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
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.