Article
Peer-to-Peer Approach to Increasing Staff Competency and Engagement in Wound and Ostomy Care
Year Published: 2024
Please Click the Link Below:
A Peer-to-Peer Approach to Increasing Staff Competency and Engagement in Wound and Ostomy Care
Please follow Journal Rules and Guidelines before posting.
Discuss the research question or main problem discussed in the study.
ReplyDeleteThis study was a quality improvement project done to enhance nurses' knowledge of wound care as well as increase engagement and learning retention of wound and ostomy knowledge. When it comes to wound care, nurses do not receive adequate or enough time to learn about adequate wound and ostomy care. This creates a learning disparity which results in poor patient outcomes and costs the hospital a lot of HAPIs.
How does this research article compare to our practice.
At PSJMC skills fair the wound nurse has very limited time to teach or review much with the nurses. This study provided over an hour of teaching with recurrent refreshment classes based only on wound and ostomy care which is very different than PSJMC. The wound nurses would teach a few nurses more in depth so that they could be a good strong resource in their unit for wound care, we have similar practices at PSJMC. Each unit has a skin team which includes a few nurses who go around and check patients' skin and educate nurses on how to protect pressure point and bony prominences.
Discuss the research question or main problem discussed in the study?
ReplyDeleteWith the increasing number of people affected by pressure injuries and living with an ostomy, there is a demand for increased involvement of board -certified nurse specialist and competent providers to address the care for patients with complex wound and ostomy issues. It reveals that nurses have limited level of pressure injury knowledge and skills due to less educational content during prelicensure preparation and limited time allotement for on -the-job training . And lack of ostomy care clinicians who can provide education to patients resulted to lack of knowledge upon discharge.
What are the advantages and disadvantages to the proposed recommendations in the article?
The formation of expert panel of skin care champions (SCC)with educational knowledge related to wound and ostomy care and educational program using peer to peer approach increases and improves the wound and ostomy competencies of clinical nurses.Which then ensures the effective and safe nursing care for patients with wound and ostomy issues.
Describe the method used by the author of the study
ReplyDeleteThe method used in this project was a peer to peer approach in which staff educated each other with a mobile ostomy cart and a wound cart. The participants were RNs and nursing support staff who worked in the ICU and med-surg units at a hospital in Bronxville, New York. The framework used was the Plan-Do-Study-Act model.
How does this research article compare to practice, policies and procedures?
At PSJMC we have a SWAT team and we have meetings where we get extra training on NPWT, ostomy care, wound care, and pressure injury prevention. These presentations are very helpful in educating the SWAT team members about wound care. This year we also had a special presentation on 7NE with the UBC members. The presentation went over ostomy pouch changing techniques and how to fix leaks and damaged peri-stomal skin. I like the technique used in the QI project in this article. I think the ostomy and wound cart technique would be helpful to teach nurses at PSJMC.
Discuss the sample size used in the study?
ReplyDeleteThere were 72 nurse participants in this study working in a 288 bed community hospital located in the Northeastern U.S. The project was implemented in 1 intensive care unit and 6 adult medical-surgical units.
Discuss the research question or main problem discussed in the study?
The main research question of this study is the limited knowledge of nurses on pressure injury and ostomies. Pressure injuries and people living with ostomies affects millions in the U.S annually. There is a significant demand for nurses to address care for patients with complex wound and ostomy issues. The purpose of this study is to provide an innovative, participatory approach to the education of staff nurses and support personnel to improve skills and competencies in wound and ostomy care. Through a peer-to-peer approach, education and competencies, patient safety increases and improves nursing skills and staff empowerment.
Discuss the sample size used in the study?
DeleteThe Plan to do study Act (PDSA) model was used as the framework for the study addressing different styles to improved knowledge and competencies of staff nurses in relation to wound and ostomy care. There were 72 nurse participants in this study working in a 288 bed community hospital located in the Northeastern U.S. The project was implemented in 1 intensive care unit and 6 adult medical-surgical units.
Discuss the research question or main problem discussed in the study.
ReplyDeleteThe study was done to improve nurses knowledge on wounds and ostomy care. Nurses did not get enough education and did not received enough time to learn about adequate wound and ostomy care. Lack of knowledge increased of HAPI's and decreased patient education on discharge.
Discuss the method used by the author of the study.
The author used peer to peer approach which increased and improved the wound and ostomy competencies of nurses. That improved safe nursing care of patient with wounds and ostomies issues.
This comment has been removed by the author.
ReplyDeleteWhat are the advantages to the proposed recommendations in the article?
ReplyDeleteThe advantages to this quality improvement project include
increased visibility of wound/ostomy educational staff and the supplies.
Opportunities for hands-on education on each unit with the support of their peers. And opportunities for questions in a non-stressful environment with the Wounds on Wheels Cart
Having a Skin care resource staff nurse available on the units who has undergone rigorous training and is credentialed by the hospital.
The Wounds on Wheels cart makes learning fun.
What are the disadvantages of implementing the article recommendations on your unit or hospital?
The mobile Wound Care Skills Fair as mentioned was only held on one day during daytime hours 0700-1700. This excludes nightshift and anyone who wasn't on staff that day.
The amount of time and money involved to train the 72 Skin Care Resource Nurse is extensive and 10 received even further training to become expert SCC. It would be a large task to take on for the hospital's WCOCNs to educate those staff. The article never said if that education time was paid time. That makes a big difference.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
ReplyDeleteThe overall response and knowledge retention rates in this study suggest that participants gained essential knowledge pertaining to wound and ostomy care. However, there is no available baseline data from prior years where standard educational programs were implemented, making comparison impossible.
