A Quasi-experimental Study to Assess the Effect of Technology-Assisted Training on Correct Endorsement of Pressure Ulcer Preventive Interventions

The two-fold purpose of the Detroit Medical Center (DMC) Braden Scale Training Module is to teach nurses to use the Braden Scale to correctly assess pressure ulcer risk and to effectively plan risk-based prevention interventions. A pre-test, post-test, two-group, quasi-experimental study was conducted to evaluate the effect of web-based DMC Braden Scale Training on staff nurses' ability to correctly endorse the use or non-use of 10 commonly-used risk-based pressure ulcer preventive interventions for patients at different levels of risk for pressure ulceration. "Regular" or "new" users of the Braden Scale from three hospitals assessed 102 patients. On eight out of 10 preventive interventions, the percentages of correct endorsements were higher for patients at extreme levels of risk (generally not at risk or high/very high risk) than they were for patients at midlevels of risk. Correct endorsement of prevention interventions was unaffected by group membership. Training substantially improved ability to correctly endorse interventions, but for new user only. Importantly, patients at midlevels of risk may be more vulnerable to pressure ulceration than their risk assessments indicate simply because nurses have great difficulty determining which preventive interventions should be implemented for this group of patients. Alternative approaches to training are needed to ensure that regular users of the Braden Scale are adequately prepared to use risk-based information to effectively plan pressure ulcer prevention.