Background and aims
Pressure injuries are a significant quality and safety issue in residential aged care, impacting resident wellbeing, quality of life and clinical outcomes. During Phase 3 of the project, Warrigal identified variability in staff knowledge, confidence and accuracy when staging pressure injuries. This inconsistency contributed to concerns regarding the reliability of pressure injury data, documentation practices and the ability to accurately monitor and respond to skin integrity risks across the home.
The aim of the Phase 4 project was to improve workforce capability in pressure injury assessment and staging while strengthening the reliability of pressure injury data. The project sought to build staff confidence, standardise assessment practices, improve documentation accuracy and support evidence-based decision making related to skin integrity management.
The project team implemented a comprehensive education and quality improvement program that included:
- Development and delivery of pressure injury staging education sessions for clinical (Registered nurses), care staff and visitors and residents.
- Creation of practical resources including pressure injury staging guides, reference tools and visual learning aids. Including realism simulation pressure injury skin models, life sized mannequins to highlight high risk areas, relevant dressing/skin care consumables and equipment.
- Introduction of a Pressure Injury Staging Quiz to assess baseline knowledge and measure learning outcomes.
- Facilitation of face-to-face workshops and learning sessions with staff led by subject matter experts.
- Review and analysis of pressure injury data pre, during and post education to identify trends, inconsistencies and opportunities for improvement.
- Promotion of consistent terminology and documentation practices across the service.
- Ongoing monitoring and evaluation of staff knowledge, confidence and documentation quality.
- Follow up post implementation phase quiz.
The project achieved several positive outcomes, including:
- Increased staff confidence in identifying and staging pressure injuries.
- Improved consistency and accuracy of pressure injury documentation and data.
- Enhanced reliability of pressure injury data used for monitoring, reporting and quality improvement.
- Increased awareness of evidence-based pressure injury prevention and management strategies.
- Improved understanding of the relationship between accurate assessment, clinical decision-making and resident outcomes.
- Improved use and understanding of the Braden risk assessment tool.
- Development of sustainable educational resources that can continue to support workforce development including skin care protocols and equipment selection flowcharts.
The project demonstrated that targeted education combined with practical resources can improve both clinical capability and data quality outcomes in residential aged care.
Future work will focus on:
- Embedding pressure injury staging education into orientation and annual education programs.
- Continuing pressure injury documentation and data reliability audits.
- Expanding educational resources to support broader skin integrity and wound management practices. Including A series of short films focusing on: How to attend a skin inspection, how to attend a risk assessment and escalation pathways.
- Monitoring the long-term impact of education on clinical outcomes and data quality.
- Sharing project findings and resources across the aged care sector to support broader workforce capability development.
- Exploring digital learning and skill assessment opportunities to improve accessibility and sustainability of training.
The project has established a foundation for ongoing improvement in pressure injury management and demonstrates how targeted education can improve both workforce capability and in turn enhancing the quality of clinical data used to support resident care.
- Pressure injury staging remains a challenging clinical skill and requires ongoing education and reinforcement.
- Staff learn most effectively when education is designed to specific scopes, practical, interactive and supported by visual resources.
- Reliable clinical data is dependent on consistent assessment and documentation practices.
- Frontline staff engagement is essential for successful implementation and sustainability of quality improvement initiatives.
- Small improvements in assessment accuracy can have a significant impact on organisational data quality and resident outcomes.
The project team strengthened skills in:
- Quality improvement methodology.
- Data analysis and interpretation.
- Educational resource development.
- Clinical auditing and evaluation.
- Change management and stakeholder engagement.
- Translation of evidence into practical aged care resources.
Sector Resources:
Warrigal and ARIIA are pleased to share the following resources with the aged care sector to assist other providers wanting to implement similar solutions.
