Intensive Care Nurses’ Knowledge of Pressure Ulcers: Development of an Assessment Tool and Effect of an Educational Program

Abstract

Background Critically ill patients are at high risk for pressure ulcers. Successful prevention of pressure ulcers requires that caregivers have adequate knowledge of this complication. Objective To assess intensive care nurses’ knowledge of pressure ulcers and the impact of an educational program on knowledge levels. Methods A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed 3 times: before an educational program, within 2 weeks after the program, and 20 weeks later. Multivariate analysis was performed to determine if attributes such as length of time since qualifying or level of intensive care unit experience were associated with test scores. The content and results of the assessment test were evaluated. Results Completion of the educational program resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational program. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Conclusion Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational program, but soon returned to baseline.

Commentary on Kwong E, Lau A, Lee R & Kwan R (2011) A pressure ulcer prevention programme specially designed for nursing homes: does it work? Journal of Clinical Nursing 20, 2777–2786

“…It is interesting to note, however, that over the duration of the programme, knowledge levels did not sustain, whereas skill levels continued to improve. This finding is not unique to the current study; other researchers have noted that knowledge levels are not sustained over time, reiterating the necessity of ongoing education and training (Tweed & Tweed 2008). However, what is worthy of discussion is the interplay between knowledge and skill.…”

Development and psychometric validation of PUKAT 2·0, a knowledge assessment tool for pressure ulcer prevention

“…However, these tools were characterised by a limited evaluation of psychometric properties. For example, Tweed et al (23), Strand et al (24) and Saleh et al (25) developed tools for research purposes, which were only pilot studied and reviewed by experts. Another knowledge assessment tool, often mentioned in literature, is the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) (26).…”

Knowledge about medications and products to prevent and treat pressure ulcers: a cross‐sectional survey of nurses and physicians in a Primary Health Care setting

“…Very few studies in the field of pressure ulcers and wound care (PUWC) have included physicians (Kimura & Pacala 1997, Odierna & Zeleznik 2003, Krause et al 2004, Gupta et al 2012, even though this is the profession that can legally prescribe the medications and healthcare products needed to prevent and treat these conditions. In addition to reports that physicians have less PUWC-specific knowledge than nurses (Gupta et al 2011), the literature shows that PUWC is one of the areas where nurses have contributed the greatest scientific evidence, demonstrating their knowledge and detecting relevant training needs (Panagiotopoulou & Kerr 2002, Pancorbo-Hidalgo et al 2007a, 2007b, Tweed & Tweed 2008, Strand & Lindgren 2010.…”

“…Wound care has undergone substantial change in recent years, from the traditional (dry) treatment to moist wound healing, which has better clinical outcomes and cost-effectiveness (Garc ıa Fern andez et al 2007). Access to scientific publications and proper ongoing training is fundamental to stateof-the-art knowledge of the scientific community's advances in improving wound care (Tweed & Tweed 2008).…”