Implementation of an Evidence-Based Tool to Evaluate the Impact on the Consistency of Pressure Injury Identification and Staging
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Date
2025-05
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The Ohio State University
Abstract
The purpose of this DNP initiative was to evaluate the implementation of an evidence-based tool on pressure injury staging and identification. This initiative was conducted at a National Cancer Institute (NCI) designated hospital that is a part of a large academic medical center in the Midwestern region of the United States. The initiative was developed and implemented to evaluate the use of the NE1 Wound Assessment Tool (WAT) on pressure injury identification and staging among a certified Wound, Ostomy, and Continence Nursing (WOCN) team. A total of 191 records were reviewed for adoption and fidelity. During the observation period, the tool was completed in 136 of the 191 observations, representing a 71% adoption rate. The 136 records were then evaluated for fidelity. A total of 121 records (89%) reflected 100% fidelity. Sixty-five patient records were sent to the WOCN team to determine the degree of agreement across the team. With the use of the NE1 WAT, the team saw an improvement in the overall degree of agreement. Percent agreement ranged from 76.92- 83.08%, with the initiative goal being 80%. However, while the overall percentage agreement with the use of the NE1 WAT, the Kappa Statistic ranged from 0.4902-0.6261, indicating moderate agreement across the team for each assessment. The implications of this initiative indicate that the use of the NE1 WAT can have a positive impact on the overall identification and staging of pressure injuries in an acute care setting.
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Keywords
NE1 Wound Assessment Tool, Pressure Injury Staging