1
|
Timko-Progar M, Drain J, Stovall-Patton K. Implementation of an Evidence-Based, Content-Validated, Standardized Support Surface Algorithm Tool in Home Health Care: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2024; 51:101-106. [PMID: 38527317 DOI: 10.1097/won.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE The purpose of this quality improvement project was to provide a standardized, repeatable, and easy-to-use process for selecting a support surface for prevention or treatment of pressure injuries (PIs). PARTICIPANTS AND SETTING The Wound, Ostomy, and Continence Nurses Society Support Surface Algorithm was chosen to guide clinicians in selection of an appropriate support surface. These clinicians provide services to approximately 465,000 patients across the nation annually. APPROACH This quality improvement project aimed to establish clinician knowledge and comfort levels when recommending a support surface and providing a standardized way to identify the appropriate support surface once a patient had been identified as at risk. The support surface algorithm was incorporated into our agency's electronic medical record (EMR); we chose this interactive algorithm to facilitate support surface selection among clinicians with no specialized expertise in PI treatment or prevention. OUTCOMES Clinicians reported an increase in knowledge and comfort levels in the ability to select an appropriate support surface following implementation of the clinical decision support tool. Benchmarking data illustrated a decrease in the year over year aggregate (September 2018 to September 2021) trending for the Centers for Medicare & Medicaid Services quality outcome measures surrounding potentially avoidable events related to PIs. IMPLICATIONS FOR PRACTICE Implementing the support surface algorithm assisted clinicians with support surface selection, elevated and standardized clinician practice, and reduced potentially avoidable events. As a result of this project, the Wound, Ostomy, and Continence Nurses Society Support Surface Algorithm Tool has been fully integrated into our EMR and is a standardized part of our clinical assessment.
Collapse
Affiliation(s)
- Monica Timko-Progar
- Monica Timko-Progar, BSN, RN, ET, CWS®, FACCWS, Amedisys Home Health and Hospice Care, Washington, Pennsylvania
- Jerri Drain, MBA, BSN, RN, CWON, Amedisys Home Health and Hospice Care, Bunch, Oklahoma
- Kimberly Stovall-Patton, DNP, MSN, RN, COS-C, CWON, Amedisys Home Health and Hospice Care, Cedar Park, Texas
| | - Jerri Drain
- Monica Timko-Progar, BSN, RN, ET, CWS®, FACCWS, Amedisys Home Health and Hospice Care, Washington, Pennsylvania
- Jerri Drain, MBA, BSN, RN, CWON, Amedisys Home Health and Hospice Care, Bunch, Oklahoma
- Kimberly Stovall-Patton, DNP, MSN, RN, COS-C, CWON, Amedisys Home Health and Hospice Care, Cedar Park, Texas
| | - Kimberly Stovall-Patton
- Monica Timko-Progar, BSN, RN, ET, CWS®, FACCWS, Amedisys Home Health and Hospice Care, Washington, Pennsylvania
- Jerri Drain, MBA, BSN, RN, CWON, Amedisys Home Health and Hospice Care, Bunch, Oklahoma
- Kimberly Stovall-Patton, DNP, MSN, RN, COS-C, CWON, Amedisys Home Health and Hospice Care, Cedar Park, Texas
| |
Collapse
|
2
|
Meaume S, Marty M. Prevention of pressure injuries using a non-motorised decompression air mattress: a non-interventional study. J Wound Care 2023; 32:538-543. [PMID: 37682790 DOI: 10.12968/jowc.2023.32.9.538] [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] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Prevention of pressure injuries (PI) is a public health issue. Among the preventive measures, the use of support surfaces adapted to the risk of PI occurrence is recommended. This study aimed to report the incidence of PIs in patients at medium-to-high risk of occurrence of PIs and using a new non-motorised automated decompression air mattress combined with other recommended PI prevention measures. METHOD An observational, national, multicentre, prospective, non-comparative study, with a follow-up period of 35 days was conducted. Patients at medium-to-high risk of PIs and without PIs at baseline were included if they were lying on a specific non-powered automated decompression air mattress. The primary outcome was the percentage of patients who developed at least one category 2 or more severe PI of the sacrum, backbone or heel between day 0 and day 35. RESULTS In total, 81 patients were included from four participating centres. There was one report of a patient with a PI that fitted within the definition of the primary outcome, meaning an incidence of 1.2% (95% confidence interval (CI) 0-6.7%). More than 80% of patients rated the overall comfort and the stability of the non-motorised automated decompression air mattress as satisfactory or very satisfactory. In more than 80% of cases, the healthcare teams found the use of the mattress to be easy or very easy. CONCLUSION This study has shown that in combination with other preventive measures, the use of a specific non-motorised air mattress with automated decompression is associated with a low incidence of PIs in patients with medium-to-high risk of occurrence of PIs.
