QSEN SimulationPressure Ulcer Assessment

Stacey Johnson BSN, RNBethel College

MNUR 613

Pressure Ulcers O Common problemO Reduce quality of lifeO Indicator of quality of care O Assessment requires a

multidisciplinary approach

Learning OutcomesO Cognitive

O Outlines the factors involved in development of a pressure ulcer.

O AffectiveO Discusses the importance of a holistic approach to pressure ulcer assessment.

O PsychomotorO Describes the pressure ulcer using

NPUAP guidelines.

ScenarioO 75 year old maleO Fractured hipO History of cognitive impairmentO Frequently incontinentO Weight lossO Developed a pressure ulcer to

coccyx

Equipment Needed

RolesO Family memberO NurseO Nursing assistantO Dietician

TimeO Scenario 20 minO Debriefing 20 min

o Wound mannequino Centimeter wound

measuring deviceo Sterile cotton swabso Gloveso Educational material

Assessment Procedure

MeasurementO Length x Width x

DepthO Length- head to toeO Width- side to sideO Depth- deepest

part of wound using sterile cotton swab

• Wash hands and put on gloves.

• Describe location of the wound

• Describe drainage type and amount

• Describe skin surrounding the wound

• Assess for s/s infection• Measure the wound• Document

QSEN Competency

O Educate the patient and caregiver on treatment and prevention strategies

O Provide physical and emotional comfort

Patient Centered Care

• Knowledge- Empower patient and family through education

• Skills- Assess for presence of pain

• Attitude- Value nurses role in relief of pain

QSEN Competency O Nursing

O Nursing AssistantO MDO DieticianO Social ServiceO Therapy

Teamwork & Collaboration

• Knowledge-Describe how teamwork improves outcomes

• Skills-Assumes the role of team member in treatment of pressure ulcer

• Attitude-Values teamwork

QSEN Competency

O NPUAP GuidelinesO AMDA GuidelinesO National

Clearinghouse

Evidence Based Practice

• Knowledge-Describes guidelines for pressure ulcer assessment

• Skills-Locate clinical practice guidelines for pressure ulcers

• Attitude-Values evidence based practice

QSEN Competency O CMS

Quality Improvement

• Knowledge-Recognizes the importance of prevention of pressure ulcers in quality care

• Skills-Uses quality measures to evaluate care

• Attitude-Values contributions to improve outcomes related to pressure ulcers

QSEN Competency

O Turning and repositioning q 2 hours

O Infection controlO Toileting

programsO Monitoring for

incontinenceO Use of support

surfacesO Educating nursing

assist staff

Safety

• Knowledge- Describes a culture of safety in prevention of pressure ulcers

• Skills-Communicates observations related to plan of care being followed

• Attitude-Values monitoring of care activities provided by team

QSEN Competency

O Electronic health records for documentation

O Electronic database for plan of care

O On-line slide shows

O Internet resources for patient education

Informatics

• Knowledge-Describe how information technology can improve outcomes related to pressure ulcers

• Skills-Use technologies to communicate care plan and uses internet resources

• Attitude-Value nurses role in implementation of technology for improvement of pressure ulcers

DebriefingO Explains nursing interventions to

prevent and treat pressure ulcers.O Uses evidence based guidelines to

measure and describe wound.O Discusses roles of team members in

wound treatment and prevention.

References Bloom B. S. (1956). Taxonomy of educational objectives, handbook book I: The cognitive domain. New York: David McKay Co. National Pressure Ulcer Advisory Panel. (2009) Treatment of pressure ulcers: Quick reference guide. Washington DC: National

Pressure Ulcer Advisory Panel.Jankowski, I,M.(2010). Matching patient safety goals to the nursing specialty. Using wound, ostomy, continence nursing services. The Journal of Nursing Administration, 40(1), 26-31.Jaul, E. (2010). Assessment and management of pressure ulcers in the elderly. Drugs and Aging, 27(4), 312-325.Sterner, E., Lindholm, C., Berg, E., Stark, A., & Fossum, B. (2011).

Category I pressure ulcers how reliable is clinical assessment? Orthopaedic Nursing, 30(3), 194-205.