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Taylor W. Neuburg
The purpose of this project is to provide registered nurses at Maryview Medical Center’s
Intensive Care Unit (MMC ICU) with information necessary to utilize pressure injury prevention
products available on the unit consistently in patient care from shift to shift. The rates of hospital
acquired pressure injuries (HAPIs) on the rise and directly correlate with negative patient
outcomes (Meehan, Beinlich, & Hammonds, 2016). According to Edgar (2017), Pressure injuries
can lead to infection, scarring, discomfort, along with increased length of hospital stay, and cost
of care. With the rates of HAPIs on the rise, it is necessary to develop a teaching plan to educate
nurses about HAPI prevention strategies in efforts to decrease rates of HAPIs and improve
patient outcomes.
Practice and Performance (2015) was used as the foundation for my teaching project.
Assessment, diagnosis, outcomes identification, planning, implementation, and evaluation are all
vital parts of the nursing process (Bell, 2015). The nursing process is the foundation of AACN’s
Standards of Professional Practice and Performance and is the guide used to create my teaching
intervention. The nursing process is typically used in relation with patient care, but it is just as
applicable towards addressing a problem and developing a teaching intervention. The chosen
standards address both the teaching and learning roles in nursing practice through outlining the
Needs Assessment
The target audience is the nursing staff of MMC’s ICU. The learners will be 13 registered
nurses that voluntarily offered to participate in the needs assessment and teaching interventions.
The participants range in age from 24 - 36 years old. The target audience members all have a
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The nurses at MMC’s ICU are a population is of interest because a quality improvement
initiative was initiated in 2012 to decrease the rate of HAPIs on the unit. A unit-based
intervention of early detection of at risk patients and implementation of Prevalon boots, TAPS
system, and repositioning every two hours helped decrease rates. The study revealed that the
interventions reduced rates of HAPIs on the floor (Edgar, 2017). Even though nurses have been
provided with all the tools necessary to prevent HAPIs, pressure injuries are still occurring on the
unit. Since the necessary tools are provided on the unit to prevent HAPIs and injuries are still
occurring, a needs assessment needs to be conducted to further understand where the weakness is
already know, what they are interested in learning about, and what they perceive as barriers to
patient repositioning being carried out in practice. To get an understanding of the informational
needs of the target audience, each participant filled out a self-administered questionnaire
(Appendix A).
Before developing a teaching plan, it is important to understand the learning styles of the
target audience. Individuals that receive information in a way that is tailored to their learning
style have better outcomes and are overall more satisfied with the learning materials (Bastable,
2014, pg. 154). To gain insight to the individual learning styles of the target population of
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learners, the VARK Learning Styles questionnaire was used. The VARK questionnaire was
developed by Flemming and Mills and is used to identify visual, aural, read/write, and
kinesthetic learning styles (Bastable, 2014, pg. 154). The VARK questionnaire (Appendix B)
revealed that there were 4 visual style learners, 2 reading/writing style learners, 6 kinesthetic
style learners, and 1 learner that was both reading/writing and visual style.
The needs assessment revealed that inconsistency with use of products from shift to shift
is a problem on the unit that negatively impacts HAPI patient outcomes. The focus of the
teaching plan should be on pressure injury prevention products available on the unit and their
uses. If all nurses are consistent with the products and interventions being used, the rates of
The focus of the teaching plan was education on pressure injury prevention products
available on the unit and their uses. The teaching intervention was planned to last for a total of
30 minutes and take place in the conference room on the unit. The first 10-minute portion of the
presentation addressed the cognitive learning domain. A slide show (Appendix D) was used to
outline and explain the different pressure injury prevention products available on the unit and
their uses. The nurses provided with a printed copy of the slide show. A brief posttest (Appendix
F) was administered after the presentation of the products. The next 10-minute segment of the
presentation addressed the affective domain and provided the opportunity to identify personal
barriers to utilizing all HAPI prevention tools in practice through open group discussion. The last
demonstration of how to use the products was provided on a practice manikin. Prior to leaving
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the teaching session, nurses had to provide a teach back demonstration of how to use all the
HAPI prevention products on the unit. An example of the teaching grid used is provided in
Appendix C.
Overall, the day of the actual presentation went smoothly. All 13 of the nurses
that offered to participate were present for the teaching session. The night before the
presentation, I had gathered and set out all the supplies needed in the conference room. Even
though I was really nervous, all of my colleagues were supportive and respectful during the
presentation. The one major glitch faced was not being be able to record my presentation while I
was presenting due to HIPPA concerns. As a result, I had to record a mock presentation. The
mock presentation was accurate in depicting the content delivered in the presentation, but it
naturally did not convey the authenticity and “less scripted” version of my actual professional
presentation. The teaching plan was developed and implemented based on the cognitive learning
theory. The cognitive learning theory involves, “perceiving the information, interpreting it based
on what is already known, and then reorganizing the information into new insights or
understanding” (Bastable, 2014). The cognitive learning theory was used by reinforcing previous
knowledge about HAPI prevention tools and their uses through an educational intervention.
Education will empower and instill nurses with the confidence to implement all the tools and
Evaluation
The objectives of the teaching session were evaluated using a variety of different
methods. The evaluation methods used were a post test, question and answer session, and the
learners providing a return demonstration. The posttest (Appendix E) was used after the
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slideshow to evaluate if the learners could list the five HAPI prevention tools on the unit and
explain how they are used. All of the learners were able to complete the posttest with 100%
accuracy. A question and answer session was used after learners identified barriers to
implementing all HAPI prevention tools in practice and how to overcome the barriers
individually and as a unit. All learners actively participated in the question and answer session
and provided positive feedback. A return demonstration was used to evaluate the learner’s ability
to demonstrate how to accurately use the HAPI prevention tools. All of the 13 learners were able
to provide a return demonstration on the practice manikin with 100% accuracy. Overall, the
instruction was effective as evidenced by 100% of the learners meeting the educational
objectives. As an educator, I felt very organized and prepared. The instruction and teaching
session went smoothly. The learners were engaged and actively participated in the teaching
session. I also received feedback the learners enjoyed the teaching session and were thankful I
Summary
Nurses play a flexible role in delivering education and both formally and informally.
Education varies from educating patients about a disease process to doing a formal in-service
presentation to educate peers. This project was an eye-opening experience. I never realized how
many factors came into play with developing a teaching intervention. It was beneficial to learn
the full process of constructing a teaching plan and actually carrying out the teaching plan. If
there is ever a situation in the future where I have to educate peers professionally, I will
reference this project and use it as a guide. I am thankful for this experience; I now have a new
References
Bastable, S. B. (2014). Nurse as educator: principles of teaching and learning for nursing
Bell, L. (2015). AACN Scope and Standards for Acute and Critical Care Nursing Practice. Aliso
Meehan, A., Beinlich, N., & Hammonds, T. (2016). A Nurse-Initiated Perioperative Pressure
Injury Risk Assessment and Prevention Protocol. AORN Journal, 104(6), 554-565.
http://vark-learn.com/the-vark-questionnaire/
Honor Pledge
I pledge to support the Honor System of Old Dominion University. I will refrain from any form of
of the academic community it is my responsibility to turn in all suspected violations of the Honor
Appendix A
Name:______________
3.) What do you perceive as barriers to HAPI prevention strategies being carried out
on the floor?
5.) What would you like to learn more about in relation to HAPI prevention?
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Appendix B
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Appendix C
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Appendix D
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Appendix E
Posttest
1. List the 5 tools available on the unit used to prevent HAPIs and a brief description
of how to use them.
a.)
b.)
c.)
d.)
e.)
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