Collapse
Affiliation(s)
- Sylvie Meaume
- Rothschild Hospital, Geriatric Department and Wound Care Unit, Assistance Publique Hôpitaux de Paris, 75000 Paris, France
| | - Marc Marty
- Independent Methodologist in Clinical Research, 94000 Créteil, France
| |
Collapse
|
3
|
Context for Practice: Refocusing on Prevention and Management in a World Recovering From the COVID-19 Pandemic. J Wound Ostomy Continence Nurs 2022; 49:505-509. [PMID: 36417371 DOI: 10.1097/won.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
4
|
Compression for Lower Extremity Venous Disease and Lymphedema (CLEVDAL): Update of the VLU Algorithm. J Wound Ostomy Continence Nurs 2022; 49:331-346. [PMID: 35809009 DOI: 10.1097/won.0000000000000889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The Wound, Ostomy and Continence Nurses (WOCN) Society charged a task force with updating the venous leg ulcer (VLU) algorithm to include the addition of lymphedema with the new title of "Compression for Lower Extremity Venous Disease and Lymphedema (CLEVDAL)." As part of the process, the task force was charged to develop consensus-based statements to serve as clinical guidance related to CLEVDAL. The 3-member task force assisted by a moderator completed a scoping literature review to identify recommendations supported by research to qualify as evidence-based and to identify areas where guidance is needed to provide CLEVDAL. Based on the findings of the scoping review, the WOCN Society convened a panel of experts to develop consensus statements to direct care for those with lower extremity venous disease and lymphedema. These consensus statements underwent a second round of content validation with a different panel of clinicians with expertise in venous disease and lymphedema management. This article reports on the scoping review and subsequent evidence-based statements, along with the generation and validation of consensus-based statements to assist clinical decision-making in the CLEVDAL algorithm.
Collapse
|
5
|
Abstract
The Wound, Ostomy, and Continence Nurses (WOCN) Society identified the need to define and promote peristomal skin health. A task force was appointed to complete a scoping literature review, to develop evidence-based statements to guide peristomal skin health best practices. Based on the findings of the scoping review, the Society convened a panel of experts to develop evidence- and consensus-based statements to guide care in promoting peristomal skin health. These consensus statements also underwent content validation using a different panel of clinicians having expertise in peristomal skin health. This article reports on the scoping review and subsequent 6 evidenced-based statements, along with the generation and validation of 19 consensus-based statements, to assist clinical decision-making related to promoting peristomal skin health in adults.
Collapse
|
6
|
Meaume S, Rousseaux C, Marty M. Incidence of pressure ulcer in patients using an alternating pressure mattress overlay: the ACTIVE study. J Wound Care 2021; 30:143-149. [PMID: 33573487 DOI: 10.12968/jowc.2021.30.2.143] [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: 11/11/2022]
Abstract
OBJECTIVE The primary objective was to determine the clinical benefit of using a specific alternating-pressure mattress overlay (APMO) in the prevention of pressure ulcer (PU) in patients at medium to high risk. METHOD This prospective study was conducted in five rehabilitation centres and three nursing homes. Patients at medium to high risk of PU, but without PU at baseline, and lying between 15 and 20 hours per day on a specific APMO were included. The primary endpoint was the percentage of patients who developed a sacral, spine, heel or trochanteric PU (supine support areas) of at least category II, at day 35. All patients were included in the analysis. RESULTS A total of 89 patients were included; of whom six patients (6.7%) dropped out of the study (average (±standard deviation) follow-up 32±5.4 days). No sacral, spine, heel or trochanteric PU of at least category II was reported (i.e., an incidence of 0% [95% Confidence Interval: 0-4.1%] according to the exact Clopper-Pearson method]. Patients were 'satisfied' or 'very satisfied' with the comfort and stability of the APMO. The caregivers assessed as 'very easy' or 'easy' the implementation, maintenance and use of the APMO (turning over, moving to a sitting position). CONCLUSION In combination with the usual measures to prevent PU, the results of our study showed a low incidence of PU in high-risk patients lying for between 15 and 20 hours a day on an APMO, use of which is therefore recommended in these patients.
