Wound Care Training Using Simulation: Impacts on Clinical Knowledge, Skill Performance, and Satisfaction Among Skilled Nursing Facility Staff

Impaired skin integrity, wound formation, and infections are significant health concerns. Therefore, competent wound care is essential for skilled nursing facility residents in long-term care. To recoup losses sustained during the COVID-19 pandemic, one skilled, nursing facility in North Carolina increased admissions from other facilities from 59% to 68%, which resulted in a surge of residents with pre-existing and complex wounds. High staff turnover and inconsistent wound care practices were also observed. Research suggests that healthcare institutions with high attrition may experience degradations of clinical knowledge, skill proficiency, and safe, quality nursing care delivery. Evidence supports the use of simulation-based education sessions to improve staff knowledge and clinical skill proficiency involving wound care. The purpose of this project was to ensure safe, quality, evidence-based nursing practice of long-term care residents at risk for impaired skin integrity and wound healing. The project aims included a systematic record review to evaluate the incorporation of simulation-based scenario techniques into an existing wound care training program and examine its effects on clinical knowledge, skill proficiency, and satisfaction. The Plan-Do-Study-Act quality improvement framework guided this project. Results of a paired-t test indicated a significant difference between Pre-test (M = 24.9, SD = 7.2) and Post-test knowledge following the implementation of simulation-based scenarios in wound care training (M = 64.3, SD = 19.4), t(26) = 9.8, p \u3c .001). Other results following the integration of hands-on wound care simulation-based training included 100% skill proficiency and 89% staff satisfaction (n = 27). Identified barriers and sustainment recommendations were provided to key stakeholders. The project results can serve as a beginning point for a greater understanding of evidence-based practices and quality improvement approaches for educators and leaders who oversee the nursing care of residents at risk for impaired skin integrity and wound healing in skilled nursing facilities.https://digitalcommons.odu.edu/gradposters2023_healthsciences/1016/thumbnail.jp

Effect of Perceived Stress on Cytokine Production in Healthy College Students

Chronic psychological stress impairs antibody synthesis following influenza vaccination. Chronic stress also increases circulating levels of proinflammatory cytokines and glucocorticoids in elders and caregivers, which can impair antibody synthesis. The purpose of this study was to determine whether psychological stress increases ex vivo cytokine production or decreases glucocorticoid sensitivity (GCS) of peripheral blood leukocytes from healthy college students. A convenience sample of Reserve Officer Training Corps (ROTC) students completed the Perceived Stress Scale (PSS). Whole blood was incubated in the presence of influenza vaccine and dexamethasone to evaluate production of interleukin-6 (IL-6), interleukin-1-beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ). Multiple regression models controlling for age, gender, and grade point average revealed a negative relationship between PSS and GCS for vaccine-stimulated production of IL-1β, IL-6, and TNF-α. These data increase our understanding of the complex relationship between chronic stress and immune function