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Learning Objective 1: The learner will be able to define the following terms kinds of pressure ulcers: community acquired and hospital acquired.
Learning Objective 2: The learner will be able to describe the importance of initial admission of skin by inspection of bony prominences and devices on diverse patient populations.
In the United States, regulatory agencies are required to be notified when a patient exhibits a stage 2 pressure ulcer. Without initial identification of this community acquired pressure ulcer upon admission, it will be considered hospital acquired. Therefore, the hospital will then need to assume care and cost to manage and treat this pressure ulcer.
Method:
The method a randomized, cross over trial was conducted. A convenience sample of 72 RNs participated in this study. A baseline, each RN performed an admission assessment on 2 simulated patients with dark pigmented skin with pressure ulcers on bony prominences and devices. After that education was conducted, another assessment occurred using the opposite mannequin. The number of pressure ulcers was to be identified for baseline and after the treatment (education).
Results:
Paired T Tests compared results from morning to afternoon. Also, there was a comparison between Hispanic and African American mannequins. The number of pressure ulcers identified between the AM and PM session improved slightly. However, the paired t-test indicates that results were statistically significant between comparisons.
Implications:
-Providing education for assessing ethnically diverse patient population with medical devices should be part of initial and ongoing training for all staff nurses.
-A follow up study should be conducted several months after the initial study.
-This small study demonstrated that further research needs to be conducted where there are patient populations that are not culturally diverse.
-The ethnic diversity of our nurses reflects our patient population, thus assessment of dark pigmentation did not make a difference.
-Device use is very high within the hospital system and nurses must assess underneath each device to prevent potential harm.