Abstract

Introduction Pressure ulceration is a significant, mainly avoidable problem within NHS trusts and community facilities across the UK.1 Education of healthcare staff is an integral component of pressure ulcer prevention, with deficiencies leading to increased numbers and severity of ulceration.2 Local root cause analyses have recurrently shown significant deficits in education around the skin assessment and documentation. Despite this, access to educational opportunities and intrinsic workforce pressures are in conflict, further exacerbated by current face-to-face restrictions post-COVID19. There is a desperate need for accessible and effective educational options, with 360-degree video and virtual reality (VR) offering immersive learning opportunities deliverable in a range of healthcare settings. Methods We created a series of 360-degree 3D videos entitled ‘Ginty’s Goggles: React to Risk’. Immersive delivery through VR headsets transports the learner to a clinical space where they gain a one-to-one tutorial from an experienced tissue viability nurse assessing a simulated patient. Superimposed content is used to highlight various grades of ulceration, with interactivity promoted by asking learners to complete the relevant documentation at various ‘pause points’. Following this, comparisons between learner generated documentation and the gold-standard are used to aid learning. This intervention was piloted at the Norfolk and Norwich University Hospital on a range of healthcare professionals with pre/post questionnaire data obtained. Evaluation outcomes focussed on subjective self-efficacy with the identification and documentation of pressure ulceration. Results The pilot included 30 individuals with job roles ranging across the multidisciplinary team. Each healthcare professional experienced the first VR scenario. Self-efficacy increased significantly post-intervention with >50% of participants feeling more prepared to conduct a full skin assessment and more confident with categorisation of identified pressure ulceration (p Discussion and Conclusions Pressure ulceration and their complications convey significant costs to patients and healthcare establishments. They can present an economic burden to trusts of more than £12,000 per day, with a lack of staff education contributing to increased numbers and worsening severity of ulceration. VR and 360-degree video can provide one-to-one, immersive, technology-enhanced learning solutions which are both low-cost and accessible. Our results suggest that healthcare professionals both value and see the potential of this technology, developing greater levels of self-efficacy and feeling more prepared for clinical practice following exposure to the VR content. References NHS Improvement ( 2018). Pressure ulcers: revised definition and measurement (Summary and Recommendations). Available at: https://improvement.nhs.uk/documents/2932/NSTPP_summary__recommendations_2.pdf [Accessed 27 August 2020]. Porter-Armstrong AP, Moore ZEH, Bradbury I, McDonough S ( 2018). Education of healthcare professionals for preventing pressure ulcers. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD011620.

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