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Gagnon J, Probst S, Chartrand J, Reynolds E, Lalonde M. Self-supporting wound care mobile applications for nurses: A scoping review. J Adv Nurs 2024; 80:3464-3480. [PMID: 38186080 DOI: 10.1111/jan.16052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/11/2023] [Accepted: 12/23/2023] [Indexed: 01/09/2024]
Abstract
AIM This study provides an overview of the literature to identify and map the types of available evidence on self-supporting mobile applications used by nurses in wound care regarding their development, evaluation and outcomes for patients, nurses and the healthcare system. DESIGN Scoping review. REVIEW METHOD Joanna Briggs Institute scoping review methodology was used. DATA SOURCES A search was performed using MEDLINE, Embase, CINAHL (via EBSCO), Web of Science, LiSSa (Littérature Scientifique en Santé), Cochrane Wounds, Érudit and grey literature, between April and October 2022, updated in April 2023, to identify literature published in English and French. RESULTS Eleven studies from 14 publications met the inclusion criteria. Mostly descriptive, the included studies presented mobile applications that nurses used, among other things, to assess wounds and support clinical decision-making. The results described how nurses were iteratively involved in the process of developing and evaluating mobile applications using various methods such as pilot tests. The three outcomes most frequently reported by nurses were as follows: facilitating care, documentation on file and access to evidence-based data. CONCLUSION The potential of mobile applications in wound care is within reach. Nurses are an indispensable player in the successful development of these tools. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE If properly developed and evaluated, mobile applications for wound care could enhance nursing practices and improve patient care. The development of ethical digital competence must be ensured during initial training and continued throughout the professional journey. IMPACT We identified a dearth of studies investigating applications that work without Internet access. More research is needed on the development of mobile applications in wound care and their possible impact on nursing practice in rural areas and the next generation of nurses. REPORTING METHOD The Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Review guidelines were used. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Julie Gagnon
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, Québec, Canada
| | - Sebastian Probst
- HES-SO, University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Care Directorate, University Hospital Geneva, Geneva, Switzerland
- Faculty of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Julie Chartrand
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Emily Reynolds
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Michelle Lalonde
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, Ontario, Canada
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Patel B, Edwards T, Schrire T, Barnard K, Sen S. Is the quality of mobile health applications for burns being adequately assessed? J Burn Care Res 2021; 43:814-826. [PMID: 34673981 DOI: 10.1093/jbcr/irab197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
High quality mobile health applications (mhealth apps) have the potential to enhance the prevention, diagnosis and treatment of burns. The primary aim of this study was to evaluate whether the quality of mhealth apps for burns care is being adequately assessed. The secondary aim was to determine whether these apps meet regulatory standards in the UK. We searched AMED, BNI, CINAHL, Cochrane library, Embase, Emcare, Medline and PsychInfo to identify studies assessing mhealth app quality for burns. The PRISMA reporting guideline was adhered to. Two independent reviewers screened abstracts to identify relevant studies. The quality of identified studies was assessed according to the framework proposed by Nouri et al, including design, information/content, usability, functionality, ethical issues, security/privacy and user-perceived value. Of the 28 included studies, none assessed all seven domains of quality. Design was assessed in 4/28 studies; information/content in 26/28 studies; usability in 12/28 studies; functionality in 10/28 studies; ethical issues were never assessed in any studies; security/privacy was not assessed; subjective assessment was made in 9/28 studies. 17/28 studies included apps that met the definition of 'medical device' according to MHRA guidance, yet only one app was appropriately certified with the UK Conformity Assessed (UKCA) mark. The quality of mHealth apps for burns are not being adequately assessed. The majority of apps should be considered medical devices according to UK standards, yet only one was appropriately certified. Regulatory bodies should support mhealth app developers, so as to improve quality control whilst simultaneously fostering innovation.
