Digital Repository Masters Theses Spring 2026 The Impact of WoundSpecific Education and Resources on Nurse Confidence Levels Brooke Boyce Weber State University Follow this and additional works at: https://dc.weber.edu/collection/wsudoctoral Boyce, B. 2026. The Impact of Wound-Specific Education and Resources on Nurse Confidence Levels Weber State University Doctoral Projects. https://cdm.weber.edu/digital/collection/WSUDoctoral This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact archives@weber.edu. WSU REPOSITORY MSN/DNP The Impact of Wound-Specific Education and Resources on Nurse Confidence Levels Project Title by Brooke Boyce Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY 4/25/26 Ogden, UT Date Brooke Boyce, BSN, RN, MSN Student 4/25/26 Student Name, Credentials (electronic signature) Date 4/25/26 MSN Project Faculty (electronic signature) Anne Kendrick, DNP, RN, CNE (electronic signature) DNP, N, CNE MSN Program Director Note: The program director must submit this form and paper. Date 4/25/26 Date 1 The Impact of Wound-Specific Education and Resources on Nurse Confidence Levels Brooke Boyce Annie Taylor Dee School of Nursing Weber State University Trish Gibbs MSN Project 4/19/26 2 Abstract Purposes/Aims: This project aims to standardize wound care practices and increase nurses' confidence in providing wound care by providing advanced wound care education, support from a wound expert, and evidence-based practice resources. Rationale/Background: Wound care practices are often variable between nurses. The current literature notes that evidence is not consistently applied in practice within wound care. Variability in practice leads to inconsistent wound healing and increases the risk of infection and other complications. Methods: Wound care education and simulation will be developed and provided to five home health nurses in a pilot study. The nurses will be surveyed before and after the project to evaluate their knowledge and confidence level in providing wound care. Patient wound documentation, including measurements and assessments, will be reviewed to assess wound progression during care provided by trained nurses. Results from the pre- and post-surveys will be compared to see if nurse confidence levels have improved. Patient and nurse data will be kept confidential when summarizing the results. The Iowa Model of Evidence-Based Practices will be used as the framework for this project. Results: This project aims to increase nurses’ confidence in providing wound care by enhancing knowledge and skills, potentially improving wound-healing rates. Conclusions: This project has the potential to increase nurses' confidence in providing wound care and to improve wound healing by applying evidence-based practice. This information could be used as a basis for future wound care training projects. Keywords: Wound care, nursing, confidence, competence, knowledge 3 The Impact of Wound-Specific Education and Algorithms on Nurse Confidence Levels Wound care practices vary between clinicians and are often not guided by evidence-based practice (Blackburn et al., 2023). Variability in wound care practices can lead to delays in wound healing, which can cause pain, reduced quality of life, a significant financial burden, hospitalizations, and potentially life-threatening situations (Grešš Halász et al., 2021). This project will investigate the relationship between the wound care education nurses receive, the utilization of evidence-based practice resources, and the impact on clinician confidence levels and patient outcomes. Statement of Problem Variabilities in wound care practices exist among clinicians in dressing selection, application, and wound cleansing. This issue has been extensively documented in international literature (Blackburn et al., 2023), with 83% of clinicians reporting a lack of wound care education (Majchrzak, 2021). The prevalence of chronic wounds is increasing (Jensen et al., 2024). This issue is further complicated by nursing staff shortages and inadequate wound-care training, resulting in prolonged wound-healing times for patients. This increases the number of necessary home health nurse visits, further straining limited staffing (Jensen et al., 2024). This project aims to investigate the relationship between wound care education for nurses and evidence-based practice protocols for dressing selection. It will also explore the impact of education and protocols on nurses' confidence in providing wound care, and on patient woundhealing rates in the home health setting. This project is designed for home health nurses and nurse leaders to understand the impact of these factors and how providing additional wound care 4 education to nurses, along with evidence-based practice protocols, can increase the nurses’ confidence levels and, in turn, improve the rate of patient wound healing. Significance of the Project This project is essential because chronic wound rates are increasing (Jensen et al., 2024), nursing shortages persist, and nurses often lack the wound-specific education and support they need (Majchrzak et al., 2021). By addressing nurse wound care education and providing evidence-based protocols, nurse confidence in providing wound care will improve. The increase in clinician confidence has been shown to decrease the frequency of dressing changes (Blackburn et al., 2023). The project also has the potential to reduce the average healing time for wounds, thereby lessening the strain on nursing staff, as fewer home health nurse visits will be required per patient. This will also decrease the financial burden for patients, home health agencies, and insurance companies. Nurses who receive advanced wound care education demonstrate increased confidence and competence in their clinical practice. Enhanced wound care education is associated with improved quality of care, which in turn contributes to better patient outcomes (Grešš Halász et al., 2021). Review of the Literature This literature review examines recent research on the impact of wound-specific education on nurses' confidence