The impact of an educational intervention on Home Support Workers' ability to detect early pressure ulcer damage.

Background: Internationally, pressure ulcers remain a significant health care problem. This has prompted a growing interest in why pressure ulcer prevalence remains, and a desire to investigate why the prevention process continues to fail. Skin assessment is an essential component in pressure ulcer prevention. Evidence suggests that patients may not receive the correct level of care to maintain their skin integrity. Skin assessment is not the sole responsibility of the registered nurse. Home Support Workers are directly involved in patient care and they play a pivotal role in completing a comprehensive skin assessment. Therefore, all health care workers completing a comprehensive skin assessment require education in order to fulfil this role.

Aim: To investigate the impact of an educational intervention on Community Home Support Workers’ ability to detect early pressure ulcer damage.

Method: A repeated measure design was employed to quantify the effectiveness of an educational intervention, consisting of one pre-test and two post-tests. This was followed by a workshop tasked with reflecting on the educational intervention.

Findings: Home Support Workers were asked to accurately classify 20 photographs of varying stages of skin severity at each measuring point. At the baseline, 58% of the photographs were classified correctly. In the post-test 1, the results were lower, with 55% of the photographs being correctly classified. In the post-test 2, correct classification increased to 58%, e.g. back to the original baseline scores. There was a moderate negative relationship between pre-training and post-test 2 scores (r=-.44; n=27; p=0.02). To capture the participants’ issues following the educational, words used by them were recorded, as they represented the terms and language that the participants placed on their main concerns and affirmations.

Conclusion: The educational intervention has been shown not to have a statistical significant positive effect on Home Support Workers’ ability to detect early pressure ulcer damage. There was a negative correlation between pre-training and post-test 2 scores. The workshop group findings exposed the challenges which exist relating to difficulties understanding relevant theoretical health concepts. These issues are fundamentally related to a low health literacy among the study participants.