Collapse
Affiliation(s)
- Sylvie Meaume
- Rothschild Hospital - Geriatric Department and Wound Care Unit, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Marc Marty
- Rothschild Hospital - Geriatric Department and Wound Care Unit, Assistance Publique Hôpitaux de Paris, Paris, France
| |
Collapse
|
7
|
Lesão por pressão decorrente do posicionamento cirúrgico e fatores associados. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao00642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
8
|
A Multicenter, Comparative Study of Two Pressure-Redistribution Mattresses with Repositioning Intervals for Critical Care Patients. Adv Skin Wound Care 2020; 33:1-9. [PMID: 32058444 DOI: 10.1097/01.asw.0000653160.13611.5d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the effectiveness of two protocols for preventing pressure injuries (PIs) in Chinese hospitals. DESIGN AND SETTING A multicenter, open-label, comparative study conducted in seven Chinese acute care hospitals. PATIENTS AND INTERVENTION In total, 1,654 eligible patients were identified, and 1,204 were enrolled in the study. Enrolled patients were randomly assigned into the trial group (4-hour repositioning combined with a viscoelastic foam mattress; n = 602) or the control group (2-hour repositioning combined with a powered air pressure redistribution mattress; n = 602). Participants received their respective protocols until they were discharged, died, or for at least 7 days. MAIN OUTCOME MEASURES The incidence of PIs, Braden Scale scores, and the time to development of PIs. MAIN RESULTS Ultimately, 596 trial group patients and 598 control group patients were analyzed. Thirteen patients had single new stage 2 or worse PIs. The total incidence of PIs was 1.1%. The difference between the two groups was significant (0.3% vs 1.8%). However, the difference between the groups' Braden Scale score median during the intervention was not significant (13 vs 13.5). CONCLUSIONS The 4-hour repositioning interval combined with a viscoelastic foam mattress did not increase PI incidence or risk. These findings could help providers select the right pressure redistribution mattresses and repositioning intervals for critical care patients.
Collapse
|
9
|
Interventions Post Catheter Removal (iPCaRe) in the Acute Care Setting. J Wound Ostomy Continence Nurs 2020; 47:601-618. [DOI: 10.1097/won.0000000000000704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
|
11
|
Wound Healing in the Long-Term Acute Care Setting Using an Air Fluidized Therapy/Continuous Low-Pressure Therapeutic Bed: A Multiple Case Series. J Wound Ostomy Continence Nurs 2020; 47:284-290. [PMID: 32384532 DOI: 10.1097/won.0000000000000646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND We evaluated a new bed that updates the functionality of the current air fluidized therapy (AFT)/continuous low-pressure (CLP) pressure redistributing beds. This bed was evaluated in conjunction with standard wound care interventions in a long-term acute care hospital (LTACH). The AFT feature is designed to provide pressure distribution via a fluid-like medium that forces air though millions of tiny silicone beads that float the patient's body to achieve maximum immersion and envelopment. The CLP feature of the bed provides pressure distribution for the upper body. Standard wound care was provided that included debridement, topical treatments, and biophysical therapies such as negative pressure wound therapy, as indicated. CASES Our multiple case series comprised 10 medically compromised patients with 25 wounds. Their mean age was 63 years, 50% were male, and the mean cumulative Braden Scale score was 12.4 out of 23, indicating a high risk for pressure injury (PI). Seven of 10 patients were incontinent of urine, 6 had fecal incontinence, and 2 had ostomies. Types of wounds treated included 2 large tissue defects from surgical excisions for the treatment of gangrene and 23 PIs. On admission, wounds had an average surface area of 139.1 cm. The mean percentage of reduction in wound surface area was 59.3% over an average of 31.3 days of therapy. No new wounds formed during their course of care despite being at elevated risk. CONCLUSIONS Findings from this multiple case series suggest that the AFT/CLP bed facilitates healing of advanced wounds in medically complex patients when included as part of a wound care program. Despite mild to high risk, no new PIs developed, and severe PIs and large tissue defects significantly improved or completely resolved. One hundred percent of surveyed staff members recommend use of the AFT/CLP bed.