in providing care and its potential effect on patient outcomes. The themes identified in the review of the current literature include a) patient outcomes improve with nurses receiving wound care education, b) wound healing times are improved with protocols based on evidence-based practice, c) nurse confidence levels improve with wound education, and d) nurses having access to support from a wound expert improves patient 5 outcomes. The project PICOT question is: (P) In nurses treating patients with chronic wounds, does having a protocol based on EBP (I), compared to current practices (C), affect nurses’ confidence levels in caring for wounds (O) within 3 months (T)? Framework This project will use the Iowa Model of Evidence-Based Practice. The Iowa Model was selected due to its streamlined process that facilitates nurses in incorporating research into practice (Melnyk & Fineout-Overholt, 2023). The steps of the model are: 1) identifying an issue or opportunity; 2) stating the purpose; 3) forming a team and performing a literature review; 4) designing and implementing a pilot study; 5) developing a protocol and collecting data; 6) assessing if the practice change is effective and ready for implementation; 7) hardwiring the change into the current system; and 8) disseminating the results (Bell, 2022). The problem identified in this project is inconsistent wound care practices among nurses. The purpose is to investigate the impact of additional wound care training for nurses using an evidence-based practice algorithm. The first step in the project is to form a team consisting of nurse leaders and wound specialists. Next, a pilot study will be designed and implemented to investigate the experience of nurses and wound care patients. The development of a standardized, evidence-based wound care education protocol and algorithm will follow this. Finally, the effects on nurses' confidence levels and patient outcomes will be explored. Results will be summarized and disseminated in a case study. Strengths and Limitations A strength of the Iowa model is simplicity of use. It features a clear map of the process of bringing evidence-based practice into nursing practice. It also features feedback loops that enable an easy return to a previous step (Melnyk & Fineout-Overholt, 2023). This can be utilized if a 6 step is found to be ineffective. A limitation can be the staff's willingness to provide feedback (Henson & Jeffrey, 2024). Staff nurses may have limited time outside of patient care to complete surveys and discuss the project. Team commitment is essential, especially as this model can take time to complete (Henson & Jeffrey). This can be an issue with competing demands on staff and leadership’s time. Time commitments pose a challenge due to the ongoing nature of this model. Staff may lose interest in involvement in the project over time. This model also ensures that projects are a priority for the organization implementing them (Bell, C. A. F., 2022). The findings must demonstrate a benefit that justifies continuing the process; failing to establish a strong enough benefit poses a potential risk to the project's progression. Search Strategies A literature review was conducted using the Cumulative Index to Nursing and Allied Health Literature database (CINAHL) to find current literature. Articles were limited to the period from 2020 to 2025 to ensure the information was current. The search terms used were combinations of “wound care or wound healing or wound management or wound treatment” AND “nurse or nurses or nursing” AND “confidence or competence or knowledge or skill.” Synthesis of the Literature Three themes identified in the literature were: a) patient outcomes improve with woundcare specific education of nurses, b) patients with wounds have improved outcomes with evidence-based practice protocols, c) nurse confidence levels improve with wound education, and d) support from a wound expert improves patient outcomes. Patient Wound Outcomes Improve with Education of Nurses The current literature supports providing nurses with wound-specific education to improve patient outcomes (Blackburn et al., 2023; Grešš Halász et al., 2021; Jensen et al., 2024; 7 Majchrzak, 2021; Parker, 2025; Phillips, 2025). Further nurse training reduces variation in wound care practices. It improves wound healing rates when nurse education is combined with multidisciplinary teamwork for wound patients, and hospital admissions decrease (Parker, 2025). Grešš Halász et al. (2021) found a positive correlation between nurses’ knowledge and attitude towards treating pressure injuries. Having more knowledge can motivate nurses to provide better care. Another factor that affected nurses' patient care was their work culture. Haines (2025) stated that a positive culture for healthcare workers improves patient outcomes, as indicated in a systematic review and meta-analysis of workplace cultures. A positive culture has been shown to improve patient outcomes by 90%, reduce mortality by 48%, and decrease hospital readmissions (Haines, 2025). There were fewer pressure injuries and higher patient satisfaction. A positive, supportive environment for nurses benefits patients. It is common for nurses to resort to ritualistic dressing practices, default to familiar dressings, and experiment with dressings (Blackburn et al., 2023; Haines, 2025). Ongoing education is needed for nurses to standardize care and improve patient outcomes (Hurd et al., 2025). Ongoing education reinforces learning and helps prevent nurses from reverting to habitual practices that lack evidence-based support (Blackburn et al., 2023). Wound Outcomes Improve with Evidence-Based Practice Protocols Current literature supports using evidence-based practice protocols for improved wound healing rates (Blackburn et al., 2023; Boersema et al., 2021; Haines, 2025; Herring et al., 2023; Hurd et al., 2025; Jensen et al., 2024; Majjouti et al., 2025; Milne, 2023; Oliveira et al., 2021; Parker, 2025; Phillips, 2025). Protocols provide a streamlined method for integrating evidencebased