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Affiliation(s)
- Benjamin Patel
- Southmead Hospital Burns Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Thomas Edwards
- Southmead Hospital Burns Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Timothy Schrire
- Southmead Hospital Burns Unit, North Bristol NHS Trust, Bristol, United Kingdom
| | - Katie Barnard
- Library and Knowledge Service , North Bristol NHS Trust, Bristol, United Kingdom
| | - Sankhya Sen
- Southmead Hospital Burns Unit, North Bristol NHS Trust, Bristol, United Kingdom
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Hayashida K, Yamakawa S. Topical odour management in burn patients. BURNS & TRAUMA 2021; 9:tkab025. [PMID: 34458382 PMCID: PMC8389170 DOI: 10.1093/burnst/tkab025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/25/2021] [Indexed: 12/31/2022]
Abstract
Preventing microbial colonization or infections that cause offensive smells may lead to odor reduction. As both anaerobic and aerobic bacteria cause the release of malodor from wounds, the most direct way of avoiding or eliminating wound odor is to prevent or eradicate the responsible infection through the debridement of necrotic tissues. However, some burn patients with malodorous wounds are unable to undergo debridement due to systemic conditions, especially in the acute stage. Moreover, the optimal drug doses and dressings to ensure the efficacy and cost-effectiveness of odorous burn wound management is unclear. The purpose of this commentary is to outline the odor management options available for burn patients, focusing on topical strategies. Numerous potential therapies for treating odorous wounds after burn injuries are suggested.
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Affiliation(s)
- Kenji Hayashida
- Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-0021, Japan
| | - Sho Yamakawa
- Division of Plastic and Reconstructive Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-0021, Japan
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Smith K, Poterlowicz K, Southern S, Mahajan AL, Jivan S. The effect of a known object in a static image of a burn to improve the burn size estimation. Burns 2021; 47:1295-1299. [PMID: 33495039 DOI: 10.1016/j.burns.2020.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/27/2020] [Accepted: 12/31/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Currently information regarding burn size from referring departments to burn centres varies in accuracy. Inaccurate assessment of burn size can lead to over or under treatment. Photographs of injuries may improve accuracy of assessment. We aimed to assess the accuracy of measuring burn size on a static image by including a standard object in the image. METHODS Simulated burn areas were drawn on different body parts of the model. Using an iPhone® model 5 s with an 8 megapixel camera we took photos of the marked area, and repeated them with the palm, a standard bank card and a penny in the picture. First the Du Bois formula, was used to calculate body surface area. Members of the Burns team were asked to view the photos (n = 30) and estimate the percentage of the simulated burn. RESULTS We found an overall overestimation of burn size. Small areas of the forearm were better estimated and within 1.1% of the calculated surface area, however we found no improvement when using a standard object in these images. The back areas were most overestimated ranging from 0.9%-8.9% despite all being the same sized area. CONCLUSIONS Static images tend to overestimate burn size despite the use of a standard object in the image.
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Affiliation(s)
- Kirsty Smith
- Plastic Surgery and Burns Research Unit, The University of Bradford, Richmond Road, Bradford, BD7 1DP, UK; Bradford Teaching Hospitals, Duckworth Lane, Bradford, BD9 6RJ, UK.
| | - Krzystof Poterlowicz
- Department of Life Sciences, The University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
| | | | - Ajay L Mahajan
- Plastic Surgery and Burns Research Unit, The University of Bradford, Richmond Road, Bradford, BD7 1DP, UK; Bradford Teaching Hospitals, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Sharmila Jivan
- Pinderfields Hospital, Aberford Road, Wakefield, WF1 4DG, UK
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Dacy A, Haider N, Davis K, Hu W, Tang L. Design and evaluation of an imager for assessing wound inflammatory responses and bioburden in a pig model. JOURNAL OF BIOMEDICAL OPTICS 2019; 25:1-9. [PMID: 31515974 PMCID: PMC6739619 DOI: 10.1117/1.jbo.25.3.032002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
Our work details the development and characterization of a portable luminescence imaging device for detecting inflammatory responses and infection in skin wounds. The device includes a CCD camera and close-up lens integrated into a customizable 3D printed imaging chamber to create a portable light-tight imager for luminescence imaging. The chamber has an adjustable light portal that permits ample ambient light for white light imaging. This imager was used to quantify in real time the extent of two-dimensional reactive oxygen species (ROS) activity distribution using a porcine wound infection model. The imager was used to successfully visualize ROS-associated luminescent activities in vitro and in vivo. Using a pig full-thickness cutaneous wound model, we further demonstrate that this portable imager can detect the change of ROS activities and their relationship with vasculature in the wound environment. Finally, by analyzing ROS intensity and distribution, an imaging method was developed to distinguish infected from uninfected wounds. We discovered a distinct ROS pattern between bacteria-infected and control wounds corresponding to the microvasculature. The results presented demonstrate that this portable luminescence imager is capable of imaging ROS activities in cutaneous wounds in a large animal model, indicating suitability for future clinical applications.
