream Learning Center. The WOC nurses sought to improve CSIs accuracy in wound classification and pressure ulcer staging by conducting Inter-rater Reliability testing of wound identification and pressure ulcer staging prior to each quarterly NDNQI survey for over 1 year. Each test was followed by discussion and clarification. The reliability test consisted of pictures of different stages of pressure ulcers, and non-pressure wounds such as venous and arterial ulcers, diabetic ulcers, moisture associated dermatitis, and skin tears. After the test, each wound was discussed in terms of characteristics, types, and stage (for pressure ulcers). Baseline test results showed an average of 78.25% competency in April 2014. By July 2015, scores increased to an average of 86.02% competency. These data indicate that simple strategies can be effective in improving staff nurse accuracy in wound classification and pressure ulcer staging. However, we are working to further advance CSI proficiency in identification of pressure ulcers and other types of wounds through ongoing education and use of our online resources.