practice into clinical settings, making it more accessible and practical for staff to implement. Hurd et al. (2025) found a reduction in rates of systemic infection and hospitalization 8 in patients treated using an evidence-based practice protocol. Wound care protocols have been shown to improve patient outcomes (Jensen et al., 2024). Research has found benefits for patient wound outcomes when protocols are utilized. Majchrak et al. (2021) found that protocols reduce amputations for patients with diabetic foot wounds and patients with chronic lower limb ischemia. Protocols for managing deteriorating or hard-to-heal wounds can guide nurses when to seek expert advice to minimize the risk of patient complications (Jensen et al., 2024; Haines, 2025). The use of protocols can improve woundhealing rates and help prevent serious complications. One challenge in applying protocols to wounds in the buttocks region is identifying the wound type. As pressure injuries and incontinence-associated dermatitis can occur in this region and share overlapping characteristics, it can be challenging to differentiate between the two. Majjouti et al. (2025) developed an AI tool, with expert support, to distinguish between stage 1 and 2 pressure injuries and incontinence-associated dermatitis of the gluteal region. Tools such as this can help nurses identify wound types, enabling the application of appropriate treatment protocols (Majjouti et al., 2025). Wound care protocols may include guidance on specific wound types, such as leg ulcers, and instructions for identifying the wound type and selecting appropriate dressings (Hurd et al., 2025). It may also include determining when to refer to a specialist and managing exudate levels (Hurd et al., 2025). Wound care protocols help nurses make informed, evidence-based decisions in patient care (Hurd et al., 2025). They can increase nurse confidence levels in caring for different types of wounds (Jensen et al., 2024). Nurse Confidence Levels Improve with Wound Education 9 The literature suggests that wound education increases nurses’ confidence in their care (Blackburn et al., 2023; Jensen, 2024; Parker, 2025). Majchrzak et al. (2021) found that 80% of nurses favored a wound education program. Similarly, Jensen et al. (2024) found that nurses improved their wound care skills, knowledge, motivation, and confidence by using a simplified wound care protocol and education. Ninety-three percent of nurses reported that the wound care protocol was a helpful resource (Jensen et al., 2024). Furthermore, Blackburn et al. (2023) stated that nurses require fewer dressing options and encouragement to adopt a holistic approach to wound care. Similarly, Herring et al. (2023) demonstrated that strategically placed posters with QR codes throughout hospital units enhanced nurses’ access to evidence-based wound care information via mobile devices. Additional wound care resources and education for nurses can enhance their confidence, and there are various ways to provide them. When nurses lack confidence in wound care, they often change dressings more frequently (Blackburn et al., 2023; Hurd et al., 2025). More frequent dressing changes can delay wound healing, cause patient distress, and increase financial costs (Blackburn et al., 2023). For example, Hurd et al. (2025) found that nurses who did not use a protocol changed dressings on average 3.5 times per week, compared with 2 times per week for those who did. Reduced dressing changes were associated with faster healing times (Hurd et al., 2025). Additionally, the average woundhealing time was 13 weeks with the protocol and 25 weeks without it (Hurd et al., 2025). Unnecessary extra dressing changes increase the risk of infection, contamination, and pain, interfering with wound healing (Hurd et al., 2025). Enhancing nurses' confidence through education can improve patient wound outcomes. Wound Expert Support Improves Patient Outcomes 10 This literature review suggests that having support from a wound expert when needed improves patient outcomes (Baldridge et al., 2025; Boersema et al., 2021; Haines, 2025; Jensen et al., 2024; Majchrzak et al., 2021; Parker, 2025). Protocols, created by wound experts, can help nurses make more informed decisions regarding wound care, especially when caring for patients with complicated or non-healing wounds (Boersma, 2021; Hurd et al., 2025; Jensen, 2024; Majchrzak et al., 2021; Parker, 2025). Wound nurses can educate staff and help standardize practice (Parker, 2025). The role of wound nurses is multifaceted and can benefit patients and nurses in multiple ways. Multidisciplinary care can improve patient outcomes (Parker, 2025). A pilot project by Parker (2025) demonstrated that standardizing wound care practices and implementing early intervention by a wound specialist when needed resulted in an average reduction in wound healing time from 19 weeks to 4 weeks and an average cost savings of 74% per patient. Majchrzak et al. (2021) reported that multidisciplinary care for diabetic foot ulcers resulted in fewer amputations, lower mortality rates, shorter hospital stays, and improved healing rates. Boersma et al. (2021) suggested that if a wound does not heal at a rate of 30% per week, an interdisciplinary team should be involved sooner. This is especially critical when caring for chronic wounds, which are impacted by chronic health conditions, such as venous insufficiency, diabetes, neuropathy, smoking, and vascular disease (Hurd et al., 2025). The other underlying conditions must be addressed to facilitate wound healing (Hurd et al., 2025). This is why multidisciplinary teamwork is essential for chronic and non-healing wounds, as underlying conditions can be addressed. According to Hurd et al. (2025), a 50% improvement in patient outcomes with the use of multidisciplinary teamwork. Lack of clinician expertise is often overlooked as a factor in delayed wound healing (Boersema et al., 2021). Involving wound care 11 and other experts for chronic, non-healing wounds is crucial, as multidisciplinary teamwork has been