Article: The Effectiveness of Pressure Injury Prevention Education for Patient Care Technicians in an Adult Acute Care Setting
A Quality Improvement Project
Year Published: January 2025
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Discuss the sample size used in the study
ReplyDeleteData was collected from 24 PCTs, and 43 patients at an inpatient acute care medical center in the U.S. This was a small number of patients used and may have contributed to the beta-error. A beta-error is a type ll error which confirms an idea that should be rejected.
Discuss the limitations of the article: limited sample size, design flaws, and/or author bias:
The sample size was only 43 patients. This is a small sample size. 24 PCTs participated but only 21 of them completed the skills check off sessions and motivational interviewing. The attitude outcome score was low. It mentioned that this may have been because of the extra work. Also, since 66.7% of the PCTs had gotten prior education on HAPI prevention strategies, there was not an improvement in the knowlegde area. The baseline knowledge area was already 92% at the beginning so there was not much room for growth.
Bethany Sobesto 3/7/25
Redo of question: Discuss the sample size use in the study.
DeleteInformation was collected from 24 PCTs, and 43 patients at an acute care medical hospital in the United States. These were inpatients. This was not a large sample of patients. This small sample size contributed to the beta error which occured. In hypothesis testing, a beta error will show that the data should be rejected because there was a false null hypothesis which should have been thrown out, but was not. So the failed to detect the false hypothesis and the null hypothesis was retained.
Discuss the research question or main problem discussed in the study?
ReplyDeleteThe question of this article is to determine if HAPIs are preventable with the implementation of an educational toolkit for patient care technicians in the acute care setting. With increased costs to facilities related to HAPIs, there has become a higher reliance of care onto unlicensed assistive personnel. A review of previous studies showed that there were knowledge and practice deficits in HAPI prevention among these PCTs. This article sought to show the relationship between educational interventions for these caregivers and a reduction in HAPI rates.
How does this research article compare to our practice, policy and/or procedure?
Similar to the interventions seen during this 8-week study, our facility takes great care in auditing for HAPIs. All caregivers here are involved with patient care receive HAPI-related education during orientation, annual competency training, regular wound rounding, and reminder emails. Each unit does their own turn auditing on each shift, and our SWAT team is now meeting monthly to support our efforts in decreased HAPIs here at PSJMC. Similar to this facility, we noticed gaps in our Nursing Sensitive Indicators when compared to the national benchmark, and many units established QI projects/product initiations as well as increased educations for their RNs and CNA/PCTs.
What are the advantages and disadvantages of implementing the article recommendations in your unit and or your hospital?
ReplyDelete-In our unit where most of our patients are mostly elderly with decrease mobilities and lots of co morbidities, nurses play an important role in preventing HAPIs. However, the high workloads and at times less staffing is a challenge for nurses in implementingHAPI prevention strategies. Joint effort of nurses and CNA/PCT would help to decrease HAPIs and improve patient outcomes. By providing knowledge and educational tool kit designed to our CNAs ,it can potentially improve the implementation of HAPI prevention strategies.
Discuss the research question or main problem discussed in the study.
- Aside from nurses, healthcare organizations also rely on PCTs to provide nursing care to prevent HAPIs. According to the article, factors such as lack of knowledge, lack of education and training, staffing insufficiency may contribute to PCT’s decrease practice in HAPI prevention.HAPIs may result to patient’s negative outcomes, increase hospital stays and increase use of resources and hospital use.
Research question: The purpose of this study was to determine whether HAPIs could be prevented by implementing an educational tool kit for PCTs in an adult acute care setting. With HAPI's contributing greatly to prolonged hospital stays and significant impacts on morbidity and mortality, this study implemented in person presentations, skills training sessions, printed reference guides and visual graphics to increase PCT knowledge of HAPI prevention. The main goals of the study were to evaluate changes in HAPI and unit acquired pressure injury prevalence rates, measure PCTs attitudes toward and knowledge regarding HAPI prevention and identify PCTs implementation of HAPI prevention strategies.
ReplyDeleteSample Size: This quality improvement study was conducted in a 26-bed inpatient adult acute care unit in an academic medical center in Maryland. The unit employs 26 PCTs and cares for adults with complex medical conditions such as stroke, CHF and ESRD. The project was implemented from the third week of September through the second week of November. Inclusion criteria were all patients on the unit if they had a Braden Scale of less than 18 during the initial audit days. Patients were excluded if they did not have a Braden scale in their chart, had COVID 19, refused to be assessed, actively dying, off the unit during data collection or had behavioral concerns determined by the charge nurse. Data was collected from all PCTs employed full or part time on the identified unit, exclusion criteria were PCTs from a float pool or per diem position.
