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An Application of Knowles' Six Principles of Adult Learning to Develop

a Wound Care Program about Assessment & Management of

Pressure Injuries at Runnymede Healthcare Centre
Medically Complex Care Unit, Runnymede Healthcare Centre

Introduction Application
The Medically Complex Care Unit at Runnymede Healthcare
Adult Learners are: Application to Wound Care Program
Centre (Runnymede) provides care for patients with multiple
medical needs that may result from acute injury, chronic Motivated and Self-Directed Set up the program that moves from more to less
illnesses or disabilities. structure, from less to more responsibility and from
more to less direct supervision, at an appropriate
pace that is challenging yet not overloading for
At Runnymede, patients benefit from an inter-professional the participants.
approach and leading practices in wound care along with
chronic disease management and prevention. Establish an environment where participants feel
safe and comfortable expressing themselves
Runnymede addresses the growing need for specialized care have open lines of communication, involve all
such as to treat complex wounds, but not limited to pressure participants and encourage group based
injuries, diabetic foot ulcers and surgical and lower extremity problem solving.
Bring Life Experience and Find out about the participants interests and
A Standardized inter-professional Skin & Wound Assessment Knowledge past experiences (personal, work and study
Team (SWAT) are taking the lead in addressing complex related).
wounds needing advanced management. SWAT comprised of
a Wound Care Nurse Practitioner, Advanced Practice Nurse, Goal Orientated Provide real case-studies (through patient
Clinical Educator and an Occupational and Physiotherapist. contact and reporting) as a basis from which to
learn about the theory. *Participants value
anecdotes of the facilitators own experience.

Problem Relevancy Orientated Asking the participants to do some pre and post
reflection and on how it will help them to meet
their learning goals.
Pressure injury (commonly known as bed sores/pressure
ulcers) can cause severe pain and have a significant impact
Practical Through clinical placement, interacting with real
on a patients quality of life.
clients and their real life situations, participants
move from theory knowledge to hands-on
Runnymedes Quality Indicator (QI) Plan is to reduce problem solving where they can recognize
occurrence of new pressure injuries to 0%. QI plan for 2016/17 firsthand how and what they are learning applies
benchmark showed 1.49% of residents having new pressure to life and work context.
injuries (more than Stage 2).
Like to Respected Acknowledging the wealth of experiences that
the participants bring to the educational
A needs assessment was conducted in October December
2016 among front-line clinicians (Nurses, Clinical Dietitians,
Occupational and Physiotherapist). The results indicated a
need for an educational curriculum about the new National
Pressure Ulcer Advisory Panel (NPUAP) Pressure Injury staging
guidelines. Discussion
Provide support to the Quality Improvement Plan to reduce
incidence of new pressure injuries among admitted patients.
3% 5% Highly trained healthcare workforce.
5% 5%
10% High growth rate in professional practice and education.
10% 1% Reduction of labor costs by capitalizing appropriate wound care
32% 30%
products use by knowledgeable front-line clinicians.
50% 40% 94% Curriculum is limited to pressure injury prevention. Many other
advanced wound care managements maybe needed for
advancement of wound prevention program at Runnymede
Healthcare Centre.
No training program exist for pressure injury prevention and
management at Runnymede Healthcare Centre.


Growing economy and demand to professionals having a sound
knowledge in advanced wound care management.
Recognizing Clinical Quality Indicators (CQI) by Local Health
Integration Network (LHIN). Increasing the knowledge, and clinical
To identify possible ways on how to improve skin and wound judgment of healthcare clinicians will improve CQI ratings, hence,
resources can be used to different related opportunities.
assessments among front-line clinicians. Annual national wound conference meetings.

To develop an educational curriculum based on Knowles' six Threats

principles of adult learning for front-line clinicians at the Governmental cutbacks to support wound care management.
Medically Complex Care Unit at Runnymede Healthcare Legal and ethical implications for pressure injuries to the nurses and
Centre. facility.
Nurses are held accountable for hospital-acquired pressure injuries
To increase the knowledge, skills, and clinical judgement of that develop and worsen during admission.
The reputation of the hospital is at stake.
front-line clinicians about skin and wound health through a
poster presentation and an Educational program about
Assessment and Management of Pressure Injury. References
1. Knowl es, M.S. (19 70 ). The modern practiceof adul teducation: Androgogy versus pedagogy. New York: New York Associati on Press.
2. Kaufmann, D. (2 00 3). ABC of Learnin gand Teachin gi n Medi cineApply n i gE ducational Theory i n Practice. Briti sh Medi cal Journal,
At the end of the educational curriculum, participants will: 3.
3 2 6 , 2 1 3-2 16.
Lei b, S. (2 0 0 8 ). Pri nciples of Adul t Learn in g. Retri eved from:
http://honol ul u.hawii .edu/i ntranet?commi ttees/FacDevCom/gui debk /teachtip/adul ts-2htm
Demonstrate evidence-based best practices. 4. NPUAP Press Release New Stagi ng Sy stem For PressureI nju y r Apri l 1 3, 2 01 6.
5. Regi stered NursesAssociati on ofO ntario (20 16 ). Assessmentand Managementof Pressure n I j uri es for theI nter-professional Team,
Demonstrate an understanding of wound assessment and Thi rd E di ti on. Toronto, ON: RegisteredNurses Associati on of Ontari o.
6. Zoghi , M., Brown, T., Wil li ams, B., Roll er, L., Jaberzadeh, S., Palermo, C. & Holt, T. A. (2 01 0). Learn i ng styl epreferencesof Austral a i n
management for patients with pressure injury. heal th sci ence students. Journal of All e i d Heal h t , 39 (2), 9 5-1 03 .

Integrate and reflect on wound care principles into their clinical