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Chuang ST, Liao PL, Lo SF, Chang YT, Hsu HT. Effectiveness of an E-Book App on the Knowledge, Attitudes and Confidence of Nurses to Prevent and Care for Pressure Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15826. [PMID: 36497905 PMCID: PMC9737897 DOI: 10.3390/ijerph192315826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
AIMS This study evaluates the effectiveness of an interactive E-book app training program in improving nurses' knowledge, attitudes, and confidence to prevent and care for pressure injury. DESIGN Randomized experimental study. METHODS Participants were recruited from a teaching hospital in Taiwan. The study was carried out between 20 March 2014 to 1 April 2016. In total, 164 participants were randomly assigned to a pressure injury E-book app training program (n = 86) or a conventional education program (n = 78) with a one-month follow-up. Outcome variables were levels of pressure injury knowledge, attitudes, and confidence of pressure injury care. RESULTS Participants answered 51.96% of the pressure injury knowledge questions correctly before the intervention and 75.5% after the intervention. The pressure injury attitude score was slightly positive, with moderate confidence in pressure injury care. The knowledge, attitudes, and confidence of pressure injury care of the two groups in the pretest and posttest groups increased significantly. Analysis of covariance indicated that nurses in the pressure injury E-book app group had significantly greater improvement in knowledge, attitudes, and pressure injury care confidence as compared with the control group. CONCLUSION The pressure injury E-book app interactive training program was effective in improving nurses' knowledge and attitudes toward pressure injury care and in enhancing their confidence in pressure injury care; therefore, this program has potential for nurses' in-service education in both Taiwan and worldwide. IMPACT E-book apps allow individuals to control the time and place of learning. Direct observation of procedural skills can provide feedback to trainees on techniques to ensure learning effectiveness and pressure injury care quality.
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Affiliation(s)
- Shu-Ting Chuang
- Taichung Tzu Chi Hospital, No. 88, Section 1, Fengxing Road, Taichung 427, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, No. 880, Section 2, Jianguo Road, Hualien 970046, Taiwan
| | - Pei-Lin Liao
- Tzu Chi Fondation Tzu Chi Taichung Home-Based Long-Term Care Facilities, No. 88, Section 1, Fengxing Road, Tanzih District, Taichung 427, Taiwan
| | - Shu-Fen Lo
- Department of Nursing, Tzu Chi University, No. 701, Section 3, Zhongyang Road, Hualien 97004, Taiwan
| | - Ya-Ting Chang
- Taichung Tzu Chi Hospital, No. 88, Section 1, Fengxing Road, Taichung 427, Taiwan
| | - Hsiang-Tzu Hsu
- Tzu Chi Foundation Long-Term Care Promotion Center, No. 88, Section 1, Fengxing Road, Taichung 427, Taiwan
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Allen LL, Uphold CR, Koniaris-Rambaud C, House K, Gray F, Fitzgerald L, Vaughan C, Johnson TM. Palliative care aspects of wound healing in complex patients: a case report. J Wound Care 2021; 30:845-852. [PMID: 34644138 DOI: 10.12968/jowc.2021.30.10.845] [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] [Indexed: 12/27/2022]
Abstract
DECLARATION OF INTEREST The authors have no conflicts of interest to declare.
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Affiliation(s)
- Latricia L Allen
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Constance R Uphold
- VA Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, US
| | - Christine Koniaris-Rambaud
- Department of Medicine, Emory University, Atlanta, GA, US.,Department of Family and Preventive Medicine, Emory University, Atlanta, GA, US
| | - Kim House
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Frances Gray
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US
| | - Linda Fitzgerald
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US
| | - Camille Vaughan
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Theodore M Johnson
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US.,Department of Family and Preventive Medicine, Emory University, Atlanta, GA, US
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Floríndez LI, Carlson ME, Pyatak E, Blanchard J, Cogan AM, Sleight AG, Hill V, Diaz J, Blanche E, Garber SL, Clark FA. A qualitative analysis of pressure injury development among medically underserved adults with spinal cord injury. Disabil Rehabil 2020; 42:2093-2099. [PMID: 30621460 PMCID: PMC9022558 DOI: 10.1080/09638288.2018.1552328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose: Medically underserved adults with spinal cord injury (SCI) remain at high risk of incurring medically serious pressure injuries even after receiving education in prevention techniques. The purpose of this research is to identify circumstances leading to medically serious pressure injury development in medically underserved adults with SCI during a lifestyle-based pressure injury prevention program, and provide recommendations for future rehabilitation approaches and intervention design.Methods: This study entailed a qualitative secondary case analysis of treatment notes from a randomized controlled trial. Participants were 25 community-dwelling, medically underserved adults with SCI who developed medically serious pressure injuries during the course of the intervention of the RCT.Results and conclusions: Among the 25 participants, 40 unique medically serious pressure injuries were detected. The six themes related to medically serious pressure injury development were: (1) lack of rudimentary knowledge pertaining to wound care; (2) equipment and supply issues; (3) comorbidities; (4) non-adherence to prescribed bed rest; (5) inactivity; and (6) circumstances beyond the intervention's reach. Together, these factors may have undermined the effectiveness of the intervention program. Modifications, such as assessing health literacy levels of patients prior to providing care, providing tailored wound care education, and focusing on equipment needs, have potential for altering future rehabilitation programs and improving health outcomes.Implications for rehabilitationTo provide patients with spinal cord injury with the necessary information to prevent medically serious pressure injury development, health care providers need to understand their patient's unique personal contexts, including socio-economic status, language skills, and mental/cognitive functioning.When providing wound care information to patients with spinal cord injury who have developed a medically serious pressure injury, practitioners should take into account the level of health literacy of their patient in order to provide education that is appropriate and understandable.Practitioners should be aware of how to help their patient advocate for outside services and care that address their equipment needs, such as finding funding or grants to pay for expensive medical equipment.
