Nursing student trained how to treat wound care patient using training doll
HealthDecember 28, 2021

Assessing nurses’ competence with simulated wound care

By: Sarah Handzel, BSN, RN
Simulation is commonly used among higher learning institutions and healthcare facilities to train and evaluate nurses’ skills and competencies.

Many studies have suggested that simulation is an effective learning method, especially when it comes to developing nursing students’ psychomotor skills. Common simulation exercises include vaccination, resuscitation, and leadership training. For continuous training in healthcare settings, common scenarios include mental health training and pediatric nursing.

Wound care competence has been found to be limited among both nursing students and practicing registered nurses. For many years, tests evaluating pressure injury knowledge, and diabetic foot ulcer and leg ulcer knowledge have been used to assess competence. However, tests to measure general nursing wound care knowledge are few.

It’s essential to assess nurses’ and student nurses’ competence in wound care to help improve quality of care and patient safety. A new study published in Advances in Skin & Wound Care: The Journal for Prevention and Healing described the development of a wound care simulation to use as a competence assessment method among participants.

Developing the wound care simulation

Researchers developed the simulation with an evaluation of 14 items relevant to wound care competency. These items included etiology, care and prevention, and wound assessment and management. Participants’ scores were calculated using the total number of competencies passed and the percentage of correct actions in the simulation.

After identifying simulation competence areas, the research team formulated a suitable patient case. The team intended to keep the research case simple to maintain focus on the competencies that could be easily and reliably measured or observed. A panel of eight wound care experts, including two RNs, an authorized wound care nurse, two wound care researchers, a podiatrist, and a vascular surgeon and a plastic surgeon, each with a focus on wound care, reviewed the patient case and competencies.

A total of 14 skill and performance assessments were included:

  • Pain assessment
  • Procedure preparation
  • Aseptic technique and procedure
  • Pain management
  • Tissue type and color identification
  • Identifying signs of an infection
  • Debridement
  • Bacteria sampling
  • Use and function of wound care products
  • Diabetic foot ulcer care
  • Documenting the description of the wound
  • Documenting care
  • Motivation and self-care
  • Consultation

Results point to mixed results

A total of 50 participants took part in the wound care simulation. While everyone involved completed the entire assessment, the durations of the simulation varied between six and 35 minutes. The results were eye-opening: only two-thirds of participants assessed the patient’s pain before starting wound management. Just over half of the nurses managed the patient’s pain appropriately. Only one third demonstrated proper asepsis, while only half prepared themselves for the procedure by moving any needed equipment closer to the patient.

However, most of the participants showed competence in other areas, including the assessment of possible wound infection and identification of the tissue type in question. These results could be used in wound care education planning and continuing education for nursing professionals. The research team believes the simulation could also be easily modified to cover other chronic conditions and wounds, since most of the items in the assessment are valid for different etiologies.

Based on the findings, such simulations could be used as invaluable competence assessment methods for both student nurses and professional RNs. This promising tool for future use could focus on the development of various patient cases and various wounds.

Webinar: Engaging Simulation-based Learning to Promote Clinical Competency Skills
Sarah Handzel, BSN, RN
Freelance Health and Medical Content Writer, Wolters Kluwer Health
Sarah has over nine years’ experience in various clinical areas, including surgery, endocrinology, family practice, and pharmaceuticals. She began writing professionally in 2016 as a way to use her medical knowledge beyond the bedside to help educate and inform healthcare consumers and providers.
  1. Advances in Skin & Wound Care: July 19, 2021 - Volume - Issue -
    doi: 10.1097/01.ASW.0000756676.32202.b1
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