What are the advantages and disadvantages to the proposed recommendations in the article?
Most of the patients admitted to PSJMC are elderly and are from Skilled Nursing Facility. These pose a greater risk of developing pressure ulcers. Most PUs are avoidable. However, the prevalence of PUs remains high. The prevalence of PU is as an indicator of the quality of hospital care. Nurses are responsible for providing safe prevention of PUs in at-risk patients, but it is often seen that they have poor adherence to pressure ulcer prevention guidelines, which may be due to their lack of knowledge. Nurses need regular training in this area. Improving nurses' knowledge of PU prevention through Peer to peer approach not only improves the quality of PU care, but also reduces the length of hospital stay and the number of patients suffering from pressure ulcers.
What are the advantages and disadvantages of the proposed recommendations in the article: I appreciate the creativity and passion put into peer teaching/inspiring. Having nurses from various units teaching their peers is a very ideal teaching method as they can speak to real world application. However, there is a significant cost of providing this additional education. The method used in this study does have positive effects on providing education and the unique and fun aspect of the delivery method generated a energy and positive buzz. I can see this being influential at PSJMC.
ReplyDeleteKaren Caneday, RN, 6NE
How does this research article compare to our practice, policy and/or procedure?
ReplyDelete-This article shows that the peer-to-peer educational approach to nursing education was very effective as traditional educational session run by certified WOC nurses. When I started St Joe, our hospital has already implemented the peer-to-peer educational approach instead of traditional educational workshop for skin care. As this article mentioned, our WOC nurses has offered many opportunities including educational sessions to nurses who are interested in skin care and recruited as SWAT team. SWAT team members are different from mere 'skin care champions,' which mentioned in the article since we are a team, who can help with each other to get the tasks done. Our current activities of ICU SWAT team would be an evolving educational method, I think; we currently make a monthly skin round breaking into a smaller group educating/reminding/helping our colleague nurses as a skin resource nurse.
What are the advantages and disadvantages to the proposed recommendations in article?
-The advantages of Champion system, which some nurses are recruited and educated for a special purpose, are accessibility to their peers who work in the same shift with a champion nurse. As a result the peer nurses who are empowered by the Champion can provide the better/best skin care for a patient on that day. As a result, Champion nurses who may feel their doing is very rewarding. As a result, this can contribute a virtuous circle having decreasing Patient's length of stay, increasing staff retention. The advantages of Champion system is assignment free or not for Champions when they work as resource; for example if a Champion nurse has assigned patients as their peers it could be a tremendous burden on a Champion nurse depending on he/her assignments or the problems which the peers have. Additionally regarding assignment, Champion nurse might get a patient who has lots of skin problems due to abuse by Charge nurse. How about payment, it can increase turnover if Champion nurse doesn't get additional pay when they work as resource; they might leave hospital soon because they don't feel fair especially if they have to have Patient assignment and work as a skin resource.
What are the advantages and disadvantages to the proposed recommendations in the article:
ReplyDeleteThe authors of the article came up with a amusing and educational way to train staff on wound and ostomy care. They recruited staff nurses to become skin care champions(SCC), trained them in wound and stoma care and created fun carts (Woundie and Stomie) that carried teaching materials with games that the SCC could take to the units as a way to educate staff. This would be something that could easily be implemented at PSJMC as we already have the SCC as SWAT - it just would require some additional education to the team. In addition, the hospital already has something like this with the Magnet carts. The disadvantage to this would be the time and cost of further educating the nurses. Regardless, I think this would be a great way to engage all nurses in wound and ostomy care.
How does this research article compare to our practice, policy and/or procedure:
ReplyDeleteAt PSJMC, we already have skin care champions as SWAT who review the skin of every patient monthly. What the authors suggest in this article would educated the SWAT team, and expand wound and ostomy education to the other nurses. While we don't yet have wound and ostomy carts (like Woundie and Stomie), it would be relatively easy to create something like this at PSJMC as we already do something like this for Magnet. Furthermore, we could easily create surveys which could evaluate the success of implementing this idea.
1. what are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe purpose of this quality improvement (QI ) project was to provide innovative participatory approach to the education of staff nurses and nursing support personnel to improve skills and competencies in wound and Ostomy care while enhancing staff engagement and empowerment but the disadvantges was there were only 72 particiapants exhibited knowledge retention 5 months after initial participation which is very limited that could restrict the need for educational innovation regarding wound and ostomy care yo improve quality of care, nursing care outcomes and staff engagement
2. Discuss the sample size used in the study.
ReplyDeleteThe sample size has only 72 participants which is very limited to emerging the need for educational innovation regarding wound and ostomy care to improve quality of care, nursing care outcome and staff engagement. Through a peer to peer approach to wound and ostomy care education,enhace clinical knowledge and competencies can result in improved patient safety and increase care outcomes.
1. What are the advantages to the proposed recommendations in the article?
ReplyDeleteThe following are some benefits of this quality improvement project: enhanced visibility of the supplies and the wound/ostomy education professionals. Possibilities for practical instruction in every subject with peers' assistance. and chances for inquiries in a relaxed setting with the Wounds on Wheels Cart having a staff nurse with extensive training and hospital credentials who is qualified to provide skin care services on the units. Learning is enjoyable when using the Wounds on Wheels trolley.
