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

Introduction: Internationally, pressure ulcers remain a significant health care problem (NPUAP, EPUAP and PPPIA, 2014). Skin assessment is an essential component in pressure ulcer prevention, however, there is evidence to suggest that patients may not always receive the correct level of care to maintain their skin integrity (Samuriwo, 2010). Home Support Workers are directly involved in patient care, and they have a pivotal role to play in skin assessment (Athlin et al, 2010). All health care workers require education to fulfil this role.

Aim & Objective: To investigate the impact of an educational intervention on 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. To capture participant issues following the educational intervention, words used by them were recorded, as they represented the terms and language used to articulate their main concerns and affirmations.

Outcomes: Education was provided to Home Support Workers and this was followed by an assessment of their ability to correctly classify 20 photographs detailing varying stages of skin damage severity. At the baseline (pre-education), 58% of the photographs were classified correctly. The post-test 1 results were lower, with 55% of the photographs being classified correctly. In post-test 2 findings, results increased to 58%, achieving 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).

Conclusion: The educational intervention has been shown not to have a statistically significant positive effect on Home Support Workers’ ability to detect early pressure ulcer damage. The moderate negative relationship between pre-training and post-test 2 scores and can be principally explained by low health literacy among the participants. The workshop group findings exposed educational issues relating to participant ability to understand theoretical health concepts. These difficulties were fundamentally linked to low health literacy among the participants.