Evidence for the Validity of a Tool for Improved Pressure Ulcer Staging by the Non-Expert in the Live Patient

Abstract

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses. Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada. Methods: Subjects assessed 11 wounds on the patients independently. They then received brief orientation to the NE1 WAT. The subjects then re-assessed the same 11 wounds utilizing the NE1 WAT. Accuracy in wound assessment was then compared when performed with and without the tool. Results: Wilcoxon signed-rank tests were used to compare scores before and after training on how to use the tool. The subjects showed a significant improvement in pressure ulcer staging (p=.005), identification of wounds other than pressure ulcers (p = .024), and overall score across all aspects of wound assessment when using the NE1 WAT (p = .017). Discussion: This study provides evidence for the validity of the NE1 WAT. Improved wound assessment would likely improve care. Due to Medicare billing rules, the NE1 WAT has the potential to impact hospital remuneration. Conclusion: Following brief orientation on tool use, there was increased accuracy of novice nurse wound assessment on live patients