Pilot Study to Evaluate Clinical Education as a Means to Improve Pressure Ulcer Documentation by Hospital Staff Nurses

Background: NPUAP recommends the use of standardized measurement documentation of PU. EMR review from a hospital indicated the lack of standardized measurement for PU by staff nurses. Student nurses undergo training to assess and evaluate PU in patients. Program includes: evaluation of the wound bed, effective wound measurement, evaluation of wound edges, assessment of exudate and infection, evaluation of periwound, effective pain management, and education regarding the underlying factors that may delay wound healing. It was hypothesized that the use of this training for student nurses would enable them to provide more effective assessment and measurement of PU when compared with staff nurses currently working at the facility.

Methods: A pilot study including 10 nurses from each group were assigned to evaluate 10 patients with PU receiving care at the facility. Both groups were required to assess the patient using the (PUSH) Tool. Student nurses and the staff nurses were compared with assessments made by a wound care expert.

Results: Statistically significant differences in total PUSH scores for student nurses and staff nurses (p = 0.02). Further, differences in PUSH scores provided by nursing staff and the wound care expert were noted (p = 0.01). However, a comparison of total PUSH scores provided by nursing students and the wound care expert indicated that there were no statistically significant differences in the scores (p = 0.32).

Conclusion: Student nurse PUSH scores were commensurate with those reported by the wound care expert. Staff nurse PUSH scores were significantly different from both student nurses and the wound care expert. It seems feasible to argue that nursing students are better educated and trained to evaluate pressure ulcers in the clinical setting. As such, training provided for student nurses could provide a viable option for improving staff nurse skill for accurate assessment of PU.