Assignment Task
Introduction
Pressure injury s are defined as localised damage to the skin or underlying soft tissue, which can be intact or open, and graded from Category I to Category IV (National Pressure injury Advisory Panel, 2016). For residents at the end of life in residential aged care facilities, pressure injury s are a common condition (Jaul, & Calderon-Margalit, 2015). Pressure injury results in increased length of stay in the hospital from 4 to 30 days, decline in quality of life, and increased pain, morbidity, and mortality (Lawrence, Fulbrook, & Miles, 2015). In Australia, A total number of 121,645 pressure injury cases were estimated in the year 2012- 13(Nguyen, Chaboyer, & Whitty, 2015). A recent estimate of the proportion of people with pressure injury s at a given time in an aged care ranged between 1% and 46% (Hahnel, Lichterfeld, Blume-Peytavi, & Kottner, 2017). Moreover, A$983 million per annum the was the estimated treatment cost of pressure injury across all states and severity in 2012-13, which represented approximately 1.9% of all public hospital expenditure or 0.6% of the public recurrent health expenditure. In 2017, Clinical Excellence Commission (2018) estimated the prevalence of pressure injury to be 9.5% to 17.6% in hospitals and 8.9% in aged care settings.
Pressure injury is an index of nursing care quality, and prevention of pressure injury is one of the main nursing tasks, which is influenced by nurse’s knowledge. The level of nurse’s knowledge on pressure injury prevention was estimated to range from 28% to 74% (Dalvand, Ebadi, & Gheshlagh, 2018). Implementation of pressure injury preventive care strategies in practice is also affected by poor knowledge towards pressure injury prevention (Simonetti et al., 2015). In addition, a study by Kwong, Hung, and Woo, (2016) identified the cause for thedevelopment of pressure injury to be the improper use of pressure injury prevention materials, non-compliant and improper prevention practices, the perception that the preventive care wasbeing performed correctly, inadequate readiness to use the risk
assessment tool, an unfavourable environment, supply of unfavourable resources, and various management styles in the homes with or without nurses. However, poor knowledge and practice of nurses have its own significant contribution for higher prevalence of pressure injury s. Most of the pressure injury s are preventable, one of which measures is to strengthen the nurse’s knowledge on pressure injury prevention practices (Kim, & Lee, 2019). One of the important steps to improve nurses’ knowledge and practice of pressure injury prevention is in-service training (Nuru, Zewdu, Amsalu, & Mehretie, 2015)
AIM
The aim of this work-based project is to improve nurse’s knowledge of pressure injury prevention in an aged care facility.
Project Question: What is the impact of educational intervention on nurse’s knowledge of pressure injury prevention in an aged care setting.
Objective
The objective of this project is to evaluate the impact of educational intervention on nurse’s knowledge of pressure injury prevention in an aged care facility by using pre-test and post- testdesign.
Project setting
The project will be conducted in a 76 bedded aged care facility in Sydney. At the moment, the age care facility is caring approximately 65 residents. The facility has a total of 35 nurses including both permanent and casuals.
Project Design
A pre-test/post-test design will be used to evaluate the impact of educational intervention on nurse’s knowledge of pressure injury prevention through a questionnaire. The pre-test/post- test design is one of the most common between subject approaches with many variations. In a basic pre-test/post-test design, an observation is taken once prior to the intervention and once after the intervention (Edmonds, & Kennedy, 2016).
The questionnaire for this project is adapted and modified from Pieper Pressure injury Knowledge Assessment Test, which was developed by Pieper, and Mott (1995). The proposed timeframe for this project is provided in Appendix A.
Intervention
The quality improvement interventions for this project is educational intervention through YouTube videos (links provided in Appendix B). YouTube encourages student’s engagement and improves in-depth learning (Roodt, Harry, & Mwapwele, 2017). It is also an established social media platform that is used as a formal and informal learning tool by millions of users worldwide. For this project, the educational interventions will be three YouTube videos by Queensland Health (2015), BVS Training (2018) and Park (2015). These videos point out the risk factors, cause and prevention of pressure injury s. The length of each video is approximately four minutes. Shorter length video is found to be effective as an educational intervention as it maintains participant’s interest and is time saving (Cowdery, Powell, Fleming, & Brown, 2019).
The quality improvement interventions will be implemented by placing a poster as a memo (provided under appendix C) regarding education for pressure injury prevention on the notice board along with a list for the interested nurses to put their name and phone number. Using the phone number of the interested participants, a group will be created in Viber and the links of the YouTube videos will be sent. Then the participants will be able to access the videos and gather knowledge.
A study by Van der Kleij, Feskens, & Eggen, (2015), immediate feedback was found to be significant in learning. So, after the intervention has been implemented, feedback from the nurse’s will be collected verbally to identify the effectiveness of the intervention.
Sample size
Convenience sampling approach will be used to select the sample size. Convenience
sampling is a type of non-random sampling where members of the target population that meet certain practical criteria, such as easy accessibility, geographical proximity, availability at a given time, or the willingness to participate are included for the purpose of the study (Etikan, Musa, & Alkassim, 2016). Considering the willingness to participate, 20-25 nurses are expected to participate. To ensure participation, posters will be placed in the notice board about the interventions and purpose of the project.
Data Collection
Data will be collected over four weeks of time. Firstly, verbal consent from nurse’s and manager will be taken and pre-test data will be collected over a week time. The printe
handout of pre-test questionnaire will be placed in the staff room and nurses’ station. It will also be distributed in hand over the week. All the filled-out questionnaire will be collected at the end of the week. A meeting will be scheduled with manager to discuss the progress of the project. Following which, the educational interventions will be carried out for one week to ensure every interested participant get enough time to access and gain knowledge through the videos. Feedback from the nurses will be collected to determine the effectiveness of intervention and the effectiveness will be shared with manager. Then, post-test data will be collected a week after completion of educational intervention. For post-test data collection, the same questionnaire as of pre-test will be distributed to the participants of educational intervention over a week. The completed questionnaire will then be collected at the end of the week.
Data Collection Tool
The data collection tool is a true/false questionnaire adapted and modified from Pieper Pressure injury Knowledge Assessment Test (Pieper, & Mott, 1995). The questionnaire is provided in Appendix C. The questionnaire will assess the staff’s knowledge about prevention of pressure injury. Assurance of confidentiality and no personal data collection of participants will be provided. Permission to carry out the project will be ensured. The questionnaire consists of 10 questions with “true” and “false” as a response. Every correct answer will be marked 1 and incorrect one will be marked as 0. The data collected will then be analysed to evaluate the significance of the intervention.
Data Analysis
The data collected through audit tool will be grouped and entered into Microsoft Excel as per the audit tool criteria. The significance of the educational intervention will be measured by comparing the data collected from pre-test and post-test by using t-test. All the categorical data obtained from the audit will be summarized in descriptive statistics: percentages. Tables and graphs will be used to make the summary of the analysis clear to everyone.
Expected Outcomes
The expected outcomes of this project will be improved knowledge of nurse’s regarding the pressure injury prevention. All the participants will be expected to gain insight in the prevention of pressure injury . The summary of the project will be handed out to all the nurse’s for improving the knowledge regarding pressure injury prevention
Feasibility
This project will collect data from non-identifiable sample. Approval for the proposal from Facility manager has been sought. Support and co-ordination from the nurses are expected to carry out this work-based project.