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Affiliation(s)
- Lucía I. Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Mike E. Carlson
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Jeanine Blanchard
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Alison M. Cogan
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA;,Washington DC Veterans Affairs Medical Center, Washington, DC, USA
| | - Alix G. Sleight
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA;,National Cancer Institute, Rockville, MD, USA
| | - Valerie Hill
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA;,Department of Rehabilitation, Exercise, and Nutrition Sciences, Occupational Therapy Program, University of Cincinnati, Cincinnati, OH, USA
| | - Jesus Diaz
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Erna Blanche
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | | | - Florence A. Clark
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
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Assadian O, Kammerlander G, Geyrhofer C, Luch G, Doppler S, Tuchmann F, Eberlein T, Leaper D. Use of wet-to-moist cleansing with different irrigation solutions to reduce bacterial bioburden in chronic wounds. J Wound Care 2019; 27:S10-S16. [PMID: 30307816 DOI: 10.12968/jowc.2018.27.sup10.s10] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE: The influence of different irrigation solutions, in conjunction with wet-to-moist cleansing, on the reduction of sessile, non-planktonic bacteria which colonise wounds, has not been investigated. In this study, the antibacterial effect of different irrigation solutions, during a 20-minute wet-to-moist cleansing, has been evaluated in chronic wounds. METHODS: This study was designed as a prospective cohort study with 12 study arms and was conducted between June 2011 and April 2016. Patients with chronic wounds present for more than three months, irrespective of previous treatments, were recruited into this study. Quantitative wound swabs were obtained before and after a 20-minute, wet-to-moist cleansing, using different wound irrigation solutions. Sterile 0.9% saline served as a control. RESULTS: We recruited 308 patients, of which 260 patients with 299 chronic wounds were eligible for analysis. Staphylococcus aureus was the most common recovered (25.5%) microorganism, of which 8% were meticillin-resistant Staphylococcus aureus (MRSA) strains. Although 0.9% saline supported cleansing of the wound bed, it did not significantly reduce the bacterial burden. The highest reduction of bacterial burden was achieved with an aqueous solution containing betaine, zinc and polyhexamethylene biguanide (polihexanide; ln RF=3.72), followed by a 3% saline solution containing 0.2% sodium hypochlorite (ln RF=3.40). The most statistically significant reduction of bacterial burden, although not the highest, was achieved with povidone-iodine (ln RF=2.98; p=0.001) and an irrigation solution containing sea salt 1.2% and NaOCl 0.4% (ln RF=2.51; p=0.002). CONCLUSION: If a reduction of bacterial burden is warranted, wound irrigation solutions containing a combination of hypochlorite/hypochlorous acid, or antiseptics such as polihexanide, octenidine or povidone-iodine, ought to be considered.
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Affiliation(s)
- Ojan Assadian
- Department for Hospital Epidemiology & Infection Control, Medical University of Vienna, Vienna General Hospital, Vienna, Austria. and Institute for Skin Integrity & Infection Prevention, School of Human & Health Sciences, University of Huddersfield, Huddersfield, UK
| | | | - Claudia Geyrhofer
- CWM Academy, Zurich, Switzerland, WCC Wound Competence Centre, Linz, Austria
| | - Gerlinde Luch
- CWM Academy, Zurich, Switzerland, WCC Wound Competence Centre, Linz, Austria
| | - Stefan Doppler
- Kepler University Hospital, Neuromed Campus, Department of Pathology & Microbiology, Linz, Austria
| | - Felix Tuchmann
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Thomas Eberlein
- CWM Academy, Zurich, Switzerland, WCC Wound Competence Centre, Linz, Austria
| | - David Leaper
- Emeritus Professor of Surgery, University of Newcastle upon Tyne, Visiting Professor, Imperial College, London, UK
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Abstract
The immense burden imposed by chronic wounds-those persisting over 6 weeks despite active intervention-on patients and health services is well recognised. There are various reasons for why a wound fails to progress towards closure, and clinicians must investigate the underlying cause of wound chronicity, as this information guides the management of such wounds. The TIME framework (T=tissue; I=infection/inflammation; M=moisture balance; E=wound edges) is a useful tool for practitioners to systematically undertake wound assessment and product selection. This article discusses chronic wound management based on the TIME framework, examining the aspects to be considered when managing chronic wounds. It also describes the process of dressing selection for overcoming the various barriers to wound healing, specifically discussing the AQUACEL family of dressings.
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Affiliation(s)
- Leanne Atkin
- Vascular Nurse Consultant, Mid Yorkshire NHS Trust; Lecturer, University of Huddersfield Chair of the Legs Matter campaign
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Madden M, Stark J. Understanding the development of advanced wound care in the UK: Interdisciplinary perspectives on care, cure and innovation. J Tissue Viability 2019; 28:107-114. [DOI: 10.1016/j.jtv.2019.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/20/2019] [Accepted: 03/25/2019] [Indexed: 11/28/2022]
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Abstract
Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid. Irrigation and cleansing provided by Ringer's solution from the dressing further removes any necrotic tissue or eschar. Once effective wound bed preparation has been achieved a second dressing, HydroTac™, provides an ongoing hydrated wound environment that enables re-epithelialisation to occur in an unrestricted fashion. This paper presents 3 case studies of slow healing wounds treated with HydroClean plus™ which demonstrates effective wound debridement.
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Affiliation(s)
- Leanne Atkin
- Lecturer Practitoner/Vascular Nurse Specialist, Institute of Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Queensgate, Yorkshire
| | - Karen Ousey
- Professor and Director, Institute of Skin Integrity and Infection Prevention, School of Human and Health Science
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