2. What are the advantages and disadvantages to the proposed recommendations in the article?
The majority of patients from skilled nursing facilities that are admitted to PSJMC are elderly. These increase the possibility of pressure ulcer development. Most PUs can be prevented. The prevalence of PUs is still quite high, though. The frequency of PU serves as a gauge on the standard of hospital care. It is the duty of nurses to provide safe pressure ulcer prevention for patients who are at-risk, however it is frequently observed that they do not follow recommended guidelines closely, maybe as a result of ignorance. In this sector, nurses require ongoing training. Using a peer-to-peer strategy to increase nurses' understanding of PU prevention not only results in better PU care but also shortens hospital stays and decreases the number of patients that suffer.
Luna Chowdhury
4 North
1. What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe Advantages in clinical approach to wound care can help people heal faster ,feel more comfortable and return to their normal lives .And the purpose of this was to provide innovative participatory approach to the education of staff nurses and nursing and nursing support personnel to improve skills and competencies in wound and ostomy care while enhancing staff engagement and empowerment. Also a few of the advantages were early detection could improve healing, reduced scarring ,reduced the risk of infection, improved quality of life, reduced irritation, improved comfort, prevention of future wounds. While disadvantages include but not limited to some treatment methods for wounds have limitations such as high costs, low efficacy, and high risk of infection and chronic wounds can also be unresponsive to conventional treatments.
2. Discuss the sample size used in the study.
The sample size has only 72 participants which is very limited to emerging the need for educational innovation regarding wound and ostomy care to improve quality of care, nursing care outcome and staff engagement. Through a peer to peer approach to wound and ostomy care education, enhance clinical knowledge and competencies can result in improved patient safety and increase care outcomes. The Plan to do study Act (PDSA) model was used as framework for the QI intervention addressing different learning styles to improved knowledge and competencies and staff nurses pertaining to wound and ostomy care.
Discuss the research question or main problem discussed in the study:
ReplyDeleteData shows the need for increased interest in engagement in RNs to address the care for complex wound and ostomy needs of acute care patients. HAPI rates continue to rise, but there are several factors working against hospitals (lack of wound education during prelicensure, limited time during orientation to educate new workers, limited number of clinicians who are competent in ostomy care). There is a huge economical and health impact that occurs with pressure injuries. This project aimed to enhance standard education for new RNs, and use innovative wound/ostomy education carts and "skin care champions" to increase the overall skill and competency level of the hospital workers.
Discussion the sample size used in the study:
The study consisted of 72 participants within a 288 bed hospital - the project was specifically implemented on 7 units (6 medsurg and 1 ICU). With a sample size of only 72, the study is limited in terms of being able to represent the target population fully if trying to show the impact of skin care champions across many facilities. A larger sample size across various types of hospital settings would be able to show the generalizability of these results.
Describe the method used by the author of the study:
ReplyDeleteAn innovative peer-to-peer teaching approach has been shown to
improve educational outcomes in teaching nurses and nursing
students related to wound and ostomy skills and competencies
versus traditional instructor-led methods.
The method used in this project was a peer to peer approach in which staff educated each other with a mobile ostomy cart and a wound cart. The participants were RNs and nursing support staff who worked in the ICU and med-surg units at a hospital in Bronxville, New York. The framework used was the Plan-Do-Study-Act model.
DeleteThe project was specifically implemented on 7 units (6 medsurg and 1 ICU). With a sample size of only 72, the study is limited in terms of being able to represent the target population fully if trying to show the impact of skin care champions across many facilities. A larger sample size across various types of hospital settings would be able to show the generalization of these results.
ReplyDelete1. Discuss the sample size used in the study.
ReplyDeleteThe study was completed in 1 intensive care unit and 6 adult medical-surgical units of a 288-bed community hospital in Bronxville, New York from January to October 2020. There were 72 participants. Participants included RNs and nursing support staff working in intensive care and medical-surgical units. There was a post intervention survey. Data showed 65% nurses exhibited knowledge retention 5 months after initial participation; 85% reported a high level of engagement; and 97.5% reported high level of satisfaction 5 months after project implementation.
2. What are the advantages and disadvantages of implementing the recommendations on your unit or in your hospital?
The advantages of implementing the recommendations would be increased skills, knowledge and collaboration amongst staff. It would be cheaper to utilize a mobile education cart than using an outside vendor/webinar, and leadership would be content with increased engagement or satisfaction.
The disadvantages could include the variability of knowledge in those that provide the training and the added time to go around and teach all staff.
1. What are the advantages and disadvantages to the proposed recommendations in the article:
ReplyDeleteThe advantages to the approach used in the study are for one the increased and focused knowledge base given to select staff members who can in turn educate and help other nurses and unit staff. Peer-to-peer involvement and teaching is also a more engaging form of learning that forces action and responses as opposed to one-way didactic lectures. In addition, 68% of participants retained knowledge of what was taught after 5 months.
Disadvantages of the model include the protracted planning phase of the project from January to October before the project was actually implemented. Also, there were no reportable data from the original standard wound and ostomy education programs, and thus no direct comparison between both approaches. Another shortcoming of the approach is it does not address actual practice changes of staff or an increase/decrease in affected patient outcomes.