shown to improve patient outcomes for complex wounds significantly. It is also noteworthy that patient compliance, lifestyle modifications, and healing rates are improved with patient education (Jensen et al., 2024). A wound specialist can help by empowering patients with knowledge regarding the wound care they are receiving (Jensen et al., 2024). Fostering critical thinking among patients increased patient involvement in care among 71% of participants in a study (Jensen et al., 2024). Patient education should focus on modifiable risk factors such as smoking, glycemic control, and the importance of compression for venous stasis (Boersema et al., 2021). This is an important, yet often overlooked, factor in wound healing. Summary of Literature Review Findings and Application to the Project This literature review highlighted four main themes: a) patient wound care outcomes improve when nurses have received advanced wound care education. b) Nurses can feel more confident providing evidence-based care with advanced wound care education. c) Evidencebased practice resources simplify a plethora of information into an easy-to-follow model that nurses can readily incorporate into their practice. d) Wound expert support is needed for patients with chronic and non-healing wounds, as many health conditions can impact wound healing. These factors all contribute to improved patient outcomes. Several strategies can be implemented to incorporate the findings from the literature review into the project, including developing educational posters and adding a wound care nurse. Posters containing QR codes or algorithms provide nurses with rapid access to essential information, enhancing efficiency and knowledge retention (Herring et al., 2023). Since nurses often face heavy workloads and limited time to research current evidence-based practices (Jensen 12 et al., 2024), summarizing this information into a concise, visual guide can streamline clinical decision-making and improve patient outcomes (Jensen et al., 2024). Furthermore, involving a wound care specialist, such as a wound nurse, can enhance staff education and promote standardized wound care practices (Parker, 2025). A wound nurse can provide ongoing support by answering questions, evaluating staff competencies, and teaching effective wound management techniques, ultimately contributing to higher-quality patient care. Project Plan and Implementation This MSN project aims to enhance nurses' knowledge and confidence through a wound care education presentation, simulation, evidence-based resources on dressing selection, and support from a wound nurse. This project aims to assess whether these measures will improve nurses' confidence levels and enhance healing rates for chronic wounds. The goals of this project will be achieved by collaborating with stakeholders and educators to develop an advanced wound care course based on evidence-based practice, including a simulation. Nurses will also be provided with visual guides for dressing selection and clinical support from a wound nurse. A survey will be administered to participants at the beginning of the project and again after its completion to evaluate its effectiveness and identify areas for improvement. Plan and Implementation Process The Iowa Model of Evidence-Based Practice will serve as the framework for this MSN project to explore the impact of additional wound education on nurses' confidence levels. This model has eight steps. The first step is identifying the problem: the lack of consistency in wound care practices. The second step is creating the PICOT question. The next step was to conduct a literature review that synthesized the research. At this point, the project concept and findings from the literature review will be presented to stakeholders, including nurse leaders, educators, 13 and wound care leaders. Upon receiving stakeholder approval, an interdisciplinary team will be formed, comprising home health nurse leaders, wound care nurse leaders, a wound nurse specialist, nurse educators, the wound clinic nurse navigator, and a provider from the wound clinic. These team members will review the team lead's literature review results. The wound nurse will create infographics for nurses to reference when selecting dressings, as well as the outline for the advanced wound care course, which the wound nurse will present to the team for review. A pilot study will be planned that includes a group of five visiting nurses who will receive the advanced education, simulation experience, algorithm for reference, and wound specialist support. The nurses will take an initial survey to assess their confidence in providing wound care and their knowledge levels. Survey results will be used to compare results upon completion of the pilot study. The nurses will attend an 8-hour, full-day course on advanced wound care, which includes a 4-hour presentation and 4 hours of simulation. The nurses will complete a survey and interview after the 3 months have concluded. This information will be used to assess the project's effectiveness and determine whether it should be implemented on a broader scale. The project findings will be disseminated. These steps will fulfill the requirements of the Iowa Model framework. Interdisciplinary Team The healthcare providers participating in this project include home health and wound care nurse leaders, local home health nurse educators, a wound nurse specialist, a wound clinic nurse navigator, and a provider from the wound clinic. These clinicians will collaborate on this project to enhance nurse confidence levels and improve the rate of patient wound healing. 