Date of this Version


Document Type

DNP Project


Background: Pressure injuries (PIs) represent a significant threat to individual and population health as well as contributing to increased healthcare costs. In patients with dark/pigmented skin, the prevention and early detection of PIs is more difficult, increasing patient risk for adverse outcomes. Provider education for skin assessment in patients with dark or pigmented skin can reduce the incidence of pressure injuries.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to educate nurses about proper skin assessment in patients with dark/pigmented skin to determine if knowledge of the topic increases from baseline as a result of education.

Methodology: This quality improvement project utilized a quasi-experimental pre-/post-intervention design. Using a sample of nurses working on a medical/surgical floor, baseline knowledge of skin assessment in patients with dark/pigmented skin was evaluated. An educational program delivered via YouTube was provided to all nurses and post-intervention knowledge was assessed.

Results: In total N = 15 nurses, with a mean age of 39.6 years (SD 4.87 years) were enrolled in the project. Baseline knowledge scores increased from the pre- (M = 62.4%, SD 3.70) to post-intervention phase (M = 96.3%, SD 2.39). Inferential analysis (a Mann-Whitney U-test) indicated that there was a statistically significant increase in knowledge scores following the educational module U(Nbaseline = 15, Npost-intervention = 15) = 451.22, z = 2.29, p < .002.

Conclusions: Nurse education of skin assessments in patients with dark or pigmented skin did increase knowledge of the topic. This is an evidence-based intervention that is aligned with current research, suggesting that the use of education can be effective in practice to help prevent PIs in patients with dark or pigmented skin.

Keywords: pressure injury, skin assessment, PI, nurse, education, dark skin, pigmented