| Learning Objective #1: Describe the four steps in the PDCA Performance Improvement process. | |||
| Learning Objective #2: Identify the steps to increase the staff's knowledge of evidence based guidelines for the prevention of pressure ulcers. |
Aims/Objectives: Increase RN knowledge in evidence based guidelines to prevent pressure ulcers.
Framework: FOCUS/PDCA format. Find: Improve RN knowledge of evidence based guidelines to prevent pressure ulcers. Organize: Nurse Manager, Nurse Educator, Wound Care Nurse, Registered Dietician, and Unit Council members (RNs) who represent nursing staff met to discuss improvement process. Clarify: Despite previous staff education, pressure ulcer prevalence rate continues above Queen’s Medical Center (QMC) goal of 6.9%. Understand: Staff included 30% with less than one year experience. Experienced and new nurses had questions about appropriate bed surface selection, incontinence barrier creams, Braden scores, creating specific care plans based on Braden score, effects of diet/albumin level on pressure ulcers. Select: Activities were identified for staff education.
Design/Method: Plan: Using different teaching techniques, educational modules based on current evidence based guidelines for pressure ulcer prevention were planned. In the Do phase, educational modules were implemented March - April 2006. The educational modules included a videotape, group presentations, one on one staff/demonstration education, reading materials.
Findings: Check: Pre-test knowledge scores were compared to post-test scores showing an improvement. In Act phase, data from QMC’s quarterly Skin Rounds are being monitored to see if improving nurses’ knowledge in pressure ulcer prevention will impact rates.
Discussion and Implications: The nurses’ knowledge may not have direct impact on pressure ulcer rates. Patients on this unit have longer lengths of stays and higher acuities compared to other medical/surgical units due to multiple underlying chronic diseases affecting their ability to heal from acute illnesses and increase their risk for pressure ulcers. A different set of evidence based guidelines may need to be explored for this specific patient population.