Collapse
|
12
|
Scientific and Clinical Abstracts From WOCNext 2020 Reimagined. J Wound Ostomy Continence Nurs 2020. [DOI: 10.1097/won.0000000000000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
13
|
Abstract
This article discusses an evidence- and consensus-based support-surface algorithm designed to help clinicians choose the most appropriate support surface for preventing or treating pressure injuries based on patient, nurse, and institutional considerations.
Collapse
|
14
|
Abstract
OBJECTIVE To evaluate the effect of a pressure injury prevention algorithm on pressure injury prevention. DESIGN, SETTING, AND PARTICIPANTS This intervention study was conducted in the anesthesiology and reanimation ICU (ARICU) of a university hospital. The study included two sample groups (nurses and patients). All patients older than 18 years (prealgorithm, n = 80; postalgorithm, n = 74) in the ARICU who verbally consented were included in the study. All 15 nurses who worked in the ARICU during the postalgorithm period agreed to participate in the study. INTERVENTIONS The study was performed in four phases. In the first phase, pressure injury incidence was evaluated in the ARICU (prealgorithm period; April 1 to September 30, 2016). At the same time, a pressure injury prevention algorithm was developed. In the second phase, ARICU nurses were provided education on how to prevent pressure injury and use the pressure injury prevention algorithm. In the third phase, the nurses provided care based on the pressure injury prevention algorithm (postalgorithm period; November 1, 2016, to April 30, 2017). In the fourth phase, the incidence of pressure injury in the pre- and postalgorithm periods was compared, and the effectiveness of the algorithm was evaluated. MAIN RESULTS The pressure injury incidence was 46.10 per 1,000 patient-days in the prealgorithm period and 9.21 per 1,000 patient-days in the postalgorithm period. The decline was statistically significant (z = 9.590, P < .001). CONCLUSIONS Nursing education and the evidence-based pressure injury prevention algorithm reduced pressure injury rates. Further study of this algorithm in other ICUs and among various care populations is recommended to fully establish its efficacy.
Collapse
|
15
|
Beeckman D, Serraes B, Anrys C, Van Tiggelen H, Van Hecke A, Verhaeghe S. A multicentre prospective randomised controlled clinical trial comparing the effectiveness and cost of a static air mattress and alternating air pressure mattress to prevent pressure ulcers in nursing home residents. Int J Nurs Stud 2019; 97:105-113. [PMID: 31234104 DOI: 10.1016/j.ijnurstu.2019.05.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 05/25/2019] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pressure ulcers are a global issue and substantial concern for healthcare systems. Various types of support surfaces that prevent pressure ulcer are available. Data about the effectiveness and cost of static air support surfaces and alternating air pressure mattresses is lacking. OBJECTIVES To compare the effectiveness and cost of static air support surfaces versus alternating air pressure support surfaces in a nursing home population at high risk for pressure ulcers. DESIGN Prospective, multicentre, randomised controlled clinical, non-inferiority trial. SETTING Twenty-six nursing homes in Flanders, Belgium. PARTICIPANTS A consecutive sample of 308 participants was selected based on the following eligibility criteria: high risk for pressure ulcer and/or with category 1 pressure ulcer, being bedbound and/or chair bound, aged > 65 years, and use of an alternating air pressure mattress. METHODS The participants were allocated to the intervention group (n = 154) using static air support surfaces and the control group (n = 154) using alternating air pressure support surfaces. The main outcome measures were cumulative incidence and incidence density of the participants developing a new category II-IV pressure ulcer within a 14-day observation period, time to develop a new pressure ulcer, and purchase costs of the support surfaces. RESULTS The intention-to-treat analysis revealed a significantly lower incidence of category II-IV pressure ulcer in the intervention group (n = 8/154, 5.2%) than in the control group (n = 18/154, 11.7%) (p = 0.04). The median time to develop a pressure ulcer was significantly longer in the intervention group (10.5 days, interquartile range [IQR]: 1-14) than in the control group (5.4 days, [IQR]: 1-12; p = 0.05). The probability to remain pressure ulcer free differed significantly between the two study groups (log-rank X² = 4.051, df = 1, p = 0.04). The overall cost of the mattress was lower in the intervention group than in the control group. CONCLUSIONS A static air mattress was significantly more effective than an alternating air pressure mattress in preventing pressure ulcer in a high-risk nursing home population. Considering multiple lifespans and purchase costs, static air mattresses were more cost-effective than alternating air pressure mattresses.
