ULTRA-CARE: a pilot study on Indonesia's first ultrasonography training programme for wound care nurses

Objective: Ultrasonography (U/S) is a non-invasive and cost-effective tool for detecting soft tissue and bone abnormalities. However, its use among wound care nurses in Indonesia remains unexplored. This quasi-experimental study aimed to assess the effectiveness of the ULTRA-CARE training programme in enhancing the knowledge, skills and attitude of nurses in using U/S in wound care practice. Method: A pre- and post-test study (without control) was conducted with wound care nurses attending the ULTRA-CARE training programme. The curriculum consisted of a two-day training exercise: theoretical sessions (day 1) and practical sessions using two portable U/S devices (day 2). The Kirkpatrick model was used to assess training effectiveness across four levels: (1) satisfaction; (2) knowledge/skills; (3) behaviour; and (4) self-perceived clinical outcomes. Pre- and post-training assessments were analysed using the Wilcoxon signed-rank test. Results: A total of nine wound care nurses were included. Significant improvement in post-test knowledge scores was observed (p=0.012). Participants reported ≥80% satisfaction (Level 1) and positive self-perceived behavioural changes (Level 3). For Levels 2 and 4, two participants reported confidence levels <80%, though overall improvements in perceived diagnostic capabilities were noted. Conclusion: The findings of this study showed that the ULTRA-CARE programme significantly enhanced participants' knowledge and attitudes toward U/S use in wound care. Scaling up similar programmes or future studies could enhance early osteomyelitis detection, reduce the number of amputations, and improve patient outcomes in resource-limited settings.