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Sánchez-Gálvez J, Martínez-Isasi S, Sánchez-Hernández M, Vegue-Parra E, Yacobis-Cervantes TR, Mateo-Ramírez F, Fernández-García D. Identifying Barriers to the Acquisition of Knowledge about Skin Integrity Impairment in Nursing Students: An Educational Intervention. NURSING REPORTS 2024; 14:1170-1183. [PMID: 38804422 PMCID: PMC11130803 DOI: 10.3390/nursrep14020089] [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: 02/22/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Wound healing competence is implied in the nursing profession, but there is no standardized content regulation for wound care in university curricula. The primary objective of this study was to identify the barriers to the acquisition of knowledge about skin integrity impairment. METHODS A quasi-experimental pre-test and post-test study with an ad hoc questionnaire involved 304 students (control: 165; intervention: 139) from June to July 2023. A 10-h educational intervention focused on skin integrity assessment and treatment was conducted. RESULTS The control group, scoring 17 ± 0.22 out of a maximum of 61, achieved a significantly lower final test score (p < 0.001) compared to the wound care educational intervention group, with the pre-test group scoring 30 ± 0.76 and the post-test group scoring 43 ± 0.61. The educational intervention in wound care program improved nursing students' knowledge of prevention, assessment/diagnosis, treatment, lower limb wounds, and wound bed preparation by replacing the number of "Don't know" answers in the post-test group with correct answers. CONCLUSIONS The barriers identified to the acquisition of knowledge about skin integrity impairment in nursing studies are the following: the transversality of teaching, the teaching and evaluation system, and the variability in the training of professionals and teachers in charge of their education. The educational intervention can be used to consolidate knowledge and to enhance students' self-confidence in caring for patients with wounds.
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Affiliation(s)
- Javier Sánchez-Gálvez
- Doctoral Programme in Health, Disability, Dependence and Welfare, University of León, 24071 León, Spain;
- Faculty of Nursing, UCAM—Universidad Católica de Murcia, Campus de Cartagena, 30310 Cartagena, Spain; (M.S.-H.); (E.V.-P.); (T.R.Y.-C.); (F.M.-R.)
| | - Santiago Martínez-Isasi
- Simulation, Life Support, and Intensive Care Research Unit (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS) (RD21/0012/0025), Carlos III Health Institute, 28029 Madrid, Spain
- Clinical Nursing, Emergencies, Simulation and Teaching Innovation Research Group (CLINURSID), Department of Psychiatry, Radiology, Public Health, Nursing, and Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
| | - Miriam Sánchez-Hernández
- Faculty of Nursing, UCAM—Universidad Católica de Murcia, Campus de Cartagena, 30310 Cartagena, Spain; (M.S.-H.); (E.V.-P.); (T.R.Y.-C.); (F.M.-R.)
| | - Eva Vegue-Parra
- Faculty of Nursing, UCAM—Universidad Católica de Murcia, Campus de Cartagena, 30310 Cartagena, Spain; (M.S.-H.); (E.V.-P.); (T.R.Y.-C.); (F.M.-R.)
| | - Tamara Rafaela Yacobis-Cervantes
- Faculty of Nursing, UCAM—Universidad Católica de Murcia, Campus de Cartagena, 30310 Cartagena, Spain; (M.S.-H.); (E.V.-P.); (T.R.Y.-C.); (F.M.-R.)
| | - Francisco Mateo-Ramírez
- Faculty of Nursing, UCAM—Universidad Católica de Murcia, Campus de Cartagena, 30310 Cartagena, Spain; (M.S.-H.); (E.V.-P.); (T.R.Y.-C.); (F.M.-R.)