Discuss the sample size used in the study
ReplyDeleteThe Data were collected by 24 PCT's and 43 patients in a 26 bed inpatient adult acute care unit at Academic Medical Center in the mid Atlantic Region of the United States .Outcome data wren collected over an 8 week period from September to November 2021.Hospital Acquired pressure injury prevalence was collected using the National Database of Nursing Quality Indicators (NDNQI)survey process.Full and apart time PCT's knowledge and attitudes were assessed through modified pressure Injury Prevention Knowledge and attitudes towards Pressure Ulcer Prevention Instruments.The PCT's compliance with prevention strategies was assessed among patients using the modified NDNQI audit scores .Descriptive statistics ,Fishers Exact test and Mann Whitney U test were used for analysis
Discuss the research question or main problem discussed in the study?
It focuses on the hospital acquired pressure injury (HAPI) also known as bedsores, is localized injury to the skin and underlying tissue that develops during an inpatient stay in a hospital or other Health care facility .These injuries are caused by prolonged pressure ,friction, and or shear,often in areas where bone is closed to the skin. Usually HAPI's are pressure ulcers that occur after a patient 's admission to a hospital .They are caused by a prolonged pressure on the skin, often over bony prominences, but can also be caused by medical devices or prolonged sitting. HAPI's are often associated with factors like immobility, poor nutrition, advance age and certain medical conditions.HAPI's can lead to pain, infection ,longer hospital stays and increased health care costs.They can also contribute to reduced quality of life and even death.
1. What are the advantages and disadvantages to the proposed recommendations in the article?
ReplyDeleteThe quality improvement project aimed to enhance pressure injury prevention by educating Patient Care Technicians (PCTs). It successfully improved the implementation of preventive strategies, with measurable gains in practice behaviors and the incorporation of the educational toolkit into ongoing staff training. The collaborative, low-cost, and scalable design added to its strengths.
However, the intervention did not significantly reduce pressure injury rates, and PCTs’ attitudes toward prevention worsened—possibly due to increased workload or stress. High baseline knowledge and partial participation further limited measurable improvements. Additionally, the small sample size restricts broader applicability. While promising in changing practice, the project’s clinical impact remains inconclusive.
2. Discuss the research question or main problem discussed in the study
The primary focus of the study was to evaluate whether educating Patient Care Technicians (PCTs) using a tailored toolkit could effectively prevent hospital-acquired pressure injuries (HAPIs) in an adult acute care setting. The researchers aimed to address three key objectives: determine if the prevalence of HAPIs and unit-acquired pressure injuries (UAPIs) would decrease after the intervention; assess changes in PCTs’ knowledge and attitudes toward prevention; and measure whether PCTs would apply prevention strategies more consistently in practice.
This project was initiated in response to rising pressure injury rates on the unit and a recognized lack of standardized education for PCTs. Given that PCTs play a hands-on role in patient care, the study sought to determine whether improving their preparation could lead to better patient outcomes. In essence, the central question was whether focused, evidence-based training for PCTs could bridge gaps in practice and reduce the incidence of pressure injuries.
Discuss the research question or main problem discussed in the study
DeleteThe study's objective is to examine whether a targeted educational program for Patient Care Technicians (PCTs) could improve the prevention of hospital-acquired pressure injuries (HAPIs) within an adult acute care unit. Specifically, the study explored three lines of inquiry: whether rates of HAPIs and unit-acquired pressure injuries (UAPIs) would decline following the program, whether PCT knowledge and attitudes toward prevention would shift, and whether these staff members would demonstrate greater consistency in applying prevention measures during daily care.
This quality improvement effort was developed after the unit experienced an upward trend in pressure injury cases alongside a lack of uniform training for PCTs. Because PCTs have direct and ongoing contact with patients, the study investigated whether equipping them with structured, evidence-informed guidance could address observed practice gaps and contribute to better patient outcomes.
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ReplyDelete1. Describe the method used by the author of the study?
DeleteThe authors used the National Database of Nursing Quality Indicators (NDNQI) to collect hospital acquired pressure injury prevalence. The data was collected over 8 week period from September to November 2021. Full and part-time PCT's knowledge and attitudes were assessed through Modified Pressure Injury Prevention Knowledge and attitudes towards Pressure Ulcer Prevention instruments.
The Wound, Ostomy and Continence (WOC) nurses and the wound care committee staff nurses identified both HAPI's and UAPI's while rounding on all patients at the project site during the quarterly National Database of Nursing Quality Indicators (NDNQI) survey days.
The HAPI prevalence rate was calculated by comparing the total number of patients with HAPI with the total number of patients in the unit. The UAPI prevalence rate was calculated by comparing the total number of patients with UAPI's with the total number of patients in the unit.
2. Discuss the sample size used in the study?
Data were collected from 24 PCT's and 43 patients in a 26 bed inpatient adult acute care unit at an academic medical center in the mid-Atlantic region of the U.S. Among the 24 PCT's 16 had received prior education on HAPI prevention strategies.
