Construction Of Training Program For Prevention Of Intraoperative Acquired Pressure Injury And Effect Evaluation

ObjectiveIn order to promote the clinical application of IAPI assessment scale and reduce the IAPI incidence by operating room nursing staff,a scientific and applicable training program for the prevention of intraoperative acquired stress injury(IAPI)based on ADDIE model was established,implemented and evaluated.MethodFrom September 2020 to February 2021,nurses in an operating room from a hospital in Shandong Province were selected as the research objects.According to the semi-structured interview outline,the operating room nursing staff were interviewed,and the problems on IAPI preventive training needs was summarized.Questionnaire survey was used to evaluate the knowledge assessment scale of nursing staff,investigate the incidence of IAPI,and analyze the current situation of IAPI prevention training needs.On the basis of the preliminary investigation,the preliminary draft of the IAPI prevention training program was formed,and the expert meeting method was used to conduct two rounds of on-site demonstration of the IAPI prevention training program,and the final draft of the IAPI prevention training program was constructed,and the theoretical training,skill training courses and evaluation tools were developed accordingly.IAPI prevention training program and the related courses were used to train nursing staff.The satisfaction of nursing staff with the course after training was analyzed,and the use of knowledge assessment scale and the incidence of IAPI were compared before and after training.SPSS26.0 statistical software was applied to statistical analysis of the data.General information was described in terms of numbers and percentages.Measurement data were represented by mean standard deviation while paired T test was used for comparison before and after.Chi-square test or Fisher’s exact probability test was used for counting data.P<0.05 is a statistical difference.Result1.A total of 20 operating room nursing staff were interviewed,and 5 questions were summarized according to the interview results :(1)Knowledge forgotten,not updated in time;(2)Lack of comprehensive understanding of risk factors;(3)Improper use of protective appliances;(4)Lack of use of assessment scales;(5)demands for multiple training methods.Before the training,the average score of knowledge assessment of operating room nurses was(50.45±9.56)points,the accuracy of using assessment scale was25.64%,and the incidence of IAPI was 4.69%.2.A total of 16 experts in related fields were invited to complete two rounds of on-site demonstration on IAPI prevention training programs.The expert authority coefficients were0.85,0.945,and the recoveries of the two rounds of field evaluation scales were 100%.After two rounds of expert on-site demonstration,the experts’ opinions tend to be consistent,and the final draft of the training program was constructed for the prevention of IAPI.The developed training materials included theoretical training contents such as stress injury,IAPI and the use of assessment scale while the skills training includes the placement of surgical patients and dressing cutting.Meanwhile,four evaluation tools including the IAPI related knowledge assessment paper,the accuracy evaluation form of the use of IAPI assessment scale,satisfaction questionnaire on course and information collection form of IAPI occurrence in surgical patients.3.After training,the results are as following:(1)The average score of knowledge assessment(75.42±11.64)was higher than that before training(50.45±9.56),and the difference was statistically significant(t =15.62,P <0.05).(2)The accuracy of assessment scale(89.74%)was higher than that before training(25.64%),and the difference was statistically significant(χ~2 =62.38,P <0.05).(3)Satisfaction survey shows that 92.31% of evaluation item average is greater than 4.0,and the nursing staff satisfaction is higher.(4)The incidence of IAPI in post-training survey(2.07%)was lower than that in pre-training survey(4.69%),and the difference was statistically significant(χ~2=10.00,P <0.05).Conclusion1.In this study,a scientific and applicable training program for the prevention of IAPI was preliminary constructed based on ADDIE model.2.The implementation of the training program for the prevention of IAPI can promote the application of IAPI assessment scale in operating room nursing staff and reduce the IAPI incidence and enhance the quality of nursing.