2. How does this research article compare to practice, policy and/or procedure:
For our hospital, new grad nurses receive initial lectures and hands-on training with class models, and wound and ostomy protocols are always available online. Preceptorships offer exposure, teaching and guidance of actual patients with wounds and ostomies. There is a SWAT team on each unit that does monthly surveillance of all patients with or without wounds. RNs are required to do a full skin assessment of all of their assigned patients, take pictures of wounds and order a wound ostomy consult for any new ostomies, suspected pressure ulcers, or assessment and troubleshooting with established wounds. Dedicated wound care nurses manage consults, educate patients and family, make recommendations and put in wound care orders. Leadership-approved additional classes may be offered whereby select staff can become superusers of special topics such as ostomy care, wound vacs, etc.
Discuss the sample size used in the study.
ReplyDeleteThe study was conducted from January to October 2020 at a 288-bed community hospital in Bronxville, New York, covering one intensive care unit and six adult medical-surgical units. The sample consisted of 72 participants, including RNs and nursing support staff from these units. A survey conducted after the intervention revealed that 65% of the nurses retained their knowledge five months post-participation. Additionally, 85% of the nurses reported high engagement levels, and 97.5% expressed high satisfaction with the project five months after its implementation.
Describe the method used by the author of the study:
The study employed a mixed-methods approach to evaluate the peer-to-peer education program in wound and ostomy care. It involved selecting experienced staff members as peer educators, who then conducted training sessions for their colleagues. Data were collected through pre- and post-intervention surveys to assess changes in staff competency and engagement, supplemented by qualitative feedback from interviews and focus groups. The analysis included both quantitative measures of skill improvement and qualitative insights into participant experiences, allowing for a comprehensive evaluation of the program’s effectiveness and its impact on staff
This comment has been removed by the author.
ReplyDelete1. Discuss the research question or main problem discussed in the study?
ReplyDeleteThe essence of the article was to look at the benefits to the patients, hospital, and RNs if they were to receive more education on wound and ostomy care to enhance their existing skills. Would this improve RN engagement / knowledge retention to wound/ostomy care? This is an important question because as the article noted there are millions of patients affected by pressure injuries with preventable deaths due to those types of injuries. HAPIs and related injuries increase mortality rates and pose an economic burden on the state and hospital. Those funds could have been used on so many other things the hospital needs.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias.
One major flaw seems to be how this is affecting patients. Although the purpose of the article is not to really show this, I believe this is the number one question the hospital brass will want to know if they were to spend money for RNs to come and enact something similar. It is assumed based on knowledge retention that improving nursing skills and knowledge will lead to better patient outcomes. This assumption is reasonable but does not paint the whole picture for gaps in knowledge and skills. For example: burnout, employee retention, and proper staffing.
(1) what are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteadvantages:
Enhanced staff engagement and satisfaction: The project resulted in high participant satisfaction rates (97.5% somewhat to extremely satisfied) and sustained engagement (85% somewhat to extremely engaged).
Knowledge retention: 68% of participants exhibited knowledge retention 5 months after initial participation, suggesting the approach was effective for learning.
Innovative and interactive learning: The use of mobile "Woundie" and "Stomie" carts brought hands-on, interactive learning directly to the units, making education more accessible and engaging.
Disadvantages:
Resource intensive: Developing the educational materials, creating the mobile carts, and training the Skin Care Champions requires significant time and resources.
Limited scope: The project focused primarily on knowledge retention and engagement, but did not evaluate changes in clinical practice or patient outcomes.
Lack of baseline comparison: The unavailability of baseline data from prior years made it impossible to directly compare this approach to standard educational programs.
(2)Discuss the research question or main problem discussed in the study?
The main problem addressed in this study is the need for improved education and competency development among nursing staff in wound and ostomy care. This issue stems from several factors highlighted in the introduction:
High prevalence of pressure injuries and ostomies: The study notes that approximately 2.5 million people in the United States are affected by pressure injuries annually, and about 1 million people are living with an ostomy.
Given these challenges, the main research question or problem this study seeks to address can be summarized as:
How can an innovative, participatory approach to education improve the skills and competencies of staff nurses and nursing support personnel in wound and ostomy care, while also enhancing staff engagement and empowerment?
The study aimed to address this question by implementing a quality improvement project with the following specific aims:
Design and implement an innovative educational program using mobile wound and ostomy education carts.
1. Discuss the research question or main problem discussed in the study.
ReplyDeleteThe main problem discussed in the study highlights the need for improved education and training for RNs to manage complex wound and ostomy care more effectively. The study addresses the rising rates of HAPIs and the challenges associated with current education practices by proposing enhanced standard education, innovative training tools, and the implementation of skin care champions. These strategies aim to increase RN competency, ultimately reducing HAPI rates and improving patient care outcomes.
2. Discussion the sample size used in the study.
The sample size of 72 participants in a single hospital provides valuable insights into the impact of skin care champions and enhanced education on wound and ostomy care. However, the limited scope of this sample size raises concerns about the generalizability of the findings to other hospitals and healthcare settings. To enhance the applicability and robustness of the study outcomes, future research should aim for larger sample sizes and include a diverse range of healthcare environments. This would help in better understanding the intervention’s effectiveness across various contexts and support broader implementation strategies.
1. Describe the method used by the author of the study.
ReplyDeleteThe project used the Plan-Do-So-Study-Act (PDSA) cycle adopted by the Deming Institute in 1997. The Plan step that involves goal identification and defining interventions to be used; the Do step involves where the planned interventions are implemented. The Study step involves analyzing the effects of the interventions; the Act phase involves sustaining the desirable outcomes. Using the PDSA model as the framework for planning they collaborated on strategies to increase staff engagement and participation while enhancing wound and ostomy knowledge and skills among staff members. They have decided that peer-to-peer approach provides an evidence based, innovative approach for educating practicing nurses.
