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Gagnon J, Chartrand J, Probst S, Lalonde M. Content of a wound care mobile application for newly graduated nurses: an e-Delphi study. BMC Nurs 2024; 23:331. [PMID: 38755617 PMCID: PMC11097557 DOI: 10.1186/s12912-024-02003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 05/09/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Wound care represents a considerable challenge, especially for newly graduated nurses. The development of a mobile application is envisioned to improve knowledge transfer and facilitate evidence-based practice. The aim of this study was to establish expert consensus on the initial content of the algorithm for a wound care mobile application for newly graduated nurses. METHODS Experts participated in online surveys conducted in three rounds. Twenty-nine expert wound care nurses participated in the first round, and 25 participated in the two subsequent rounds. The first round, which was qualitative, included a mandatory open-ended question solicitating suggestions for items to be included in the mobile application. The responses underwent content analysis. The subsequent two rounds were quantitative, with experts being asked to rate their level of agreement on a 5-point Likert scale. These rounds were carried out iteratively, allowing experts to review their responses and see anonymized results from the previous round. We calculated the weighted kappa to determine the individual stability of responses within-subjects between the quantitative rounds. A consensus threshold of 80% was predetermined. RESULTS In total, 80 items were divided into 6 categories based on the results of the first round. Of these, 75 (93.75%) achieved consensus during the two subsequent rounds. Notably, 5 items (6.25%) did not reach consensus. The items with the highest consensus related to the signs and symptoms of infection, pressure ulcers, and the essential elements for healing. Conversely, items such as toe pressure measurement, wounds around drains, and frostbite failed to achieve consensus. CONCLUSIONS The results of this study will inform the development of the initial content of the algorithm for a wound care mobile application. Expert participation and their insights on infection-related matters have the potential to support evidence-based wound care practice. Ongoing debates surround items without consensus. Finally, this study establishes expert wound care nurses' perspectives on the competencies anticipated from newly graduated nurses.
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Affiliation(s)
- Julie Gagnon
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada.
- Département des sciences de la santé, Université du Québec à Rimouski, Rimouski, Québec, G5L 3A1, Canada.
| | - Julie Chartrand
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Sebastian Probst
- HES-SO, University of Applied Sciences and Arts Western Switzerland, 47 Avenue de Champel, Geneva, 1206, Switzerland
- Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton VIC 3168, Melbourne, Australia
- College of Medicine, Nursing and Health Sciences, University of Galway, University Road, Galway, H91TK33, Ireland
- Care Directorate, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, 1205, Switzerland
| | - Michelle Lalonde
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
- Institut du Savoir Montfort, Montfort Hospital, 745A Montréal Road, Suite 202, Ottawa, ON, K1K 0T1, Canada
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Swanson T, Ousey K, Haesler E, Bjarnsholt T, Carville K, Idensohn P, Kalan L, Keast DH, Larsen D, Percival S, Schultz G, Sussman G, Waters N, Weir D. IWII Wound Infection in Clinical Practice consensus document: 2022 update. J Wound Care 2022; 31:S10-S21. [PMID: 36475844 DOI: 10.12968/jowc.2022.31.sup12.s10] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clinical Practice consensus document. The updated document summarises current evidence and provides multidisciplinary healthcare providers with effective guidance and support on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII-WIC) and management plan. The aim of the 2022 IWII consensus document update was to provide an accessible and useful clinical resource in at least six languages, incorporating the latest evidence and current best practice for wound infection and prevention. Dissemination techniques for the consensus are discussed and highlighted.
