| dc.description.abstract | Despite prevention efforts, pressure injuries (PIs) remain prevalent across care settings and impose significant burden on affected individuals and the entire healthcare system. Many individuals, including those who live rurally and in long-term care (LTC) facilities, face challenges when accessing specialty care, leaving PI management to primary care providers (PCPs) and nursing staff. Minimal training and the myriad of commercially available wound care products contribute to lack of confidence in PI management.
This quality improvement project aimed to promote confidence in management of PIs in LTC residents, through development of a product selection guide, example orders, and separate education for PCPs and nursing staff. The product selection guide and educational presentations were customized according to facility product formularies. Confidence in PI management was evaluated with a qualitative post-education survey.
Evaluation of participant survey responses determined the impact of project interventions. PCPs reported low levels of confidence in PI management, citing lack of education and frequent changes in available products as barriers. PCPs perceived the education and resources as beneficial and anticipated making practice changes as a result, including selecting appropriate products and writing appropriate instructions. Nursing staff cited lack of exposure to PIs, workload, and concerns about product selection and unclear orders as barriers to their confidence. Nursing staff reported notably higher levels of confidence than PCPs and agreed education was helpful, with 63.2% anticipating probable practice change. Nursing staff planned to make changes in specific product use and wound care techniques. Lack of depth and structure in facility product formularies was noted during development of project materials and limited customization of the product selection guide and education.
Results suggest small-scale, facility-specific education, along with customized decision support tools, are effective in promoting PCP confidence in PI management. Nursing staff may benefit more from technical, skills-based education, focused on specific product use and wound care techniques. Additional efforts to create efficient, comprehensive product formularies within facilities are needed to streamline education and further promote confidence in PI management. | en_US |
