The Effect of Training Given to Nurses with Algorithm-Guided In-Situ Simulation on Preventing Pressure Ulcers: An Interventional Study

Abstract

Objective: The aim of this study was to determine the effect of training given to nurses with algorithm-guided in-situ simulation on preventing pressure ulcers. Material and Methods: This was an intervention study. The study was conducted at a university hospital's orthopedia and traumatology clinic with 21 beds. The study sample consisted of 10 post-licensure nurses and 79 pre-simulation and 84 postsimulation patients over 18 years of age, who had stayed in the clinic for at least 24 h. In the collection of data, 3 forms (the demographic data form, the information assessment form, the skill assessment form) were administered to the post-licensure nurses and 3 forms (the demographic data, the Braden scale, the follow-up form) were administered to the patients. The study consisted of 3 stages. In the first stage (01.04.2018-30.06.2018), the nurses recorded the demographic characteristics, nursing interventions for pressure ulcer prevention, pressure ulcer risks, and pressure ulcer incidence data of the patients. In the second stage, nurses participated in a scenario-based standardized patient simulation at the clinic where they worked. In the third stage (01.07.2018-30.09.2018), the nurses recorded the demographic characteristics, nursing interventions for pressure ulcer prevention, pressure ulcer risks, and pressure ulcer incidence data of the patients. The nursing interventions during this period were guided by the algorithm. Incidences of pressure ulcers for 3 months before and 3 months after the simulation were compared at the end of the study. Results: Nurses' knowledge, performance, and care interventions significantly improved during the 3 months simulation (p<0.05). Incidences of Stage 1 pressure ulcers per 1,000 patient days were 8.51 and 4.73 during the 3 months before and the 3 months after simulation, respectively (p=0.136). Conclusion: In-situ simulation is a method to reduce the incidence of pressure ulcers.