Teaching Evidence Based Guidelines to Reduce Healthcare Acquired Pressure Ulcers in Critically Ill Children using a Skin Team Model

2.50
Hdl Handle:
http://hdl.handle.net/10755/183159
Category:
Abstract
Type:
Presentation
Title:
Teaching Evidence Based Guidelines to Reduce Healthcare Acquired Pressure Ulcers in Critically Ill Children using a Skin Team Model
Author(s):
Marben, Kim
Author Details:
Kim Marben, MSN, RN, Gillette Children's Specialty Healthcare, St. Paul, MN, email: Kmarben@gillettechildrens.com
Abstract:
Purpose: This research was intended to test a team-intensive method for integrating pressure ulcer best practices at the bedside, using a critical care skin team approach to prevent healthcare acquired pressure ulcers in pediatric patients in the PICU. Method: The research design was a Pre-test/Post-test method with a training intervention. Participants were using the Braden Scale to assess each patient's risk for skin breakdown. They were pre-tested to determine their knowledge and skill regarding current pressure ulcer prevention guidelines. The pre-test revealed their need for cuing and reminders to enact the practice guidelines. The training intervention consisted of two parts, an independent-learning PowerPoint presentation that: reviewed the guidelines related to pressure ulcers; bridged learner assessment knowledge with an understanding of pressure ulcer prevention
This was followed by hands-on clinical skill training in which each nurse participated in weekly Skin Team Rounds, performing the head-to-toe assessment of patients with experts present. These rounds rotated shifts to engage all nurses over a seven week period in performing these skills. Findings: On pre-test nurses were familiar with the intentions of the guidelines and the work of the Wound Nurse. They were adequately using the Braden Scale but their knowledge fell short on a number of issues including their reluctance to: routinely consult the Wound Nurse;
consider the patient's nutritional needs; actively intervene to prevent pressure ulcers; document the presence wounds on admission and acquired during hospitalization; differentiate a pressure ulcer from other kinds of wounds; stage a pressure ulcers; assess the patient's need for a special surface. At the end of the training period, post-test revealed that nurses had mastered the evidence based guidelines. They were able to identify, stage and actively intervene to prevent pressure ulcers. All of the learners passed the didactic training test with a score of 100%. They successfully: performed a head-to-toe skin assessment; integrated their Braden Scale assessment into their patient care plan; documented their findings; identified interventions to prevent pressure ulcers; recognized when to consult the Wound Nurse for any identified risks; reported stage 1 or greater pressure areas according to the guidelines. Discussion: Evaluation of the teaching intervention showed that it was successful in demonstrating significant learning. Process measures are reflected in the progress of nurses to consistently implement the guidelines for pressure ulcer prevention. The content measures (monitoring for prevalence and incidence of pressure ulcers) is commonly used in quality monitoring and benchmark reporting for adult services. They are newly recognized as significant measures in monitoring the care of children as well. The success of this study has encouraged the researcher to replicate the teaching intervention house-wide. It will become part of the organization's strategy for skin and wound consults in 2010.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleTeaching Evidence Based Guidelines to Reduce Healthcare Acquired Pressure Ulcers in Critically Ill Children using a Skin Team Modelen_GB
dc.contributor.authorMarben, Kimen_US
dc.author.detailsKim Marben, MSN, RN, Gillette Children's Specialty Healthcare, St. Paul, MN, email: Kmarben@gillettechildrens.comen_US
dc.identifier.urihttp://hdl.handle.net/10755/183159-
dc.description.abstractPurpose: This research was intended to test a team-intensive method for integrating pressure ulcer best practices at the bedside, using a critical care skin team approach to prevent healthcare acquired pressure ulcers in pediatric patients in the PICU. Method: The research design was a Pre-test/Post-test method with a training intervention. Participants were using the Braden Scale to assess each patient's risk for skin breakdown. They were pre-tested to determine their knowledge and skill regarding current pressure ulcer prevention guidelines. The pre-test revealed their need for cuing and reminders to enact the practice guidelines. The training intervention consisted of two parts, an independent-learning PowerPoint presentation that: reviewed the guidelines related to pressure ulcers; bridged learner assessment knowledge with an understanding of pressure ulcer prevention<br/>This was followed by hands-on clinical skill training in which each nurse participated in weekly Skin Team Rounds, performing the head-to-toe assessment of patients with experts present. These rounds rotated shifts to engage all nurses over a seven week period in performing these skills. Findings: On pre-test nurses were familiar with the intentions of the guidelines and the work of the Wound Nurse. They were adequately using the Braden Scale but their knowledge fell short on a number of issues including their reluctance to: routinely consult the Wound Nurse;<br/>consider the patient's nutritional needs; actively intervene to prevent pressure ulcers; document the presence wounds on admission and acquired during hospitalization; differentiate a pressure ulcer from other kinds of wounds; stage a pressure ulcers; assess the patient's need for a special surface. At the end of the training period, post-test revealed that nurses had mastered the evidence based guidelines. They were able to identify, stage and actively intervene to prevent pressure ulcers. All of the learners passed the didactic training test with a score of 100%. They successfully: performed a head-to-toe skin assessment; integrated their Braden Scale assessment into their patient care plan; documented their findings; identified interventions to prevent pressure ulcers; recognized when to consult the Wound Nurse for any identified risks; reported stage 1 or greater pressure areas according to the guidelines. Discussion: Evaluation of the teaching intervention showed that it was successful in demonstrating significant learning. Process measures are reflected in the progress of nurses to consistently implement the guidelines for pressure ulcer prevention. The content measures (monitoring for prevalence and incidence of pressure ulcers) is commonly used in quality monitoring and benchmark reporting for adult services. They are newly recognized as significant measures in monitoring the care of children as well. The success of this study has encouraged the researcher to replicate the teaching intervention house-wide. It will become part of the organization's strategy for skin and wound consults in 2010.en_GB
dc.date.available2011-10-28T16:17:04Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:17:04Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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