Collapse
Affiliation(s)
- Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Ireland; School of Health Sciences, Örebro University, Sweden; Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Southern Denmark; School of Nursing and Midwifery, Monash University, Australia.
| | - Brecht Serraes
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Nursing department (General Hospital) AZ Nikolaas, Hospitaalstraat 1, B-9100 Sint-Niklaas, Belgium.
| | - Charlotte Anrys
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
| | - Hanne Van Tiggelen
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
| | - Ann Van Hecke
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
| | - Sofie Verhaeghe
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
| |
Collapse
|
16
|
Scientific and Clinical Abstracts From WOCNext 2019. J Wound Ostomy Continence Nurs 2019. [DOI: 10.1097/won.0000000000000530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
17
|
Peixoto CDA, Ferreira MBG, Felix MMDS, Pires PDS, Barichello E, Barbosa MH. Risk assessment for perioperative pressure injuries. Rev Lat Am Enfermagem 2019; 27:e3117. [PMID: 30698218 PMCID: PMC6336361 DOI: 10.1590/1518-8345.2677-3117] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 10/22/2018] [Indexed: 12/15/2022] Open
Abstract
Objectives: to evaluate and classify patients according to the Risk Assessment Scale for Perioperative Pressure Injuries; verify the association between sociodemographic and clinical variables and the risk score; and identify the occurrence of pressure injuries due to surgical positioning. Method: observational, longitudinal, prospective and quantitative study carried out in a teaching hospital with 278 patients submitted to elective surgeries. A sociodemographic and clinical characterization questionnaire and the Risk Assessment Scale for Perioperative Pressure Injuries were used. Descriptive, bivariate and logistic regression analyses were applied. Results: the majority of patients (56.5%) presented a high risk for perioperative pressure injury. Female sex, elderly group, and altered body mass index values were statistically significant (p < 0.05) for a higher risk of pressure injuries. In 77% of the patients, there were perioperative pressure injuries. Conclusion: most of the participants presented a high risk for development of perioperative decubitus ulcers. The female sex, elderly group, and altered body mass index were significant factors for increased risk. The Risk Assessment Scale for Perioperative Pressure Injuries allows the early identification of risk of injury, subsidizing the adoption of preventive strategies to ensure the quality of perioperative care.
Collapse
Affiliation(s)
- Camila de Assunção Peixoto
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências da Saúde, Uberaba, MG, Brazil.,Prefeitura Municipal de Uberaba, Secretaria Municipal de Saúde, Uberaba, MG, Brazil
| | | | | | - Patrícia da Silva Pires
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências da Saúde, Uberaba, MG, Brazil
| | - Elizabeth Barichello
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências da Saúde, Uberaba, MG, Brazil
| | - Maria Helena Barbosa
- Universidade Federal do Triângulo Mineiro, Instituto de Ciências da Saúde, Uberaba, MG, Brazil
| |
Collapse
|
18
|
Wound, Ostomy, and Continence Nursing: Scope and Standards of WOC Practice, 2nd Edition: An Executive Summary. J Wound Ostomy Continence Nurs 2019; 45:369-387. [PMID: 29698290 DOI: 10.1097/won.0000000000000438] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Wound, ostomy, and continence (WOC) nursing was recognized as a nursing specialty by the American Nurses Association in February 2010, and the Society published the original scope and standards of WOC nursing practice in May 2010. The Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition is the definitive resource promoting excellence in professional practice, quality care, and improved patient outcomes in WOC specialty practice. It can be used to articulate the value of WOC nurses to administrators, legislators, payers, patients, and others. The second edition also provides an overview of the scope of WOC nursing practice including a description of the specialty, the history and evolution of WOC nursing, characteristics of WOC nursing practice, and description of the trispecialty. The document describes various WOC nurse roles, populations served, practice settings, care coordination, and collaboration. Educational preparation, levels of practice within WOC specialty nursing, certification, mandate for continuous professional development, ethics, current trends, future considerations and challenges, and standards of WOC nursing practice and professional performance with competencies for each standard are provided. The purpose of this Executive Summary is to describe the process for developing the scope and standards document, provide an overview of the scope of WOC nursing practice, and list the standards of practice and professional performance along with the competencies for each level of WOC nurse provider. The original document is available from the WOCN Society's online book store (www.wocn.org).