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Affiliation(s)
- Ashley Dacy
- University of Texas at Arlington, Department of Bioengineering, Arlington, Texas, United States
| | - Nowmi Haider
- University of Texas at Arlington, Department of Bioengineering, Arlington, Texas, United States
| | - Kathryn Davis
- University of Texas Southwestern Medical Center, Department of Plastic Surgery, Dallas, Texas, United States
| | - Wenjing Hu
- Progenitec Inc., Arlington, Texas, United States
| | - Liping Tang
- University of Texas at Arlington, Department of Bioengineering, Arlington, Texas, United States
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Cogan NG, Mellers AP, Patel BN, Powell BD, Aggarwal M, Harper KM, Blaber M. A mathematical model for the determination of mouse excisional wound healing parameters from photographic data. Wound Repair Regen 2018; 26:136-143. [DOI: 10.1111/wrr.12634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/30/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Nicholas G. Cogan
- Departments of Mathematics; Florida State University; Tallahassee Florida
| | - Alana P. Mellers
- Biomedical Sciences; Florida State University; Tallahassee Florida
| | - Bhavi N. Patel
- Biomedical Sciences; Florida State University; Tallahassee Florida
| | - Brett D. Powell
- Biomedical Sciences; Florida State University; Tallahassee Florida
| | - Manu Aggarwal
- Departments of Mathematics; Florida State University; Tallahassee Florida
| | - Kathleen M. Harper
- Biomedical Research Laboratory Animal Resources; Florida State University; Tallahassee Florida
| | - Michael Blaber
- Biomedical Sciences; Florida State University; Tallahassee Florida
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A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care. PLoS One 2016; 11:e0147253. [PMID: 26918631 PMCID: PMC4769217 DOI: 10.1371/journal.pone.0147253] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 01/03/2016] [Indexed: 12/28/2022] Open
Abstract
Background Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns expert who, in turn, provides advice back. Methods and Results The application is an integrated clinical decision support system that includes a mobile phone application and server software running in a cloud environment. The client application is installed on a smartphone and structured patient data and photographs can be captured in a protocol driven manner. The user can indicate the specific injured body surface(s) through a touchscreen interface and an integrated calculator estimates the total body surface area that the burn injury affects. Predefined standardised care advice including total fluid requirement is provided immediately by the software and the case data are relayed to a cloud server. A text message is automatically sent to a burn expert on call who then can access the cloud server with the smartphone app or a web browser, review the case and pictures, and respond with both structured and personalized advice to the health care professional at the point-of-care. Conclusions In this article, we present the design of the smartphone and the server application alongside the type of structured patient data collected together with the pictures taken at point-of-care. We report on how the application will be introduced at point-of-care and how its clinical impact will be evaluated prior to roll out. Challenges, strengths and limitations of the system are identified that may help materialising or hinder the expected outcome to provide a solution for remote consultation on burns that can be integrated into routine acute clinical care and thereby promote equity in injury emergency care, a growing public health burden.
