Internal medicine interns' and residents' pressure ulcer prevention and assessment attitudes and abilities: results of an exploratory study .

 To evaluate and determine differences between attitudes of internal medicine interns and residents toward pressure ulcer (PU) prevention and to evaluate the interns' abilities to accurately identify wounds and stage PUs, an exploratory, quantitative study was conducted in a 639-bed, safety net academic center. Participants (21 internal medicine interns and 21 internal medicine residents) attending an educational session on PU prevention and care were eligible to participate. The 1-hour conference session was prepared and provided by a physician and wound care nurses. Before the lecture, participants were asked to complete an 11-question paper-and-pencil PU attitude survey. Following the lecture, they were asked to identify 11 wounds and stage PUs using the inpatient admission history and physical template used in the hospital's electronic medical record. An audience response system was used to record correct and incorrect responses. Nineteen (19) interns and 20 residents completed the survey. Twenty-one (21) interns successfully completed the wound assessment quiz. Descriptive statistics were used to examine the survey data and residents' and interns' average attitude scores were compared using independent group t-test. The results suggest that interns and residents have a positive attitude toward and are concerned about PU prevention. The significantly higher overall score among interns compared to residents (average 43.8 versus 38.8 respectively, P = 0.002) suggests interns have a more positive attitude than residents. Statistically significant differences between item scores showed that, compared to residents, interns perceived PU prevention to be more time-consuming (P = 0.01), less of a concern in practice (P = 0.02), and a lower priority than other areas of care (P = 0.003). Compared to residents, interns also were more likely to agree to with statement, "In my opinion, patients tend to not get as many pressure ulcers nowadays" (P = 0.0006). Both groups agreed that PU prevention is a greater priority than treatment and that using risk assessment tools is better than relying on clinical judgment. Wound assessment and PU staging results varied greatly, ranging from 100% for correct staging of a Stage I PU to 20% correct staging of an unstageable PU and 3% correct identification of a diabetic foot ulcer. Overall, internal medicine interns and residents have a favorable attitude toward PU prevention. Despite the limitations of this study, results suggest that enhanced medical school and residency wound care curricula are needed.