Collapse
|
19
|
de Oliveira KF, Pires PDS, De-Mattia AL, Barichello E, Galvão CM, de Araújo CA, Barbosa MH. Influence of support surfaces on the distribution of body interface pressure in surgical positioning. Rev Lat Am Enfermagem 2018; 26:e3083. [PMID: 30517574 PMCID: PMC6280176 DOI: 10.1590/1518-8345.2692.3083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/11/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE to evaluate the interface pressure (IP) of support surfaces (SSs) on bony prominences. METHOD a quasi-experimental study with repeated measures on each SS. Twenty healthy adult volunteers participated in the study. The participants were placed in the supine position on a standard operating table for evaluation of IP on the bony prominences of the occipital, subscapular, sacral, and calcaneal regions using sensors. Seven evaluations were performed for each bony prominence: one on a standard operating table, and the others on tables containing SSs made of viscoelastic polymer, soft foam, or sealed foam. Descriptive statistics and analysis of variance were used to analyze the data. RESULTS the mean IP was higher on the viscoelastic polymer-based SS compared to the other SSs (p<0.001). The mean IP was relatively lower on the density-33 sealed foam and density-18 soft foam. In addition, this variable was comparatively higher in the sacral region (42.90 mmHg) and the calcaneal region (15.35 mmHg). CONCLUSION IP was relatively lower on foam-based SSs, especially on density-18 soft foam and density-33 sealed foam. Nonetheless, IP was not reduced on the viscoelastic polymer SS compared to the control SS.
Collapse
Affiliation(s)
- Karoline Faria de Oliveira
- Universidade Federal do Triângulo Mineiro, Departamento de
Enfermagem na Assistência Hospitalar, Uberaba, Minas Gerais, Brazil
| | | | - Ana Lúcia De-Mattia
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo
Horizonte, Minas Gerais, Brazil
| | - Elizabeth Barichello
- Universidade Federal do Triângulo Mineiro, Departamento de
Enfermagem na Assistência Hospitalar, Uberaba, Minas Gerais, Brazil
| | - Cristina Maria Galvão
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
| | - Cleudmar Amaral de Araújo
- Universidade Federal de Uberlândia, Faculdade de Engenharia
Mecânica, Uberlândia, Minas Gerais, Brazil
| | - Maria Helena Barbosa
- Universidade Federal do Triângulo Mineiro, Departamento de
Enfermagem na Assistência Hospitalar, Uberaba, Minas Gerais, Brazil
| |
Collapse
|
20
|
A Prospective Randomized Clinical Trial of a Novel, Noninvasive Perfusion Enhancement System for the Prevention of Hospital-Acquired Sacral Pressure Injuries. J Wound Ostomy Continence Nurs 2018; 45:310-318. [DOI: 10.1097/won.0000000000000450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Schaarup C, Pape-Haugaard LB, Hejlesen OK. Models Used in Clinical Decision Support Systems Supporting Healthcare Professionals Treating Chronic Wounds: Systematic Literature Review. JMIR Diabetes 2018; 3:e11. [PMID: 30291078 PMCID: PMC6238865 DOI: 10.2196/diabetes.8316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 04/17/2018] [Accepted: 05/03/2018] [Indexed: 12/17/2022] Open
Abstract
Background Chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers are a massive burden to health care facilities. Many randomized controlled trials on different wound care elements have been conducted and published in the Cochrane Library, all of which have only a low evidential basis. Thus, health care professionals are forced to rely on their own experience when making decisions regarding wound care. To progress from experience-based practice to evidence-based wound care practice, clinical decision support systems (CDSS) that help health care providers with decision-making in a clinical workflow have been developed. These systems have proven useful in many areas of the health care sector, partly because they have increased the quality of care, and partially because they have generated a solid basis for evidence-based practice. However, no systematic reviews focus on CDSS within the field of wound care to chronic wounds. Objective The aims of this systematic literature review are (1) to identify models used in CDSS that support health care professionals treating chronic wounds, and (2) to classify each clinical decision support model according to selected variables and to create an overview. Methods A systematic review was conducted using 6 databases. This systematic literature review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for systematic reviews. The search strategy consisted of three