Director of Inpatient SCI Rehabilitation Barrow Neurological Institute, Phoenix, AZ Phoenix, Arizona, United States
Case Diagnosis: Patients with a spinal cord injury are at risk for developing a pressure injury1-2. Assessment of a pressure injury includes determining the size3. Several different methods can be employed for measuring the size4. Manual measurement of the size of a pressure injury is the most common5. This project aims to determine the variability of pressure injury size measurement, education of a standard for measuring, and assessment of improved reliability.
Case Description: Members of the acute inpatient rehabilitation unit were included in determining the standards and practice of pressure injury assessment. A fishbone diaphragm was used to determine barriers to assess the size of a pressure injury. Physical therapy, residents, attendings, and registered nurses were asked to measure three pressure injuries. Written instructions for the definition of the measured length and width of a wound where provided and required participants to watch a short video on measuring the length and width. Participants were asked to repeat the length and width measurements of the three pressure injuries.
Discussions: For each of the three wounds the length, width, and area where used to calculate the mean, variance, Interquartile Range, and standard deviation on initial wound measurement and again after education with written instructions and viewing the educational video. Interquartile range narrowed, variance decreased, and standard deviation decreased. F-test showed significant reduction in variance between wound #1 and #2 length measurement and wound #2 width measurement. Overall wound measurement became more consistent after education in writing and with video demonstration of wound care length and width measurement.
Conclusions: Education increases consistency in measuring a pressure injury and decreases variability in length and width of wound care assessment. Ongoing efforts should focus on continued education to make sure all members of the team have one consistent method for the assessment of pressure injury length and width.