Problem: In Long Term Care Facilities (LTCFs), about 70% of all pressure ulcers occur in persons older than 70. The direct care costs associated with pressure ulcers in LTCF exceed $3.5 billion, while costs related to legal liability are even more substantial. Litigations in LTCF are likely to favor LTCF residents in up to 87% of cases while prevention of pressure ulcers offers high-quality, cost-effective outcomes. A systematic review of healthcare evidence reveals that while the development of pressure ulcers can have a devastating impact of LTCF populations, simple EBP steps such as using supporting surfaces, repositioning the patient, optimizing nutritional status, and moisturizing sacral skin can have a positive impact on reducing physical and emotional pain and associated healthcare costs. Purpose and Scope: The purpose of this Evidence-Based Practice (EBP) project was to describe the level of healthcare knowledge regarding pressue ulcer prevention (PUP) before and after participation in a PUP teaching intervention for LTCF staff. Using descriptive-interventional methodology, the study variable of nursing knowledge regarding pressure ulcer prevention was measured before and after participation in the PUP teaching intervention by the Pressure Ulcer Knowledge Tool. The instrumentation included a 47-item questionnaire with 3 subscales assessing knowledge regarding ulcers, wounds, and prevention/risk. Goal and Objectives: The goal of the project was to successfully implement a PUP teaching intervention to LTCF staff. The objectives were: (a) to describe aggregate demographic characteristics of the LTCF participants, (b) to describe PUP pre-intervention level of knowledge, (c) to describe PUP post-intervention level of knowledge, and (d) to describe PUP level of knowledge before and after LTCF staff participation in a PUP teaching intervention. Plan and Evaluation: Phase One: Conduct a literary needs assessment using a published evidence-based critique template. Phase Two: Design a PUP teaching intervention using the EBP approach. Phase Three: Implement a PUP teaching intervention for selected LTCF staff. Phase Four: Evaluate the level of PUP knowledge before and after LTCF staff participation in the PUP teaching intervention. Ouotcomes and Results: Pre-intervention and post-intervention meaures revealed a statistically significant increase in PUP knowledge from an aggregate percentage performance of .81 at pre-test to an aggregate percentage performance of .98 at post-test. Moreover, scaled reliability estimates based on internal consistency for the full instrument achieved significance with regard to the tool’s performance in this interventional design. Although further inquiry is warranted, the findings suggest that LTCF staff can increase PUP knowledge with focused educational intervention regarding the concept, and that PUP education in LTCF may serve as a practice change outcome worthy of further consideration.