facets, respectively: Facet 1 (Algorithm), Facet 2 (Wound care) and Facet 3 (Clinical decision support system). Studies based on acute wounds or trauma were excluded. Similarly, studies that presented guidelines, protocols and instructions were excluded, since they do not require progression along an active chain of reasoning from the clinicians, just their focus. Finally, studies were excluded if they had not undergone a peer review process. The following aspects were extracted from each article: authors, year, country, the sample size of data and variables describing the type of clinical decision support models. The decision support models were classified in 2 ways: quantitative decision support models, and qualitative decision support models. Results The final number of studies included in the systematic literature review was 10. These clinical decision support models included 4/10 (40%) quantitative decision support models and 6/10 (60%) qualitative decision support models. The earliest article was published in 2007, and the most recent was from 2015. Conclusions The clinical decision support models were targeted at a variety of different types of chronic wounds. The degree of accessibility of the inference engines varied. Quantitative models served as the engine and were invisible to the health care professionals, while qualitative models required interaction with the user.
Collapse
Affiliation(s)
- Clara Schaarup
- Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
| | | | - Ole Kristian Hejlesen
- Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
| |
Collapse
|
22
|
Assessment, Selection, Use, and Evaluation of Body-Worn Absorbent Products for Adults With Incontinence. J Wound Ostomy Continence Nurs 2018; 45:243-264. [DOI: 10.1097/won.0000000000000431] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
23
|
The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients: A Prospective Randomized Controlled Trial. J Wound Ostomy Continence Nurs 2017; 44:440-444. [PMID: 28877109 DOI: 10.1097/won.0000000000000359] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to compare a viscoelastic foam overlay (VEFO) to a standard hospital mattress for pressure injury (PI) prevention. We also compared interface pressures (IPs) of the VEFO to our facility's standard hospital mattress. DESIGN Prospective, randomized controlled trial. SUBJECTS AND SETTING Data analysis was based on 110 participants (55 in each group) who were 19 years or older, had a Braden Scale for Pressure Sore Risk score of 16 or less, and were cared for on a neurology, oncology, or pulmonology inpatient care unit. The research setting was the Samsung Medical Center in Seoul, South Korea. METHODS Participants were divided into 2 groups: the experimental group were based on a VEFO on top of the standard hospital mattress used in our facility. Participants in the control group were placed on a standard hospital mattress with/without air overlay. All patients were given standard nursing care for prevention of PI. Skin assessments were completed daily over a period of 2 weeks. In addition, we compared IPs of the standard hospital mattress and the VEFO in participants randomly allocated to the intervention group. Interface pressure was measured over the sacral/coccygeal area with subjects in the supine position. Pressures were measured immediately before and immediately following placement of the VEFO and just before data collection began. Data were collected between October 2013 and November 2014. Pressure injury incidence was compared between groups using the χ test, and IPs were compared using the paired t test. INSTRUMENTS Pressure injury development was determined using the staging system described in guidelines from the National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance in 2014. Interface pressure was measured using a device manufactured for this purpose. RESULTS The incidence of PI development was significantly lower in subjects assigned to the experimental group as compared to those in the control group (3.6%-27.3% over the 2-week data collection period; P = .001). The maximum IP was significantly lower on the VEFO with standard hospital mattress than on the standard hospital mattress (paired t = 8.87, P < .001). CONCLUSIONS Patients managed with a VEFO had a significantly lower incidence of PI than those managed with a standard hospital mattress. Additional research is needed to further characterize the efficacy of the VEFO, its effect on PI healing, and its effect of PI prevention in high-risk populations such as critically ill patients.