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Affiliation(s)
| | - Karen Ousey
- Professor of Skin Integrity, Institute of Skin Integrity and Infection Prevention, University of Huddersfield, UK.,Adjunct Professor, School of Nursing, Queensland University of Technology, Australia.,Visiting Professor, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Emily Haesler
- Adjunct Professor, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.,Adjunct Associate Professor, Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Australia.,Honorary Senior Lecturer, The Australian National University Medical School, Canberra, Australia
| | - Thomas Bjarnsholt
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Keryln Carville
- Professor of Primary Health Care, Silver Chain and Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | - Patricia Idensohn
- Wound Nurse Specialist, Educator & Consultant in Private Practice, CliniCare, Ballito, South Africa.,Principal Lecturer and Co-Ordinator, School of Nursing, University of the Free State, South Africa
| | - Lindsay Kalan
- Medical Microbiology & Immunology, University of Wisconsin, US
| | - David H Keast
- Parkwood Institute, St Joseph's Healthcare, London, Canada
| | | | - Steven Percival
- Professor (Honorary), University of Liverpool, UK.,CEO and Director, Biofilm Centre, 5D Health Protection Group Ltd, Liverpool, UK
| | - Gregory Schultz
- Emeritus Professor of Obstetrics & Gynecology, University of Florida, US
| | - Geoff Sussman
- Associate Professor of Wound Care, Faculty of Medicine, Nursing and Health Science, Monash University, Australia.,Clinical Lecturer Medical Education, University of Melbourne, Australia
| | - Nicola Waters
- Senior Research Associate, Health, The Conference Board of Canada.,Adjunct Professor, University of British Columbia, Okanagan, Canada
| | - Dot Weir
- Clinician, Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, Saratoga Springs, New York, US.,Co-chair, Symposium on Advanced Wound Care, US.,Faculty, Wound Certification Prep Course, US
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Johnson AC, Buchanan EP, Khechoyan DY. Wound infection: A review of qualitative and quantitative assessment modalities. J Plast Reconstr Aesthet Surg 2021; 75:1287-1296. [PMID: 35216936 DOI: 10.1016/j.bjps.2021.11.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 05/26/2021] [Accepted: 11/12/2021] [Indexed: 12/20/2022]
Abstract
Surgical site infections (SSI) and chronic wounds represent a burden to patients and the health care system. One in 24 surgical patients will develop an SSI, making SSI the most common nosocomial infection in the USA. Early detection and monitoring of wound infection are critical for timely healing and return to normal function. However, the mainstay of wound infection diagnostic entails subjective clinical examination and semi-quantitative, invasive microbiological tests. In this review, we present current wound infection assessment modalities in the clinical and translational fields. There is a need for a point-of-care assessment tool that provides fast, accurate, and quantitative information on wound status, with minimal to no contact with the patient. In the next ten years, the evolution of wound diagnostic tools reported here may allow medical providers to optimize patient care while minimizing patient discomfort.
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Affiliation(s)
- Ariel C Johnson
- Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Edward P Buchanan
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA; Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX, USA
| | - David Y Khechoyan
- Department of Pediatric Plastic Surgery, Children's Hospital Colorado, Aurora, CO, USA.
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Arendsen LP, Thakar R, Bassett P, Sultan AH. A double blind randomized controlled trial using copper impregnated maternity sanitary towels to reduce perineal wound infection. Midwifery 2020; 92:102858. [PMID: 33157498 DOI: 10.1016/j.midw.2020.102858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the effect of copper impregnated sanitary towels on the infection rate following vaginal delivery (VD). DESIGN Single center double blind randomized controlled trial. PARTICIPANTS Women aged 18 or over who had a sutured second-degree tear or episiotomy following VD. INTERVENTIONS All women were randomized to receive either a copper-oxide impregnated sanitary towel (study group) or a non-copper sanitary towel (control group). MAIN OUTCOME MEASURES The primary study outcome was the incidence of wound infection within a 30-day period from VD, assessed via telephone questionnaire. Secondary outcomes were length of hospital stay and risk factors of infection. RESULTS 450 women were enrolled in the study of whom 225 were randomized to the copper impregnated sanitary towel (study group) and 225 to the non-copper sanitary towel (control group) group. Follow-up rate was 98.2%. A total of 102 women (23.1%) developed an infection within 30 days following VD, 19 in the study group (8.6%) and 83 (37.4%) in the control group (P = <0.001, absolute risk reduction (ARR) of 28.8%). The incidence of superficial/deep and organ/space infections was significantly lower in the study group (7.7% vs. 30.2%, P = <0.001 and 4.6% vs. 31.5%, P = <0.001 respectively) with an ARR of 22.5% and 27.0% respectively. Multivariable analysis reported Asian ethnicity and prolonged rupture of membranes as significant risk factors; for the development of infection (OR 1.91, P = 0.03 and OR = 1.97, P = 0.04 respectively). CONCLUSIONS This is the first study to demonstrate a significant reduction in infection rate following VD with the use of copper impregnated sanitary towels.
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Affiliation(s)
- Linda Petra Arendsen
- Obstetrics and Gynaecology Department, Croydon University Hospital, 530 London Road, CR7 7YE, United Kingdom
| | - Ranee Thakar
- Obstetrics and Gynaecology Department, Croydon University Hospital, 530 London Road, CR7 7YE, United Kingdom
| | - Paul Bassett
- Statsconsultancy Ltd, 40 Longwood Lane, Amersham, Bucks, HP7 9EN, United Kingdom
| | - Abdul Hameed Sultan
- Obstetrics and Gynaecology Department, Croydon University Hospital, 530 London Road, CR7 7YE, United Kingdom; Honorary Reader, St George's University of London, Cranmer Terrace, SW17 0RE, United Kingdom.
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