Pressure Ulcer Knowledge in Medical Residents: An Opportunity for Improvement

This article was published in Advances in Skin & Wound Care: March 2012 – Volume 25 – Issue 3 – p 115–117

My co-authors were:  Elizabeth A. Ayello PhD, RN, ACNS-BC, CWON, MAPWCA, FAAN; Karen Zulkowski,  DNS, RN, CWS; and Joyce Fogel MD, FACP

ABSTRACT: With the aging population and increasing complexity of patients with pressure ulcers (also known as pressure sores, decubitus ulcers, or decubiti), as well as regulatory requirements, pressure ulcers have become an important concern for physicians. Although there are some studies that measure nurses’ knowledge of pressure ulcers, there is a paucity of literature about physician knowledge of pressure ulcers. Given that the Centers for Medicare & Medicaid Services is holding physicians accountable for documenting pressure ulcers status on admission to hospitals and the increased need for collaboration with revisions to long-term-care documentation MDS 3.0: Skin Condition, physicians’ knowledge regarding pressure ulcers takes on new urgency. This study reports on pressure ulcer knowledge of physicians using 2 tools: the Pieper Pressure Ulcer Knowledge Tool and a wound photograph test. Physicians’ mean scores of 69% on the Pieper Tool were well below average scores of nurses’ 76%. Physicians had greatest difficulty identifying suspected deep tissue injury and unstageable ulcers. Pressure ulcer content, including prevention, identification, staging, and treatment, needs to be included in physician education.

Dr. Jeffrey M. Levine has authored numerous articles on topics related to healthcare of the elderly. These include medical history, prevention and treatment of chronic wounds such as pressure ulcers, elder neglect and abuse, and physical restraints. He has also edited a book on legal and regulatory aspects of nursing homes.