Collapse
|
24
|
Moya-Suárez AB, Morales-Asencio JM, Aranda-Gallardo M, Enríquez de Luna-Rodríguez M, Canca-Sánchez JC. Development and psychometric validation of a questionnaire to evaluate nurses' adherence to recommendations for preventing pressure ulcers (QARPPU). J Tissue Viability 2017; 26:260-270. [PMID: 28911962 DOI: 10.1016/j.jtv.2017.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 05/29/2017] [Accepted: 09/01/2017] [Indexed: 12/15/2022]
Abstract
AIM OF THE STUDY The main objective of this work is the development and psychometric validation of an instrument to evaluate nurses' adherence to the main recommendations issued for preventing pressure ulcers. MATERIAL AND METHODS An instrument was designed based on the main recommendations for the prevention of pressure ulcers published in various clinical practice guides. Subsequently, it was proceeded to evaluate the face and content validity of the instrument by an expert group. It has been applied to 249 Spanish nurses took part in a cross-sectional study to obtain a psychometric evaluation (reliability and construct validity) of the instrument. The study data were compiled from June 2015 to July 2016. RESULTS From the results of the psychometric analysis, a final 18-item, 4-factor questionnaire was derived, which explained 60.5% of the variance and presented the following optimal indices of fit (CMIN/DF: 1.40 p < 0.001; GFI: 0.93; NFI: 0.92; CFI: 0.98; TLI: 0.97; RMSEA: 0.04 (90% CI 0.025-0.054). CONCLUSIONS The results obtained show that the instrument presents suitable psychometric properties for evaluating nurses' adherence to recommendations for the prevention of pressure ulcers.
Collapse
Affiliation(s)
- Ana Belén Moya-Suárez
- Department of Nursing, Agencia Sanitaria Costa del Sol, Ctra. Nacional 340, Km. 187 Marbella, Málaga, Spain.
| | - José Miguel Morales-Asencio
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa, Ampliación del Campus de Teatinos, 29071, Málaga, Spain.
| | - Marta Aranda-Gallardo
- Department of Nursing, Agencia Sanitaria Costa del Sol, Ctra. Nacional 340, Km. 187 Marbella, Málaga, Spain.
| | | | - José Carlos Canca-Sánchez
- Department of Nursing, Agencia Sanitaria Costa del Sol, Ctra. Nacional 340, Km. 187 Marbella, Málaga, Spain.
| |
Collapse
|
25
|
de Oliveira KF, Nascimento KG, Nicolussi AC, Chavaglia SRR, de Araújo CA, Barbosa MH. Support surfaces in the prevention of pressure ulcers in surgical patients: An integrative review. Int J Nurs Pract 2017. [PMID: 28643855 DOI: 10.1111/ijn.12553] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the scientific evidence about the types of support surfaces used in intraoperative surgical practice in the prevention of pressure ulcers due to surgical positioning. METHOD This is an integrative literature review. The electronic databases Cochrane, PubMed, Web of Science, Scopus, Lilacs, and CINAHL were used. The descriptors surgical patients, support surfaces, perioperative care, patient positioning, and pressure ulcer were used in the search strategy. Articles that addressed the use of support surfaces intraoperatively, published between 1990 and 2016, were selected. The PRISMA guidelines were used to structure the review. RESULTS Of 18 evaluated studies, most were in English, followed by Portuguese and Spanish; most were performed by nurses. The most commonly cited support surfaces were viscoelastic polymer, micropulse mattresses, gel based mattresses, and foam devices. CONCLUSION There are gaps in knowledge regarding the most efficient support surfaces and the specifications of the products used to prevent pressure ulcers due to surgical positioning.
Collapse
|
26
|
Scientific and Clinical Abstracts From the WOCN® Society's 49th Annual Conference. J Wound Ostomy Continence Nurs 2017. [DOI: 10.1097/won.0000000000000331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
27
|
Context for Practice. J Wound Ostomy Continence Nurs 2017; 44:208-209. [DOI: 10.1097/won.0000000000000336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|