14 Home Health Nursing Leadership. The approval and support of home health nursing leaders are essential to the project, as it cannot be implemented without their approval. Nursing leaders will need to monitor the project's progress and provide ongoing feedback on nurse selection and involvement. Wound Nursing Leadership. Wound nursing leadership will also need to approve the project for it to proceed. These nurses will review and approve the educational presentation, simulation, and educational materials for accuracy and clarity. These leaders can also assist in guiding the project's implementation and in connecting the project lead with the wound clinic navigator and the wound clinic provider. Home Health Nurse Educators. The home health nurse educators are essential to the project, assisting with the creation of the educational presentation and simulation in conjunction with the wound nurse. These team members have the knowledge and resources for assisting with creating these. Additionally, these clinicians will also assist with the presentation and simulation, as multiple nurses will be needed to present and guide the simulation. Home Health Wound Nurse. The home health wound nurse will act as the project lead, conduct the needs assessment and literature review, create a PowerPoint presentation summarizing the project, and coordinate meeting times with stakeholders to present the project and obtain approval. At these meetings, the wound nurse will present the project outline via a PowerPoint presentation. After gaining approval, the wound nurse will collaborate with leadership to select five visiting nurses to participate in the project. If these nurses agree, the wound nurse will send the survey to the nurses and collect it before they start the education. Next, the wound nurse will create the educational presentation and simulation, with assistance from the nurse educators as needed. This nurse will present the education and facilitate the 15 simulation. The wound nurse will create the dressing selection resources and share them with the nursing educators for feedback and approval. After approval is obtained, the nurse will provide the wound reference resources to the visiting nurses for reference during the project. The wound nurse will be available to assist the nurses with questions and in-person support for wound care during the pilot project. After the completion of the pilot project, the wound nurse will survey the participants again. The wound nurse will review the wound measurements and photographs of the patients these nurses have been caring for. This nurse will then discuss with the navigator and wound clinic provider whether the pilot project had an impact on patient healing. Next, the wound nurse will then collect the data and conduct a debriefing with all stakeholders and participants. From here, the wound nurse will collaborate with educators and leadership to determine if the project should be implemented more widely. The nurse will summarize and disseminate the results. Wound Clinic Nurse Navigator. The wound clinic nurse navigator will work with the home health wound nurse to coordinate patient care of mutual patients that the visiting nurses are seeing during the pilot study. The navigator and wound nurse will review and discuss the patient’s wound progress. The navigator will also relay the provider's feedback to the wound nurse. Wound Clinic Provider. The wound clinic provider will review the presentation outline, simulation, and algorithms for accuracy and completeness. Providers will also submit input as stakeholders on the project. The provider will guide patient care and assess the effectiveness of the care nurses are providing to patients, as well as the progress of patients’ wounds. At the end of the pilot project, the provider will provide feedback on the project's effectiveness and determine whether it should be implemented more widely. 16 Description and Development of Project Deliverables There are five deliverables for this project. The five deliverables include 1) a PowerPoint presentation outlining the project for stakeholders, 2) an infographic about dressing selection based on wound type, 3) an infographic about dressing selection based on drainage level, 4) a survey for the participating nurses to take before and after the project, and 5) a reference guide for staging pressure injuries. This section will outline the deliverables and their application to the project. PowerPoint Presentation for Stakeholders. The first deliverable is a PowerPoint presentation (see Appendix A) outlining the project to obtain stakeholder approval. Stakeholders include home health nursing leadership, wound nursing leadership, home health nurse educators, the wound clinic nurse navigator, and a provider from the wound clinic. The purpose of this PowerPoint is to outline the pilot project and gain stakeholder support, whose approval is necessary for its implementation. Treatments Based on Wound Type. The second deliverable is an infographic for nurses to reference when selecting dressings (See Appendix B). This deliverable aims to provide concise evidence-based information for nurses to select dressings based on wound type. Images of each wound type are included. Wounds included in the infographic are those for which nurses may be required to select dressings, such as skin tears, incontinence-associated dermatitis, stage 1 and 2 pressure injuries, and intertrigo. Wound Dressings Based on Drainage Level. The third deliverable is an infographic for nurses to reference when selecting dressings based on the amount of wound drainage (see Appendix C). Drainage levels are divided into categories: none, small, medium, and 17 large/copious. Suggested dressings are listed next to the drainage level, based on their absorption capacity. This deliverable is a concise summary of dressings based on drainage level. Wound Care Knowledge and Comfort Level Survey. The fourth deliverable is a survey for participating nurses to complete before and after the project (see Appendix D). This survey assesses post-graduation wound care education, general comfort level with wound care, measuring wounds, assessing tissue types, determining etiology, and comfort level with applying compression wraps and wound VAC dressings. The survey results from before and after will be compared to assess the effectiveness of the education and resources provided. Timeline The total project timeline is five months (See Appendix F). There will be one month