1. ARC Pressure Injury Prevention Toolkit Overview - HE4310

This toolkit contains a range of resources to support ARC providers with pressure injury prevention and management.

In 2024, many ARC providers in Te Waipounamu indicated that they would be interested in training materials for pressure injury prevention, particularly for healthcare assistant (HCA) staff. In response, existing resources have been selected, and new resources have been developed, with a focus on supporting ARC management and HCAs. The intention is to complement training opportunities that already exist for nurses and HCAs.

The toolkit was collated by the Te Waipounamu ARC Pressure Injury Prevention Working Group, who bring expertise from ARC, Wound Care Nurse Specialists, Gerontology Nurse Specialists, Hauora Māori services, Pacific Health, Occupational Therapy, Dietetics and Commissioning.  In 2025, the toolkit was piloted with seven ARC providers, who found the resources highly relevant and useful, and recommended the toolkit be shared with all ARC providers.

A summary of the resources can be found below, with suggestions of how they could be implemented in practice.

If you have questions or feedback, please contact hannah.o’malley@tewhatuora.govt.nz, or your local Wound Care Clinical Nurse Specialist.

Resource:

SSKIN presentation for healthcare assistants - Video or slide set options

How to use it in practice

• Week 1: Host an interactive education session for HCAs, including time for Q&A following presentation
• Include link to video in the orientation program for new HCA staff

Resource: 

SSKIN poster

How to use it in practice

• A PDF document is provided, along with a Word version of document to allow optional editing if you would like to tailor content for your facility
• Week 1: Print posters and put up in clinical areas (A3 colour is recommended). Signpost these to HCA staff

Resource:

• HCA Handouts 
  • Communication sheet
  • Foot and hand care guide
  • Skin care guide
  • Terminology and definitions for healthcare assistants
  • Wound healing and nutrition

   

How to use it in practice

• Week 2: Clinical manager familiarises themselves with content and adapts Word versions of each document as required
• The skin care guide requires you to insert the specific names and/or pictures of the following products used in your facility: moisturiser, soap substitute, barrier product, foot cream and zinc cream. Once complete, save as a PDF.
• Optional: the communication sheet may allow HCAs to clearly identify residents requiring review by the nurse, in addition to documenting in resident notes.
• Host an education session for HCAs to introduce these resources and the ‘Educational resources for residents and whānau’ (below).
• The printed resources can then be kept in a staff area where HCAs can refer to them as required.

Resource: 

• Educational resources for residents and whānau
  • Patient leaflets (several languages)
  • Teaching cards

How to use it in practice

• Week 2: Patient leaflets have been provided by the Wound Care Society of New Zealand, for staff to use with residents/patients. Print the leaflet in English and any other preferred languages for your residents.
• Print a copy of the teaching cards – A4 colour is recommended, laminate if feasible. This set of cards can be used by HCAs and nurses to help educate residents and whānau on pressure injury prevention. Consider adding to admission policy for new residents.
• Additionally, you may like to use the teaching cards at resident/whānau care planning review meetings or specifically for those identified as being at risk of pressure injury.
• Discuss with HCAs during the education session described above.

Resource: 

Mind Your Tone presentation

• • Video format

How to use it in practice

• Host an interactive education session for HCAs, with time for discussion following the video
• Week 3: This presentation is important for helping team members both prevent and identify pressure injury in residents with diverse skin tones.  As part of Ngā Paerewa it is important that all residents receive equitable health care and evidence shows those with diverse skin tones have significantly higher incidence of stage 3+ pressure injury (includes stage 3, stage 4, unstageable and suspected deep tissue injury)
• Share additional slides with HCAs interested in further learning
• Include link to video in the orientation program for new HCA staff

Resource: 

Organisation checklist

How to use it in practice

• Week 3: Clinical manager to print and complete checklist, then determine areas for further potential quality improvement
• Undertake actions in collaboration with facility management and other staff

Resource: 

Moving, handling and equipment presentation

• • Slide format

How to use it in practice

• Week 4: Host an interactive education session for HCAs in week 4, led by the clinical manager or your local Physiotherapist/Occupational Therapist
• Include link to slides in the orientation for new HCAs

Resource: 

South Island only:

• healthLearn resources

How to use it in practice

Week 4: Clinical manager familiarises themselves with content and decides whether to share online course/s and Forum with staff. If so, ensure that healthLearn access is available to all participating staff and promote course/s and Forum as relevant.

Suggested timeline of activities

Phase

Preparation

Key Activities

• Access the ARC Pressure Injury Prevention Toolkit
• Watch the Video overview of pilot study with Natalie McGuffie, GNS, and Kim Brown, Head of Clinical Quality, Arvida
• Read the Introduction document
• ARC clinical managers familiarise themselves with the toolkit resources
• Seek support from facility management to implement toolkit. Discuss the expected amount of time each HCA will require, approx. 30mins per week for 4 weeks
• Prepare to lead initial SSKIN education session/s with HCAS
• Decide if communication sheet will be trialed
• Tailor skin care guide to facility
• Inform residents and whānau of the education programme at a resident meeting. Advise them that HCA staff will be receiving training on pressure injury prevention, identification and management
• Print resources: Organisation checklist (A4 black and white), SSKIN poster (A3 colour), HCA handouts (A4 colour), Resident/whānau teaching cards (A4 colour), Patient leaflets (A4 black and white, in language/s appropriate for residents), Communication Sheet (if relevant, A4 black and white)

Phase

Week 1

Key Activities

• Host education session/s for HCAs using the SSKIN video or slides provided.
• Answer any questions HCAs may have
• Provide copies of HCA handouts in a communal area and highlight these to staff to browse over the week
• Put up SSKIN posters in clinical areas
• Prepare for Week 2

Phase

Week 2

Key Activities

• Host education session/s for HCAs to review the following resources:
  • Skincare guide
  • Nutrition and wound care
  • Hand and foot care
  • Communication sheet (if using)
  • Education cards for talking to residents
  • Patient leaflets
  • Nursing terminology glossary
• Answer any questions HCAs may have
• Prepare for Week 3

Phase

Week 3

Key Activities

• Host education session/s for HCAs using the ‘Watch your tone’ video presentation
• Discuss use of wider resources shared in Week 2
• Answer any questions HCAs may have
• Share link to additional slides for those who are interested in further learning on this topic
• Complete the organisation checklist and identify any areas for further discussion or improvement work
• Prepare for Week 4

Phase

Week 4

Key Activities

• Host education session/s for HCAs using the ‘Moving, handling and equipment’ slide set
• Discuss with HCAs option to complete online course via healthLearn
• Answer any questions HCAs may have