Georgina Rose Cabrera, DNP, PHN, GNP-BC

Abstract:

Background: Sub-optimally treated wounds and mismanagement of underlying medical conditions lead to poor patient outcomes (sepsis, amputation, and death) due to overuse of substandard wound care not supported by research and underuse of four key evidence-based wound care practices: 1) vascular studies to assess leg ulcers, 2) compression for venous leg ulcers, 3) off-loading diabetic foot ulcers, and 4) clinical decision support tool use. However, many primary care providers do not receive formal education on wound care management. Objective: Investigators evaluated primary care provider knowledge, attitudes, practice comfort, and confidence with wound care using an education session on four evidence-based wound practices. Design/Sample/Setting: This was a pre- and post-test quality improvement project conducted for primary care providers working in ambulatory care settings of a health maintenance organization (HMO). Methods: The one-hour education session offered on a virtual platform focused on four key evidence-based wound care practices. The investigators developed the 28-question pre- and post-tests with corresponding clinical vignettes to measure wound care knowledge, attitudes, practice comfort, and confidence with total scores calculated. Data was analyzed using descriptive statistics and paired t-tests. Results: Of the 28 participants, 61% were female, 68% were Medical Doctor or Doctor of Osteopathic Medicine (MD or DO), 25% were Nurse Practitioner (NP)/Advance Practice Registered Nurse (APRN) or Physician Assistant (PA), and 54% had prior wound education. Mean knowledge scores significantly increased by more than one point from pre-test to post-test (7.03, standard deviation [SD] 2.0 vs. 8.25, SD 1.0; p=0.002). Mean attitudes (12.75, SD 1.9 vs. 14.64, SD 2.5; p<0.001), mean practice comfort scores (9.93, SD 3.21 vs. 11.61 SD 3.87; p=0.003), and mean confidence level (1.86, SD 0.8 vs. 2.29, SD 0.85; p<0.001) significantly improved. Conclusions: The provision of a short education session improved immediate knowledge, attitudes, confidence, and comfort in wound care practices among primary care providers in ambulatory care settings. This provides a model of effective wound education for primary care providers in an HMO. Future studies are needed to assess the application of new wound knowledge to change clinical practice and improve patient outcomes. 

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