of preparation at the start of the project, including needs assessment, literature review, presenting the project to stakeholders, creating and delivering education to the nurses, and having the nurses complete the survey. The next phase of the study will be a three-month clinical care period. Afterward, there will be a one-month period to review the survey and project results, meet with stakeholders, and disseminate the results. For the first two weeks of the project, the wound nurse will conduct a needs assessment, conduct a literature review, and create a PowerPoint presentation summarizing the project for stakeholders (Appendix A). During the third week, the wound nurse will present the PowerPoint to stakeholders and obtain their approval. After obtaining approval, the wound nurse will identify potential nurse candidates and obtain consent to participate. Once five nurses have consented to participate and been briefed on the study, they will be asked to complete the survey. The wound nurse will create the educational presentation and simulation, with assistance from the nurse educators as needed. This will continue into week four, and then the five visiting nurses will 18 receive education and participate in the simulation at the end of the week. This will be required training before the clinical portion of the project. Starting in week five and continuing through week nineteen, the nurses will perform wound care with their increased knowledge. The wound nurse will assist nurses when they have questions. The nurses will also have the reference materials to utilize. The wound nurse will check in with the nurses weekly, either with a phone call or a Teams message, and ask how the project is progressing. The wound nurse will maintain a spreadsheet of patients the nurses are seeing, including their provider’s name, wound assessments, and measurements, and notes regarding the weekly check-ins. Upon completion of the clinical period, at week seventeen, the wound nurse will meet with the wound clinic provider and nurse navigator to discuss their assessments of the project’s effectiveness, based on the outcomes of the mutual patients. Any comments the provider and nurse navigator received from the patient about the home health nurse and the care provided will also be noted. The nurses will retake the survey, omitting question 1. The wound nurse will compare the survey results and compile the information into a PowerPoint presentation for stakeholders. During week eighteen, the wound nurse will present a PowerPoint summary of the project's findings to the stakeholders. Afterward, the wound nurse will discuss with stakeholders the project's effectiveness and whether to proceed with providing this education to the other visiting nurses. The wound nurse will spend the next two weeks summarizing the project and disseminating the findings. This project will be carried out over five months, with a month of preparation. Following stakeholder approval, five nurses will be selected, educated, and then monitored over three 19 months to assess their knowledge and the progress of their patients’ wounds. Upon completion of the three-month clinical period, two weeks will be spent assessing, summarizing, and presenting the findings and determining how to proceed. The last two weeks will be spent preparing the information for and disseminating the project findings. Project Evaluation This MSN project will be evaluated for effectiveness through a summative evaluation process that includes pre- and post-project nurse surveys, weekly check-ins, interviews with nurses, the wound clinic provider, and the nurse navigator, and an evaluation of patient chart wound data. This project will evaluate whether providing nurses with additional wound care education and resources increases their confidence in providing wound care and improves patient wound-healing rates. The survey will assess the nurses’ perceived knowledge and confidence levels in providing wound care, including wound measurements, identifying tissue types in the wound bed, determining etiology, and applying compression wraps and wound VAC dressings. After the post-survey is completed, the wound nurse will compare the pre- and post-survey results. If the selected answers demonstrate increased confidence among the nurses, this will indicate project success. The wound nurse will also have notes from weekly check-ins with the nurses and a more in-depth interview upon completion of the project. The wound nurse will interview the wound clinic provider and nurse navigator for their insights on the project based on assessments of mutual patients with the five visiting nurses. The wound nurse will assess whether participants in the interviews perceived positive changes resulting from the nurses' education. The wound nurse will also analyze the spreadsheet of patient chart wound documentation to assess the percentage of wound healing and decrease in any necrotic tissue over the course of the project. The wound 20 nurse will compile the data into a PowerPoint presentation and present the data to stakeholders. The stakeholders will determine whether the data indicates the project was effective enough to replicate on a larger scale and whether it aligns with the organization’s current goals. Ethical Considerations The autonomy of all participants will be respected during this project. Participation in education, interviews, and surveys will be optional for nurses. Nurses will be invited to participate based on the geographic area where they primarily work, preventing discrimination if the wound nurse selects nurses individually. Patient privacy will be protected in alignment with HIPAA and the organization's guidelines. Documents related to the project will be stored in the company’s secure OneDrive and accessed only on company-provided devices, ensuring data security and encryption when transmitted over the internet. Patient-identifying information will be removed before the project results are presented and disseminated. Patients will be assigned numbers and referred to as patient 1, patient 2, etc. All participants will be treated ethically and respectfully. Any concerns from the wound nurse or provider in patient care will be addressed as positive changes the nurse can implement. The privacy of the participating nurses will also be respected. Nurses' identifying information will not be included in presentations or the project summary. They will be assigned numbers and referred to as “nurse 1,” “nurse 2,” etc. during the presentation and dissemination process. Their information will also be stored on a company-provided device and in OneDrive, as secure login is required for both. The device has encryption software for online data. This project will follow all ethical guidelines of the organization and the healthcare profession regarding the treatment of patients and staff. 