2. How does this research article compare to our practice, policy and/or procedure?
At Providence Saint Joseph Medical Center. They provide an annual competency skills fair for nurses, and this includes wound management and assessment. In each unit, we have our own wound carts which includes pictures of stages of Pressure Ulcer wounds. Preventions for wounds and incontinence are available in each unit as well, such as Foams (Mepilex), Heel Offloading devices, offloading devices for turning and repositioning patients, such as waffle are available for nurses to use per policy. Wound consults are available for nurses to put as a per policy order for assessment and management of wounds.
1. How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteI believe our ministry does an amazing job in providing education to nurses in increasing their competency towards wound care and treatment. As a new graduate when I started my career with PSJMC, I was provided with the opportunity to meet with the wound care nurses Lupie and Melissa to gain more knowledge in providing wound care and not only that but also implementing proper interventions methods in order to avoid patients from developing pressure injuries. The wound care nurses, also discussed the proper staging of wounds. Additionally, it is also very nice to have the wound care guide attached to the would care supplies that helps us identify how to treat the wounds, until the wound care nurse assesses the patient themselves.
2. Discuss the sample size used in the study.
There were 72 participants in this sample study who were provided with education and were guided by two certified wound ostomy nurses. From the 72 participants, 49 of the nurses demonstrated wound care knowledge retention after 5 months of their initial participation in the study. Among the participated, 61 of them reported a high level of engagement and 70 of them reported high level of satisfaction after the implementation of the peer-to-peer project. The skills practice, helped to fulfill existing gaps in the healthcare team in wound care knowledge and competencies.
Reasearch question: The purpose of this study was to provide an innovative, participatory approach to the education of staff nurses and nursing support personnel to improve skills and competencies in wound and ostomy care while enhancing staff engagement and empowerment. With approximately 2.5 million people affected by pressure injuries annually, leading to approximately 60,000 unnecessary deaths, this specific project aimed to design and implement an innovative educational program and to develop mobile wound and ostomy education carts, recruit and educate nurses to become skin care champions, utilizing a peer-to-peer approach to enhance skills and competencies of staff nurses as it pertains to wound and ostomy care.
ReplyDeleteSample size: This project was enacted in a 288-bed facility in Bronxville, NY in 1 intensive care unit and 6 adult medical-surgical units with 72 nurses participating. Those recruited to be 'skin care champions" (SCCs) underwent education and skills enhancement training consisting of a 6.5 hour standardized continuing education program in which they received the Skin Care Resource Nurse credential. Two educational carts, "Woundie" and "Stomie" contained wound care and ostomy care education respectively.
Discuss the limitations of the article.
ReplyDeleteThe biggest limitation that was found in this study was the lack of baseline data where standard educational programs were implemented was difficult to be found and made compassion difficult in the study. Additionally, in the study it was found that staff gained education on wound and ostomy care however, it was unclear if practice changes were implemented by staff.
Discuss the research question of main problem discussed in the study.
The development of this research study was to implement more education and skill training for clinical nurses in wound and ostomy care to provide better outcome for patients. The study also wanted to enhance the staff and engagement and empowerment after having used different learning stayles in the implementation of the care provided at one hospital in the United States.
1. Discuss the research question or main problem discussed in the study
ReplyDeleteThe burden of HAPI’s and wounds is crushing. The authors conducted a quality improvement project to improve hospital staff competencies and skills in wounds and stoma care. There is an increased demand for skilled and specialized care but education and limited time for education have led to knowledge deficits. There is an increased need for staff engagement and competencies in wounds and stoma care which result in improved patient outcomes.
2. Describe the method used by the authors in the study.
A Plan-Do-Study-Act (PDSA) model was used as a framework for the quality improvement intervention. A peer to peer approach to staff education addressing different learning styles was used to improve knowledge and competencies of staff nurses. The CWOCN provided in-depth education to the skin care champions. These champions went around the hospital and provided peer education by playing games for knowledge checks and two anthropomorphic mobile Wounds on wheel’s carts to perform educational assessments. This was a useful tool to practice and increase staff competencies in wound and stoma care.
1. Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main focus of this quality improvement project was to explore how a fresh, hands-on approach to training could boost the skills of nursing staff in wound and ostomy care, while also increasing their engagement and empowerment. The researchers wanted to see if using a peer-to-peer education model would really make a difference in how well nurses retained knowledge and felt about their training. Essentially, they aimed to create a more effective learning experience that would ultimately lead to better patient care.
2. Discuss the sample size used in the study.
As for the sample size, the study involved 72 participants, including both registered nurses and nursing support staff from one intensive care unit and six medical-surgical units in a community hospital. This mix of healthcare professionals was crucial for evaluating how well the educational intervention worked. After the training, a post-implementation survey showed that 68% of participants retained their knowledge five months later, with 85% reporting high engagement levels and an impressive 97.5% expressing satisfaction. This suggests that the sample size was solid enough to draw some valuable insights about the program’s impact on staff skills and engagement in wound and ostomy care.
Discuss the research Question or Main Problem discussed in this study:
ReplyDeleteData indicates a pressing need to boost registered nurses' engagement in managing the complex wound and ostomy needs of patients in acute care settings. Rates of hospital-acquired pressure injuries (HAPI) are on the rise, influenced by several challenges faced by hospitals, such as inadequate wound education in nursing programs, insufficient time for training new staff during orientation, and a limited number of clinicians skilled in ostomy care. The economic and health consequences of pressure injuries are significant. This project aimed to improve standard education for new RNs by introducing innovative wound and ostomy education carts, as well as establishing "skin care champions," to elevate the overall skills and competencies of hospital staff.