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Szmeja MA, Cramp C, Grivell RM, Deussen AR, Yelland LN, Dodd JM. Use of a DVD to provide dietary and lifestyle information to pregnant women who are overweight or obese: a nested randomised trial. BMC Pregnancy Childbirth 2014; 14:409. [PMID: 25495459 PMCID: PMC4280000 DOI: 10.1186/s12884-014-0409-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 11/28/2014] [Indexed: 12/02/2022] Open
Abstract
Background We conducted a nested randomised trial to evaluate the effect of an educational DVD, providing information about healthy food choices and exercise during pregnancy, on diet and physical activity, among pregnant women who were overweight or obese. Methods We conducted a nested randomised trial within the context of the LIMIT randomised trial. Women were eligible with a singleton pregnancy between 10 and 20 weeks gestation, and body mass index at the time of their first antenatal appointment of ≥25 kg/m2. All women who were randomised to the Lifestyle Advice Group of the LIMIT trial received a series of consultations with both research dieticians and research assistants, in addition to standard written dietary and exercise materials (Standard Materials Group). Women randomised to the DVD Group received the same consultations and written materials, and additionally received an educational DVD (DVD Group). The primary study outcome was the Healthy Eating Index. Other study outcomes included physical activity, and gestational weight gain. Women completed a qualitative evaluation of all the materials provided. Results 1,108 women in the LIMIT Lifestyle Advice Group participated in the nested trial, with 543 women randomised to the DVD Group, and 565 women to the Standard Materials Group. Women who received the DVD compared with those who did not, had a higher mean Healthy Eating Index at 36 weeks gestation (73.6 vs 72.3; adjusted mean difference 1.2; 95% CI 0.2 to 2.3; p = 0.02), but not at 28 weeks gestation (73.2 vs 73.5; adjusted mean difference −0.1; 95% CI −1.1 to 0.9; p = 0.82). There were no statistically significant differences in physical activity or total gestational weight gain. While most women evaluated the materials positively, frequency of utilisation was poor. Conclusions Ongoing attention to the delivery of information is required, particularly with the increased use and availability of digital and multi-media interactive technologies. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12607000161426
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Affiliation(s)
- Malgorzata A Szmeja
- The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia.
| | - Courtney Cramp
- The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia.
| | - Rosalie M Grivell
- The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. .,Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
| | - Andrea R Deussen
- The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia.
| | - Lisa N Yelland
- Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia. .,The University of Adelaide, School of Population Health, Adelaide, South Australia, Australia.
| | - Jodie M Dodd
- The University of Adelaide, Discipline of Obstetrics & Gynaecology and The Robinson Research Institute, Women's & Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. .,Department of Perinatal Medicine, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
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Development and evaluation of a novel smart device-based application for burn assessment and management. Burns 2014; 41:754-60. [PMID: 25459217 DOI: 10.1016/j.burns.2014.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/05/2014] [Accepted: 10/08/2014] [Indexed: 11/22/2022]
Abstract
We have developed a novel software application that provides a simple and interactive Lund-Browder diagram for automatic calculation of total body surface area (TBSA) burned, fluid formula recommendations, and serial wound photography on a smart device platform. The software was developed for the iPad (Apple, Cupertino, CA) smart device platforms. Ten burns ranging from 5 to 95% TBSA were computer generated on a patient care simulator using Adobe Photoshop CS6 (Adobe, San Jose, CA). Burn clinicians calculated the TBSA first using a paper-based Lund-Browder diagram. Following a one-week "washout period", the same clinicians calculated TBSA using the smart device application. Simulated burns were presented in a random fashion and clinicians were timed. Percent TBSA burned calculated by Peregrine vs. the paper-based Lund-Browder were similar (29.53 [25.57] vs. 28.99 [25.01], p=0.22, n=7). On average, Peregrine allowed users to calculate burn size significantly faster than the paper form (58.18 [31.46] vs. 90.22 [60.60]s, p<0.001, n=7). The smart device application also provided 5 megapixel photography capabilities, and acute burn resuscitation fluid calculator. We developed an innovative smart device application that enables accurate and rapid burn size assessment to be cost-effective and widely accessible.
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Beard HR, Hamid KS. Worth a thousand words: Integrating clinical photographs into an electronic medical record. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2014; 2:22-5. [PMID: 26250085 DOI: 10.1016/j.hjdsi.2013.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 09/12/2013] [Accepted: 09/22/2013] [Indexed: 11/18/2022]
Abstract
Technological advances have made clinical photographs ubiquitous but the tremendous value of images is often burdened by concerns that are both legitimate and unsubstantiated. Compliant photos dramatically improve patient value and should be encouraged after adequate institutional preparation. As healthcare networks continue to transition to electronic medical records, clinicians and administrators should outline reasonable policies to integrate photos safely.
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Affiliation(s)
- H R Beard
- Wake Forest Baptist Health, Department of Orthopaedics, Medical Center Blvd, Winston-Salem, NC 27157, United States.
| | - K S Hamid
- Wake Forest Baptist Health, Department of Orthopaedics, Medical Center Blvd, Winston-Salem, NC 27157, United States.
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