21 The wound nurse will be as objective as possible when analyzing and presenting the information. There is an inherent risk of bias from the nurse conducting the interviews and data collection. The wound nurse will use chart data to obtain unbiased information on wound-healing rates. All data that can be included in the results, whether supporting the PICOT question or not, will be included. All relevant interview findings, both positive and negative, will be conveyed in the presentation on project findings to stakeholders. This will allow stakeholders to determine for themselves whether the project was successful and aligned with the organization’s objectives and goals. Discussion This project offers an approach to increase home care nurses' knowledge and confidence in providing wound care, while potentially improving wound-healing rates. Nurses generally receive limited wound care education during and after their schooling (Majchrzak et al., 2021). This MSN project aims to improve patient wound-healing rates by increasing nurses' confidence through further wound care education and resources (Hurd et al., 2025). The current literature suggests that nurse confidence and patient outcomes can be improved by nurses receiving advanced wound care education, evidence-based practice protocols, and access to expert support. The evaluation of this project will give insights into the effectiveness of implementing these measures together to support and train nurses to provide optimal wound treatments. Evidence-Based Solutions for Dissemination The findings of this project will be disseminated in several ways. After the pilot study, the team lead will compile the findings into a PowerPoint presentation to share with stakeholders. The pre- and post-project surveys of participating nurses will be compared and included in this presentation, along with information gathered through interviews with the participating nurses 22 and the wound clinic provider. The project lead will also compile a poster summarizing this MSN project and present it to the Weber State University Annie Taylor Dee School of Nursing faculty and fellow students. If this project is successful, the project lead will seek to publish findings in a nursing wound care journal to disseminate results more widely. Significance to Advanced Nursing Practice This project is crucial to advancing the nursing profession through enhanced wound care knowledge and skills. Further wound care education can increase nurses' confidence (Jensen et al., 2024). Nurses having advanced wound care education and skills training enhances the care patients receive and can lead to improved patient outcomes (Hurd et al., 2025). Implementing the process outlined in this project will enhance nurses’ critical thinking when providing wound care and improve collaboration with wound care specialists (Hurd et al., 2025). Implications The strengths and challenges in implementing this project have been identified. Strengths of this project include using evidence-based information to create references for clinicians, advanced education for nurses, and expert-level support. This project is significant because it identifies and offers a solution to a practice gap: the lack of consistency between clinicians who provide wound care and the use of evidence-based information to make treatment decisions. This project offers ways to enhance nurses’ knowledge, thereby increasing their confidence in providing wound care (Jensen et al., 2024). It includes infographics that provide concise information for dressing selection and assisting nurses in making informed care decisions. Nurses receive additional hands-on skills training in the simulation lab, preparing them to provide consistent, correctly applied wound care treatments. Evidence suggests that this 23 consistency of practice can improve patient wound-healing rates and decrease complications (Hurd et al., 2025). Weaknesses of this project include the challenge of changing clinician routines and retaining information. Nurses may revert to traditional wound-care practices and may not remember all the information taught in the course (Blackburn et al., 2023; Haines, 2025). Ongoing education will be needed to reinforce evidence-based practices. Stakeholders, the project lead, and educators will need to meet regularly to discuss practice and education gaps and how to address them. Recommendations Recommendations to improve nurse education in wound care can significantly improve the consistency of care and patient healing. The application of evidence-based wound care treatments has been shown to improve rates of chronic wound healing (Parker, 2025). This project could serve as a model, and changes to the resources, educational format, and content could be made based on feedback from participants and stakeholders. Further research is needed to assess the effectiveness of this combined approach for addressing nurses' education needs, as this was a small pilot study. Finally, online learning could be offered to reinforce and further educate nurses about wound care. Conclusion Implementing a program to improve wound care consistency and nurse knowledge can significantly impact patient healing and reduce wound-related complications (Parker, 