Discussion the sample size used in the study:
The study included 72 participants from a 288-bed hospital, specifically focusing on seven units, comprising six medical-surgical wards and one ICU. Given the relatively small sample size, the findings may not fully represent the broader target population when assessing the impact of skin care champions across multiple facilities. Expanding the sample size to include a variety of hospital settings would enhance the generalizability of the results.
Sonya Mikaelian
ReplyDelete1. Describe the method used by the author of the study.
The method used by the author in this study is the PDSA cycle which was adopted by the Deming Institute in 1997. PDSA stands for Plan-Do-Study-Act. The plan step involves goal identification and finding interventions. The do step is when the planned interventions are implemented. The study phase is when the interventions are analyzed and finally the act is when the desired outcomes are reached. The PDSA model encourages staff involvement and participation while enhancing wound and ostomy knowledge among staff members.
2. Discuss the sample size used in the study.
The target audience for this study was skin care champions in a 288 bed community hospital in New York. The project was implemented in one intensive care unit and six medical surgical units in this facility. The sample size was 72 participants from these units. This sample size is relatively small considering they were only from two types of units in one facility. To yield more accurate results and have a better sample size, participants should be been from different facilities and/or a larger sample size.
1. Describe the method used by the author of the study
ReplyDeleteThe author used a quality improvement study via a plan to do study act (PDSA) using a peer-to-peer approach. This was done by providing staff education on wound and ostomy and having them share and train amongst their other peers. Education was provided in different methods for the different learning preferences of the staff. The approach was a plan do study and act. They planned what was needed from staff, asked them to do once education was provided, and the study was performed.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
The sample size of this study was definitely a limitation due to it only being 72 participants in a small community hospital of 228 beds. The retention of the education provided had a little bit of a flaw due to maybe not continuing to apply what they learned, although a high percentage of 68% retained information 5 months after the initial education. Maybe involving other hospitals around the area would have better outcomes statewide instead of just local.
Valarie Renaux
ReplyDeletePeer-to-Peer Approach to Increasing Staff Competency and Engagement in Wound and Ostomy Care
1. Describe the method used by the author of the study.
The PDSA was the method utilized for this study. PDSA is an acronym for the following: 1) Plan; 2) Do; 3) Study; 4) Act. Isolation of a goal to reach an intervention encompasses the approach of the plan. This was further implemented in January to October of 2020 with recruitment and training. Following through with the intervention proceeding the plan occurring in November of 2020 with wounds on wheels with woundie and stomie. Analysis along with investigation falls into the category of the study that occurred in December 2020 to May 2021. The act was circumscribed the results observed in May of 2021.
2. Discuss the sample size used in the study.
The Sample size consisted of 72 subjects residing at a 288 bed community hospital located in New York. Some of these beds were located in various units within the hospital including six different medical surgical departments and the intensive care unit. The subjects in this particular study were comprised of healthcare workers ultimately showing results of their understanding in knowledge base and wound care approach. Due to this study being conducted within one hospital implemented by staff there could be some bias in the results of this study.
Valerie Dressman
ReplyDelete1. Describe the method used by the author of the study.
This study utilized the Plan-Do-Study-Act model. The Plan phase is setting a goal and interventions to reach that goal. This phase in their study was training skin care champions (SCCs) to be able to educate others. The next phase, Do, is when the plan is put into action. In this study, this was creating educational carts for wound and ostomy care called Wounds on Wheels (WoW). The study phase was to review the effectiveness of the intervention, the WoW. Lastly, the Act phase is continuing and sustaining the goal outcome, which in this case was having an annual fair with the WoWs.
2. Discuss the research question or main problem discussed in the study?
This study was a quality improvement project. The goal was to educate staff and provide them with skills necessary to improve quality of care for wounds and ostomies. It aimed to keep caregivers engaged in learning. In the end, the study assessed the effectiveness of the innovated approach.
Describe the method used by the author of the study
ReplyDeleteThe method used in this project was a peer to peer approach, staff educated each other with a mobile ostomy and a wound cart. The participants were RNs and nursing support staff who worked in the ICU and med-surg units at a hospital in New York. The framework used was the Plan-Do-Study-Act model. The "plan" is the goal identification, "Do" where the planned interventions are implemented. "Study" analyzing the effects of the study and "Act" sustaining the results of the study
How does this research article compare to practice, policies and procedures?
At Providence we have a SWAT team that performs weekly meetings and skin check in each units. We try to teach our pears what to look for and encourage them to participate in this weekly meetings. At our annual skills fair we have the wound care nurses giving us an update on new products been developed to protect our patients skin. The wound and ostomy cart would be a good idea to keep our skill updated and to prevent us from missing any skin breakdown.
ReplyDeleteThis article brings attention to the alarming statistics that pressure ulcers affect approximately 2.5 million American’s annually, which lead to approximately 60,000 preventable deaths. With approximately one million of these Americans living with an ostomy. Furthermore, a national study reported that diverticulitis with perforation and abbess, along with sepsis were leading causes of ostomy surgery. Also, the 1.4 million individuals affected and treated for colorectal cancer significantly contribute to ostomy care as well. These startling statistics clearly illustrate the increased demand for the engagement of competent board-certified nurse specialists and competent providers. Current available research reveals that nurses in the United States have limited levels of pressure ulcer knowledge due to limited education instruction during their prelicensure training and due to the scant time allotted to them during their on-the-job training.