| | - Daniel Fernández-García
- Health Research Nursing Group (GREIS), Department of Nursing and Physiotherapy, University of León, 24071 León, Spain;
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Hulbert‐Lemmel S, Madhuvu A, Team V. Acute care nurses' experience in providing evidence-based care for patients with laparotomy wounds: A scoping review. Int Wound J 2024; 21:e14591. [PMID: 38151989 PMCID: PMC10961882 DOI: 10.1111/iwj.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023] Open
Abstract
To systematically search and synthesise available literature on barriers and enablers to evidence-based care for patients with laparotomy wounds reported by acute care nurses. Specifically, we focused on wound assessment, infection control techniques, wound products used, escalation of care, dressing application, documentation and holistic care. The Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews Checklist and explanation documents directed the review. The methodology framework created by Arksey and O'Malley, updated by Levac et al., and the Joanna Briggs Institute were utilised to assist the scoping review process. Data synthesis was guided by the Theoretical Domains Framework. Six qualitative and mixed methods studies were selected for the review. Most reported barriers and enablers were mapped to knowledge, skills, beliefs about consequences, environmental context and resources and beliefs about capability domains. The main barriers were limited access to and utilisation of wound assessment tools and clinical practice guidelines for wound management and suboptimal time management skills. Inconsistent management of laparotomy wounds was related to ward culture and nurses' lack of knowledge and skills in surgical wound assessment and aseptic technique during wound encounters. The reported enablers were knowledge of multi-factorial risk factors for surgical wound recovery, valuing education and reflective practice and believing that protocols should be utilised alongside comprehensive wound assessments. Holistic wound care included patient education on the role of mobilisation and nutrition in wound healing. Acute care nurses do not routinely incorporate comprehensive, evidence-based care recommendations for laparotomy wound management. Further research on evidence-based care behaviours in managing laparotomy wounds is required. The results indicate a need for standardising the practice of laparotomy wound management while acknowledging the current challenges faced in the ward environment.
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Affiliation(s)
- Sarah Hulbert‐Lemmel
- Monash University, Nursing and Midwifery, Peninsula CampusFrankstonVictoriaAustralia
| | - Auxillia Madhuvu
- Monash University, Nursing and Midwifery, Peninsula CampusFrankstonVictoriaAustralia
| | - Victoria Team
- Monash University, Nursing and Midwifery Clayton CampusClaytonVictoriaAustralia
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Fernández-Araque A, Martinez-Delgado M, Jiménez JM, López M, Castro MJ, Gila EC. Assessment of nurses' level of knowledge of the management of chronic wounds. NURSE EDUCATION TODAY 2024; 134:106084. [PMID: 38171141 DOI: 10.1016/j.nedt.2023.106084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Chronic wounds are a challenge and a major cause of morbidity. A wound is considered chronic if healing does not occur within the expected time frame depending on the etiology and location of the wound. OBJECTIVE To assess the level of knowledge about chronic wound management of postgraduate nurses in different areas of the health system and their previous satisfaction with the training received during their undergraduate studies. DESIGN Cross-sectional study of a health system of 95,000 inhabitants and 557 nursing professionals working in it. PARTICIPANTS Nurses working in the study health system and in areas with care for patients with chronic wounds in social, primary and hospital care. RESULTS Survey results described a low knowledge of chronic wound management in general. Data on knowledge according to area of work showed that nurses in primary care had the highest knowledge of wound etiology. Nurses working in health and social care were most knowledgeable in diagnostic knowledge. Hospital nurses showed the lowest knowledge overall. A relationship was observed when nurses had a master's degree followed by an expert with better knowledge in the test. In addition, nurses reported little training in chronic wounds during their university studies (69.73 %, n = 106). CONCLUSIONS Therefore, a review of this point should be considered to improve the management of chronic wounds and their correct approach among nursing students. A review of continuing and even specialised training needs in the clinical care setting should also be considered.
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Affiliation(s)
- Ana Fernández-Araque
- Research Group "Pharmacogenetics, Cancer Genetics, Genetic Polymorphisms and Pharmacoepidemiology", Faculty of Health Science, University of Valladolid, Soria, Spain.
| | | | - Jose-Maria Jiménez
- Research Group "Multidisciplinary Assessment and Intervention in Health Care and Sustainable Lifestyles VIMAS+", Nursing Faculty, University of Valladolid, Spain.
| | - María López
- Research Group "Multidisciplinary Assessment and Intervention in Health Care and Sustainable Lifestyles VIMAS+", Nursing Faculty, University of Valladolid, Spain.
| | - Maria Jose Castro
- Department of Nutrition and Dietetics, Faculty of Nursing, University of Valladolid. Valladolid, Spain.
| | - Estela Carnicero Gila
- Department of Anatomy and Radiology, Faculty of Medicine, University of Valladolid, Soria, Spain.
