Beginning Nursing Students' Exposure to Patients with Wounds and Their Wound Care

Purpose:Learning about wounds and their care in undergraduate nursing education is critical because nurses participate in decisions related to wound care.   The purposes of this quality improvement project performed in an introductory baccalaureate nursing course were to identify: (a) the types of wounds that patients assigned to beginning students had; (b) the wound care procedures and dressings students were exposed; and (c) students’ level of participation in wound care.

Methods: This project used a descriptive design. The data were collected from faculty's (n=5) anecdotal records about the students’ (n=49) clinical experience for nine clinical days in acute care hospitals (n=3).

Results: Across the patient care experiences, 75 patients had a wound. The most common wound was a surgical incision (n=49, 65%) located on the abdomen (n=37, 75.5%) and was closed (n=36, 73.5%).  Twenty-six patients had a pressure ulcer with the most common being Stage II. The most common dressing was dry gauze (n=29). Wet-to-dry gauze was used on 18 wounds. Wound irrigation was recorded for 24 wound protocols and done with a bulb syringe or pouring solution from a container. Wound care was generally performed as non-sterile. For 25 experiences, students did wound care independently or with the supervision of the instructor; 16 students watched the care performed by another clinician; 10 students participated with another nurse in the wound care. For 22 patients, the wound care was neither observed nor done because of unit/care restrictions.

Conclusions: Beginning nursing students had some, but limited, clinical experiences with patients who had wounds, but more and varied wound care experiences are highly desirable. Nursing students need continued experience understanding varied dressings and wound treatments as well as principles of wound management. Wound care education needs to be examined across the entire curriculum and in varied clinical settings.