In an effort to increase educational awareness and training, an inventive program was designed and established using an creative educational program to develop mobile wound and ostomy carts. Certified Wound, Ostomy, Continence (CWOC) nurses would be using these carts as tools to educate staff nurses to become skin care champions (SCC). This is a peer-to-peer approach to increase the staff competency and engagement of wound and ostomy care. The peer-to-peer approach has been shown to increase educational outcomes in contrast to the traditional instructor led methods.
A 288-bed hospital in Bronxville, New York, was targeted for this Q1 project. The metric for success were verbal evaluations immediately after completion of the activity. After training from the CWOC nurses, the new SCC nurses would be allowed time away from their normal assignments to take the carts to other units in order to conduct wound and ostomy care training on those units. The primary outcome of this Q1 project was knowledge retention among the participants. A majority, (68%), exhibited knowledge retention 5 months after initial participation.
I am a strong proponent of peer-to-peer training. I work in the Cardiac Cath Lab, and I have numerous student nurses who come through the lab. I have unofficially been designated as the proctor or trainer for these students. I try to decrease their anxiety and treat them as a peer. I then draw diagrams of the procedures that simplify the process. I cover pacemaker insertions, electrophysiology studies with ablations, and coronary angiograms with stenting. These are complicated procedures that can be very overwhelming for students. But, the vast majority of the student I have worked with state that they have learned more with their brief time in lab than during their didactic classroom sessions. Everyone has a different way of learning and retaining new information, but I firmly believe that peer-to-peer education is one of the best methods.
-How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteOur facility primarily uses a wound nurse, SWAT, and health stream modules for learning. On occasion, there is peer-to-peer
teaching such as most recently for tegaderm application. Like answered in my second question below - this does not always
capture all nurses, in the same way mandatory modules do. However, it is interactive and gets the message across. I am open
to this type of learning on the floor to better educate myself. The concept of a woundie and stomie cart is beneficial for
key differentiation of each and something the nurses can benefit from.
-What are the advantages and disadvantages of implementing the article recommendations on your unit and/or hospital?
The advantage of peer-to-peer education approach is that this is a cost effective and time efficient way to educate nurses on wound and ostomy skills. It allows interactive learning and engagement. The disadvantage to this method is that the peer teaching must be a good teacher, and the peer learning should be receptive. This may not always be the nurse's preferred learning style. Also, this type of teaching does not always include night shift nurses to the same extent as dayshift nurses.
1. Describe the research method used by the author of the study.
ReplyDeleteThe research method used in the study was a peer-to-peer, quality improvement (QI) approach guided by the Plan-Do-Study-Act (PDSA) model. The project was planned between January and October 2020. It used a collaborative, iterative approach to improve wound and ostomy care practices by empowering staff to educate each other through a structured process of planning, implementation, and evaluation, guided by the PDSA model. The PDSA model enabled the team to continuously monitor progress, identify areas needing improvement, and make necessary adjustments throughout the project.
2. Discuss the research question or main problem discussed in the study?
The main research question addressed in the study focuses on how an innovative peer-to-peer educational approach can enhance the knowledge and competencies of staff nurses and nursing support personnel in wound and ostomy care. The study aims to identify gaps in knowledge, evaluate educational effectiveness, assess engagement and satisfaction and, enhance clinical outcomes. Overall, the research question encapsulates a broader concern within nursing education: how to effectively equip healthcare professionals with the necessary skills and knowledge to provide high-quality care, particularly in specialized areas like wound and ostomy management. The findings suggest that the peer-to-peer approach can fulfill these needs by fostering a supportive learning environment that promotes both knowledge acquisition and staff engagement.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe main problem the authors had was education and engagement in Wound ostomy care. The article attributes the problem to limited educational resources and limited on the job training. The described problem identifies a mismatch between the amount of resources used to treat skin issues, and an unequal balance of teaching and educational resources for nursing staff.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
-the article was written by the hospitals educators/wound care team. There were a few biases that could have played a role in the outcome of the study/survey. The survey team is also the coworkers of the people being surveyed. After a enjoyable in-service with a known colleague or friend, the survey participants may have been more likely to report positive survey results knowing that the outcome may directly affect a another coworker/colleague. The second bias that could also significantly affect the results was the type of study in general. They are basing a nurses knowlege and retention on wound/ostomy care simply by stated survey question and not actual visualized wound/ostomy care. Nurses may have a bias towards how well their knowledge actual is if they are not being required to demonstrate that knowledge.
Discuss the research question or main problem discussed in the study?
ReplyDeleteHospital-acquired pressure injuries continue to be a significant burden across healthcare facilities in the United States. Despite the urgent need for skilled and specialized care, current research reveals that nurses in the US have limited knowledge of pressure injuries due to scarce educational content during prelicensure examination and limited time allotment during on-the-job training. The purpose of this quality improvement project was to provide an innovative, participatory approach to the education of staff nurses and nursing support personnel to improve skills and competencies in wound and ostomy care while enhancing staff engagement and empowerment.
How does this research article compare to our practice, policy and/or procedure?
Project outcomes included formation of an expert panel of SCCs equipped with educational knowledge and competencies related to wound and ostomy care and development of an innovative educational program using a peer-to-peer approach enhancing wound and ostomy competencies of clinical nurses. This article asserts that a peer-to-peer approach to staff education is beneficial to address the different types of nurse learners. Immediate evaluation coupled with distanced postimplementation assessment methods was helpful as an adjunct to evaluation methods.