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Shipton NH, Luctkar-Flude M, Tyerman J, Ross-White A, Costa I, Woo K. The use of clinical simulation in wound care education for nurses: a scoping review protocol. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S26-S32. [PMID: 37596091 DOI: 10.12968/bjon.2023.32.15.s26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Many nurse educators consider simulation a valuable tool to supplement and augment learning due to current shortages of clinical placements. Wound care is integral to nursing practice yet many students and practicing nurses experience difficulties in securing sufficient learning opportunities or experience at the undergraduate level to feel competent in providing it. Emerging evidence supports simulation as a promising intervention to facilitate student learning in wound care, building nurses' confidence and competence in providing evidence-based wound care. OBJECTIVE To understand how clinical simulation is being used to educate nurses about wound assessment and management, and to explore the impact of clinical simulation on learning outcomes, including knowledge, attitudes, confidence, and skills related to wound care. INCLUSION CRITERIA Inclusion criteria include studies of nursing students and nurses, simulation educational interventions, and learning outcomes related to wound care evaluated by any measures. Any studies that do not fit these criteria will be excluded. METHODS Databases to be searched include PubMed/MEDLINE, CINAHL, ERIC, SciELO up to February 2022. Studies in English with a date limit of 2012 to 2022 will be included. Search results will be imported into Covidence and screened by two independent reviewers, first based on the title and abstract and then full text. Data will be extracted with a novel extraction tool developed by the reviewers and then synthesised and presented in narrative, tabular, and/or graphical forms. DISSEMINATION The finished scoping review will be published in a scientific journal once analysis is completed.
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Affiliation(s)
| | - Marian Luctkar-Flude
- Associate Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Jane Tyerman
- Associate Professor, École des sciences infirmières/School of Nursing, Université d'Ottawa/University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda Ross-White
- Health Sciences Librarian (Nursing) Queen's Collaboration for Health Care Quality, Joanna Briggs Institute, Kingston, Ontario, Canada
| | - Idevania Costa
- Associate Professor, School of Nursing, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kevin Woo
- Professor, School of Nursing, Queen's University, Kingston, Ontario, Canada
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ABCDEFGHI Systematic Approach to wound assessment and management. Nursing 2023; 53:16-25. [PMID: 36820688 DOI: 10.1097/01.nurse.0000918548.41494.b2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
ABSTRACT The ABCDEFGHI approach introduces a systematic approach to wound care. It instructs the clinician to Ask pertinent questions, including those that may identify local and systemic Barriers to wound healing. After obtaining a thorough history, the clinician may proceed to Clean the wound and Do a physical examination, specifically looking for Exposed structures and Factors that will complicate the healing process. Good Healing strategies involving various dressings can then be implemented to promote healing. If necessary, a referral can be made to Involve specialists using various referral pathways. Information used to synthesize this approach was obtained through a review of national and international guidelines and Google Scholar, MEDLINE, and PubMed databases. The ABCDEFGHI approach to wound assessment and management is a simple and easy-to-follow guide that can be easily implemented into practice, thereby improving clinician confidence and competence in wound care.
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Wound Care Self-Efficacy Assessment of Italian Registered Nurses and Wound Care Education in Italian Nursing Education System: A Cross-Sectional Study. NURSING REPORTS 2022; 12:674-684. [PMID: 36135986 PMCID: PMC9506369 DOI: 10.3390/nursrep12030067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
Wounds are a major public health challenge for nurses, and poor wound care has important implications for patients and health care systems. The aim of this study is to assess the Italian registered nurses’ (RNs) perception in the area of wound care, regarding their knowledge, tasks of care delivery, wound management, values, and attitudes, exploring also the previous specific education received during nursing education. An observational online web-based survey was used to assess learning goals and content for wound care education in undergraduate nursing education and the skills and level of self-efficacy in this area during clinical practice. The data were collected between April and May 2022. A total of 210 RNs were interviewed and divided into five national geographic areas. Northwestern RNs showed a better education about the wound care area during university courses: the rate of RNs that did not receive any training in the wound care area was lower than in other Italian geographical areas. Southern RNs presented a better knowledge about factors that expose the wound to becoming chronic, wound drains care, and the ability to assess diabetic foot. This study showed that, in Italy, education in wound care among nursing students is relatively poor, and many skills are achieved during an RN’s career in an empirical way.