All 24 PCT's in the unit were checked-off by the nurse educator during the first and second week of the 8 week intervention phase. The PCT's were checked off as having completed validated instruments measuring pressure injury prevention knowledge and attitudes toward pressure injury prevention.
The HAPI prevention strategies tool kit was disseminated to all 24 PCT's by e-mail during the third week. Regular unit rounding, reminder e-mails and meeting with stakeholders were used to encourage staff participation.
Discuss the research question or main problem discussed in the study.
ReplyDeleteThis study aimed to determine whether hospital-acquired pressure injuries could be reduced by providing patient care technicians (PCTs) with an educational toolkit to support their work. While PCTs play a vital role in preventing these injuries, gaps in their knowledge can sometimes limit effectiveness. The goal was to evaluate whether implementing evidence-based educational toolkits would decrease the prevalence of unit-acquired pressure injuries and see its effectiveness.
Discuss the method used by the author of the study.
The researchers applied the Knowledge-to-Action framework to guide the project. Conducted over eight weeks in a 26-bed adult acute care unit, the study involved 24 patient care technicians (PCTs) and 43 patients with Braden scores below 18. Baseline data were collected using the National Database of Nursing Quality Indicators survey, while PCT knowledge was assessed through modified versions of the Pressure Injury Prevention Knowledge and Attitude Towards Pressure Ulcer Prevention instruments. As the intervention, PCTs received an evidence-based educational toolkit designed to support pressure injury prevention in daily practice. Following the eight-week period, the same measures were administered to evaluate knowledge changes and analyze outcomes.
Discuss the limitation of the article.
ReplyDeleteDuring the eight-week study period, external events not related to the educational intervention could have influenced the outcome. For example, staffing issues, patient acuity, or even other educational initiatives occurring concurrently could have affected behaviors, making it difficult to isolate the true effect of the intervention.
Advantages and disadvantages of the proposed recommendation in the article.
One big positive impact or advantage of the study is that it still provides valuable insights which can be used to refine educational programs and implementation strategies. And as for one disadvantage; one interesting twist in this article is the attitude towards prevention slightly declined post training. This shows that education may not necessarily change one's behavior or attitude.
1. Discuss the research question or main problem discussed in the study
ReplyDeleteThe research question that is presented in this study is whether or whether not hospital-acquired pressure injuries (HAPIs) could be prevented by implementing education tool kit for patient care technicians (PCTs). Studies have shown that there is a lack of knowledge in regards to pressure injury prevention strategies amongst patient care technicians. The education tool kit for PCTs includes the in-person presentations as well as skill-training sessions, paper copies of reference guides and visual graphics. Ultimately this quality improvement project had three main aims. The first aim is to evaluate the changes in HAPI and unit-acquired pressure injury prevalence rates, second was to measure the PCT’s attitude towards the education provided, and lastly to identify the PCT’s implementation of the HAPI prevention tool kit.
2. Discuss the sample size used in the study
The quality improvement project was set in a 26-bed inpatient adult acute care unit located at an academic medical center in Maryland. There were twenty-six employed PCTs on this unit of study, but twenty-four of these PCTs participated in the QI project. Among these twenty-four PCTs, there was a variety of experience levels and experience with previous pressure injury prevention education. Sixteen of the PCTs involved in the project had received prior education on HAPI prevention strategies. There were forty three patients as well included in this quality improvement project.
1. Discuss the research question or main problem discussed in the study:
ReplyDeleteHospital-acquired pressure injuries (HAPIs) can lead to adverse patient outcomes such as physical and psychological pain and suffering that can impact patient length of stay, morbidity and mortality. In addition to LOS costs, since 2008 health care organizations are not reimbursed for stage 3 or 4 HAPIs by Medicare and Medicaid services. Nursing care protocols have been put in place as part of an interdisciplinary approach to help manage HAPI prevention, however high workloads, institutional financial pressure and inadequate supportive government resources make it difficult for nurses to effectively implement these strategies. To offset this burden, patient care technicians (PTCs) are increasingly used to assist with nursing care for HAPI prevention. Unfortunately, PCTs frequently suffer from lack of knowledge and educational training coupled with competing demands of other patient responsibilities. This quality improvement project provided various educational opportunities to PCTs to evaluate changes in HAPI rates post-intervention, measure PCTs' attitudes toward and current knowledge regarding HAPI prevention, and identify PCT implementation of these strategies.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias:
Limitations of the study include the small sample size of patients in the adult acute care unit which may according to the article lead to a beta-error. In addition, only 21 out of 24 PCTs agreed to participate in the study and so incomplete data regarding the all PCTs' current skill levels, attitudes and potential of the implementation was collected. The reported outcome was no significant change in HAPIs and UAPIs in contrast to other studies that saw a significant reduction in the prevalence of HAPI. Possible factors that might have interfered with the effectiveness of the intervention were competing patient priorities, patient noncompliance, and time and staffing limitations.