title: Effect of e-learning program on risk assessment and pressure ulcer classification - A randomized study.
abstract: BACKGROUND
  Pressure ulcers (PUs) are a problem in health care. Staff competency is paramount to PU prevention. Education is essential to increase skills in pressure ulcer classification and risk assessment. Currently, no pressure ulcer learning programs are available in Norwegian.
  
  
  OBJECTIVE
  Develop and test an e-learning program for assessment of pressure ulcer risk and pressure ulcer classification.
  
  
  METHODS
  
  
  
  METHODS
  Forty-four nurses working in acute care hospital wards or nursing homes participated and were assigned randomly into two groups: an e-learning program group (intervention) and a traditional classroom lecture group (control). Data was collected immediately before and after training, and again after three months. The study was conducted at one nursing home and two hospitals between May and December 2012.
  
  
  METHODS
  Accuracy of risk assessment (five patient cases) and pressure ulcer classification (40 photos [normal skin, pressure ulcer categories I-IV] split in two sets) were measured by comparing nurse evaluations in each of the two groups to a pre-established standard based on ratings by experts in pressure ulcer classification and risk assessment. Inter-rater reliability was measured by exact percent agreement and multi-rater Fleiss kappa. A Mann-Whitney U test was used for continuous sum score variables.
  
  
  RESULTS
  An e-learning program did not improve Braden subscale scoring. For pressure ulcer classification, however, the intervention group scored significantly higher than the control group on several of the categories in post-test immediately after training. However, after three months there were no significant differences in classification skills between the groups.
  
  
  CONCLUSIONS
  An e-learning program appears to have a greater effect on the accuracy of pressure ulcer classification than classroom teaching in the short term. For proficiency in Braden scoring, no significant effect of educational methods on learning results was detected.
authors.affiliation: Department of Orthopaedic Surgery, Oslo University Hospital, Norway. Electronic address: i.m.bredesen@medisin.uio.no.
authors.forename: Ida Marie
authors.initials: IM
authors.lastname: Bredesen
authors.affiliation: Department of Orthopaedic Surgery, Oslo University Hospital, Norway. Electronic address: karbjo@nsf.no.
authors.forename: Karen
authors.initials: K
authors.lastname: Bjøro
authors.affiliation: Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Sweden. Electronic address: lena.gunningberg@pubcare.uu.se.
authors.forename: Lena
authors.initials: L
authors.lastname: Gunningberg
authors.affiliation: Institute of Health and Society, University of Oslo, Norway. Electronic address: dag.hofoss@medisin.uio.no.
authors.forename: Dag
authors.initials: D
authors.lastname: Hofoss
mesh_terms: D003194:Computer-Assisted Instruction / Q000379:methods*; D004521:Educational Measurement / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D009730:Nursing Assessment / Q000379:methods* / Q000706:statistics & numerical data; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education*; D003668:Pressure Ulcer / Q000145:classification*; D015203:Reproducibility of Results; D018570:Risk Assessment
keywords: Braden scale; Classroom learning; E-learning; Pressure ulcer classification