How does this research article compare to our practice, policy and/or procedure?
ReplyDelete-I believe this peer to peer approach is an excellent method in educating our staff rather than having HealthStream modules yearly. Hands on education using interactive games and trivia is much better retained than reading. Our wound care department is excllent although I feel they can become overwhelmed with the case load in our facility. If staff can be educated using this method yearly at our skills fair, it might decrease the workload of our wound nurses.
Discuss the research question or main problem discussed in the study?
-This study involved using a peer to peer approach to increase staff engagement meanwhile improving staff knowledge and skills regarding wound and ostomy care. They created a Wounds on Wheels cart to aid in educating staff members. This cart included interactive trivia and other education games. Their PLAN, DO, STUDY, and Act approach was successful. It improved the staff members knowledge in taking care of these patients with wounds and ostomys.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteThis article highlights the effectiveness of a peer-to-peer educational model in nursing, demonstrating that it can be as beneficial as traditional sessions led by certified WOC nurses. When I joined St. Joe's, our hospital had already adopted this peer-to-peer approach for skin care education instead of conventional workshops. As mentioned in the article, our WOC nurses provide numerous opportunities, including educational sessions for nurses interested in skin care, and they have formed a SWAT team. Unlike the 'skin care champions' referenced in the article, our SWAT team operates collaboratively to support one another in completing tasks. Currently, our Units SWAT team's approach to education is evolving; we conduct monthly skin rounds, splitting into smaller groups to educate and assist our fellow nurses as resource nurses for skin care.
what are the advantages and disadvantages to the proposed recommendations in the article?
The aim of this quality improvement (QI) project was to implement an engaging participatory method for educating staff nurses and nursing support personnel, focusing on enhancing their skills and competencies in wound and ostomy care while also boosting staff involvement and empowerment. However, a notable limitation was that only 72 participants demonstrated knowledge retention five months after their initial training, which suggests that this limited retention could hinder the push for educational advancements in wound and ostomy care necessary to enhance quality of care, nursing outcomes, and overall staff engagement.
What are the advantages/disadvantages of the proposed recommendations of the article?
ReplyDeleteThe advantages are that there was a high percentage of staff satisfaction rates in engagement and knowledge retention. The disadvantage is that there were a lot of resources needed in developing the resource materials. It also had a limited scope and did not evaluate the patients' outcomes of this study.
Discuss the sample size in the study?
The sample size consisted of 72 participants including RNS. This study was done from January to October at a community hospital. This study included a post-intervention survey that showed 65% of nurses exhibited knowledge retention 5 months after participating, 85% reported a high level of engagement, and 97.5% satisfaction.
This comment has been removed by the author.
ReplyDeleteHow does this research article compare to our practice, policy and/or procedure?
ReplyDeleteIn this study, they decided that a peer to peer approach provides an evidence based, innovative approach for educating practicing nurses. They also considered the “mobility” and “fun” aspects of the project. This process led to creation of a mobile wound and ostomy cart, which was constructed as an alternative to traditional educational exercises. We also use peer to peer approaches at PSJMC as we have super users on particular topics including wound vacs. I also recall RNs rounding with mobile carts asking about various topics. The carts usually include snacks and sweets that draw the staff to the carts.
Describe the method used by the author of the study
This was a quality improvement project that used the Plan Do Study Act cycle .The cycle begins with the “Plan” step that involves goal identification and defining interventions to be used, the “Do” step involves where the planned interventions are implemented. The “Study” phase involves analyzing the effects of the interventions, the “Act” phase involves sustaining the desirable outcomes. This quality improvement project collaboration on strategies to increase staff engagement and participation while enhancing wound and ostomy knowledge and skills among staff members
ReplyDeleteDiscuss the research question or main problem discussed in the study?
The main problem discussed in this study is the limited knowledge of nursing and allied support staff in regards to the prevalence, prevention, and treatment of pressure injuries with patients. Despite the training and skills of staff, the United States is burdened by the concept of hospital acquired pressure injuries. This quality improvement project aims to provide a revolutionary approach to the education of nursing and allied support staff in wound and ostomy care, thus enhancing the empowerment and engagement of staff.
How does this research article compare to our practice, policy and/or procedure?
Our current practice and policy on wound care and pressure injuries would be significantly improved by following these recommendations. The innovation of a peer-to-peer approach would help propagate these teachings on a daily basis. The combination of immediate evaluation and spaced repetition of these concepts would boost the effectiveness of these new procedures.
Discuss the research question or main problem discussed in the study.
ReplyDeleteThe study was done to improve nurses knowledge on wounds and ostomy care. The purpose is to provide an innovative, participatory approach to the education of staff nurses and nursing support personnel to improve skills and competencies in wound and ostomy care while enhancing staff engagement and empowerment.
Discuss the sample size of the study: The project included an ICU unit, 6 med surg units. participants included not only RN's but also nursing support staff. Results showed that 72 participants exhibited knowledge.
The main problem addressed in this study mentions how pressure injuries effect an estimated 2.5 million people in the US, leading to 60,000 preventable deaths. Approximately 1 million people are living with ostomy bags. Diverticulitis with perforation, abscess of large bowel and sepsis were the leading causes of surgery followed by colorectal cancer.
DeleteTanya Matiossian ^
ReplyDelete