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Utami Nike D, Md Fadilah NI, Sallehuddin N, Nor Azlan AYH, Imran FH, Maarof M, Fauzi MB. Genipin-Crosslinking Effects on Biomatrix Development for Cutaneous Wound Healing: A Concise Review. Front Bioeng Biotechnol 2022; 10:865014. [PMID: 35677301 PMCID: PMC9169157 DOI: 10.3389/fbioe.2022.865014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/15/2022] [Indexed: 12/17/2022] Open
Abstract
Split skin graft (SSG), a standard gold treatment for wound healing, has numerous limitations such as lack of fresh skin to be applied, tedious process, severe scarring, and keloid formation followed by higher risks of infection. Thus, there is a gap in producing polymeric scaffolds as an alternative for wound care management. Bioscaffold is the main component in tissue engineering technology that provides porous three-dimensional (3D) microarchitecture for cells to survive. Upon skin tissue reconstruction, the 3D-porous structure ensures sufficient nutrients and gaseous diffusion and cell penetration that improves cell proliferation and vascularization for tissue regeneration. Hence, it is highly considered a promising candidate for various skin wound healing applications. To date, natural-based crosslinking agents have been extensively used to tailor the physicochemical and mechanical properties of the skin biomatrix. Genipin (GNP) is preferable to other plant-based crosslinkers due to its biological activities, such as antiinflammatory and antioxidant, which are key players to boost skin wound healing. In addition, it has shown a noncytotoxic effect and is biocompatible with human skin cells. This review validated the effects of GNP in biomatrix fabrication for skin wound healing from the last 7 years of established research articles and stipulated the biomaterial development-scale point of view. Lastly, the possible role of GNP in the skin wound healing cascade is also discussed. Through the literature output, it can be concluded that GNP has the capability to increase the stability of biomatrix and maintain the skin cells viability, which will contribute in accelerating wound healing.
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Affiliation(s)
- Dewi Utami Nike
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Izzah Md Fadilah
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nusaibah Sallehuddin
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Yasser Hamdi Nor Azlan
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Malaysia
| | - Farrah Hani Imran
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Manira Maarof
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Mh Busra Fauzi,
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Kielo-Viljamaa E, Viljamaa J, Suhonen R, Salminen L, Stolt M. Learning goals and content for wound care education in Finnish nursing education - A Delphi study. NURSE EDUCATION TODAY 2022; 110:105278. [PMID: 35114440 DOI: 10.1016/j.nedt.2022.105278] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/07/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Caring for patients with wounds requires diverse competences from nursing professionals. However, wound care education in undergraduate nursing education is often fragmented and lacks consistent learning goals and content. OBJECTIVES To create learning goals and content for wound care education in Bachelor's level nursing education in Finland and to assess the consensus relating to these learning goals and content among wound care experts. DESIGN A consensus-building approach using the Delphi technique. SETTINGS A Delphi panel of wound care experts built on an online platform. PARTICIPANTS The participants of the Delphi panel were registered nurses, authorised wound care nurses, nurse educators and physicians. METHODS Learning goals and content for wound care education which had been formulated on the basis of previous focus-group interviews were presented to the Delphi panel. The data were collected in 2021 with two online Delphi rounds: 51 panellists participated in the first round and 36 in the second round. The data were analysed using statistical and qualitative analysis. RESULTS Learning goals and content were divided into four competence areas: 1) Anatomy and physiology, 2) Care of chronic and acute wounds, 3) Wound management and care of a patient with a wound, 4) Values and attitudes. These competence areas comprised 26 learning goals and 29 pieces of content. The consensus between the panellists was high, at >90% in all competence areas. CONCLUSIONS The basis of registered nurses' wound care competence is built during their undergraduate nursing studies. The results of this study can be used to standardise wound care education by implementing consistent learning goals and content in Bachelor's level nursing education.
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Affiliation(s)
- Emilia Kielo-Viljamaa
- University of Turku, Department of Nursing Science, Finland; Novia University of Applied Sciences, Finland.
| | - Jaakko Viljamaa
- Turku University Hospital, Finland; University of Turku, Finland
| | - Riitta Suhonen
- University of Turku, Department of Nursing Science, Finland; Turku University Hospital, Finland; City of Turku, Welfare Division, Finland
| | - Leena Salminen
- University of Turku, Department of Nursing Science, Finland; Turku University Hospital, Finland
| | - Minna Stolt
- University of Turku, Department of Nursing Science, Finland
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