Wound staging: can nurses apply classroom education to the clinical setting?

Traditionally, education on wound staging has been conducted in the classroom using drawings, photographs or slides to illustrate examples of wound stages. These methods portray wounds two-dimensionally, but clinically, wounds are three-dimensional. Seven home care nurses in central Florida were given a pre-test and post-test of 16 slides, four of each stage. Field visits with three of these nurses were then conducted by an ET nurse to evaluate the application of this education into clinical practice in the home setting. The questions studied were: Do nurses learn to accurately assess stages of wounds from classroom education? Does classroom ability to stage wounds equate to ability to stage correctly in the clinical setting? Test results showed Stage II and Stage III wounds to be most problematic in the classroom. The most improvement was seen in the staging of Stage II and Stage IV wounds two-dimensionally. In the field, one nurse consistently staged wounds correctly while two had problems with correct staging. Additional investigation is required to determine if these results can be generalized to other home health nurses and if changes in clinical ability will occur over time.