2025). Combining advanced education, resources, simulation, and expert support provides a comprehensive plan to address practice gaps and needs identified in the current literature (Jensen et al., 2024; Parker, 2025). This project can contribute to enhanced wound care practices through 24 ongoing evaluation, modification, and dissemination of results. This project offers a model to support nurses in meeting the needs of wound care patients and emphasizes the importance of ongoing education and consistency of practice. References Baldridge, W., Pagnamenta, F., & Rapley, T. (2025). Reducing variance in wound care: A crosssectional study of chronic wounds in one district nursing team’s caseload. British Journal of Community Nursing, 30(Sup3), S16–S21. https://doi.org/10.12968/bjcn.2024.0110 Bell, C. A. F. (2022). Using the Iowa Model of evidence-based practice to guide the development of a skin tear management protocol. Journal of Wound Management, 23(2), 119–129. https://doi.org/10.35279/jowm2022.23.02.06 Blackburn, J., Stephenson, J., & Ousey, K. (2023). The effect of nursing education on dressing usage and wear time in the home care setting. Wounds UK, 19(1), 18–27. Boersema, G. C., Smart, H., Giaquinto-Cilliers, M. G. C., Mulder, M., Weir, G. R., Bruwer, F. A., Idensohn, P. J., Sander, J. E., Stavast, A., Swart, M., Thiart, S., & Van der Merwe, Z. (2021). Management of nonhealable and maintenance wounds: A systematic integrative review and referral pathway. World Council of Enterostomal Therapists Journal, 41(1), 21–32. https://doi.org/10.33235/wcet.41.1.21-32 Grešš Halász, B. G., Bérešová, A., Tkáčová, L., Magurová, D., & Lizáková, L. (2021). Nurses' knowledge and attitudes towards prevention of pressure ulcers. International Journal of Environmental Research and Public Health, 18(4), 1705. https://doi.org/10.3390/ijerph18041705 25 Haines, T. (2025). Barriers to healing pressure ulcers within the community setting: A service evaluation. British Journal of Community Nursing, 30(7), S6–S12. https://doi.org/10.12968/bjcn.2024.0106 Henson, A., & Jeffrey, C. (2024). Utilizing the “Iowa Model Revised: Evidence-Based Practice” to develop an intervention for use in a hemodialysis setting. Nephrology Nursing Journal, 51(2), 173–179. https://doi.org/10.37526/ 1526-744X.2024.51.2.173 Herring, L., Arrowsmith, M., Heywood, N., Baguno, C., Griffiths, J., Andrews, N., & Coombs, A. (2023). Proper care, right now: QR code bank to enable clinical staff to access healthcare resources. Wounds UK, 19(1), 51–54. Hurd, T., Murdoch, J. M., & McCarthy, C. H. (2025). The clinical and economic outcomes of an integrated care bundle using a three-layer silicone adhesive foam dressing for exudate management of chronic wounds: A retrospective cohort analysis. Journal of Wound Management, 26(2), 128–135. https://doi.org/10.35279/jowm2025.26.03.02 Jensen, M. H., Landauro, M. H., & Hansen, M. (2024). The wound care pathway: A Danish effect study. British Journal of Community Nursing, 29(Sup12), S6–S14. https://doi.org/10.12968/bjcn.2024.0129 Majchrzak, K., Bobbink, P., & Probst, S. (2021). Survey of physicians’ and nurses’ needs and expectations regarding a multidisciplinary wound clinic. Journal of Wound Management, 22(3), 21–30. https://doi.org/10.35279/jowm202110.04 Majjouti, K., Priester, V., Tapp-Herrenbrueck, M., Brehmer, A., Pinnekamp, H., Aleithe, M., Fischer, U., Kleesiek, J., & Hosters, B. (2025). Nursing-centered development of an AIbased decision support system in pressure ulcer and incontinence-associated dermatitis 26 management - A mixed methods study. BMC Nursing, 24(1), 1–9. https://doi.org/10.1186/s12912-025-03448-4 Melnyk, B., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare (5th Ed.). Wolters Kluwer Health. Milne, J. (2023). Addressing real world challenges for community nurses: Active treatment for non-healing wounds. Wounds UK, 19(4), 56–60. Oliveira, A. P., Rodrigues, M. P., Vieira de Melo, R. H., Alves de Vilar, R. L., & Lopes Sampaio, A. T. (2021). Nurses’ perspective on a wound prevention and treatment protocol [translated by Google]. Avances En Enfermería, 39(3), 345– 355. http://doi.org/10.15446/av.enferm.v39n3.87104 Parker, J. (2025). Redesigning wound care in primary care networks: A nurse-led innovation journey. British Journal of Community Nursing, 30(Sup9), S18–S24. https://doi.org/10.12968/bjcn.2025.0114 Phillips, K. (2025). Practice development. Implementing the National Wound Care Strategy Programme pressure ulcer recommendations in an acute setting. Wounds UK, 21(2), 32– 40. Wound Reference Inc. (2025). Clinician (Wound Care Basics) Homecare. https://woundreference.com/collections/share?id=24708 27 Appendix A Wound Care Pilot Project Summary for Stakeholders 28 29 30 31 32 Appendix B Treatments Based on Wound Type 33 Appendix C Wound Dressings Based on Drainage Level 34 Appendix D Wound Care Knowledge and Comfort Level Survey Please circle your answer for each question. 1. Have you had a wound care education course post-graduation from nursing school? Yes No 2. How comfortable are you selecting a dressing for a wound? Not comfortable Somewhat comfortable Comfortable Very Comfortable 3. How comfortable do you feel identifying the wound type (i.e., diabetic or pressure ulcer)? Not comfortable Somewhat comfortable Comfortable Very Comfortable 4. How comfortable are you in identifying the tissue types in a wound bed? Not comfortable Somewhat comfortable Comfortable Very Comfortable 5. How comfortable are you measuring wounds, including tunnels and undermining? Not comfortable Somewhat comfortable Comfortable Very Comfortable 6. How comfortable are you applying compression wraps? Not comfortable Somewhat comfortable Comfortable Very Comfortable 7. How comfortable are you applying wound VAC dressings? Not comfortable Somewhat comfortable Comfortable Very Comfortable 8. How comfortable are you performing wound care in general? Not comfortable Somewhat comfortable Comfortable Very Comfortable 35 Appendix E Quick Reference: Pressure Ulcers/Injuries Staging 36 37 Appendix F Visual Timeline of Project