Clinical Coders' Perspectives on Pressure Injury Coding in Acute Care Services in Victoria, Australia

Acute care nurses' experience in providing evidence-based care for patients with laparotomy wounds: A scoping review

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.

The incidence and prevalence of medical device-related pressure injuries in pediatric patients: Systematic review and meta-analysis

PROBLEM

To determine the pooled incidence and prevalence rate of medical device-related pressure injuries(MDRPIs) using the Braden QD scale, medical devices that frequently cause MDRPIs, and anatomical locations that are vulnerable to them.

ELIGIBILITY CRITERIA

Using the Braden QD scale, being published in English between 01/01/2018-and 01/03/2023.

METHODS

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations and registered in the International Prospective Register of Systematic Reviews database (No: CRD42021276501).

SAMPLE

A total of 7 studies with 25,742 pediatric patients were included.

RESULTS

The pooled prevalence and cumulative incidence of hospital-acquired pressure injuries(HAPIs) were 7.8% (95% CI: 5.2-11.4%) and 3.9% (95% CI: 0.5-24.6%) respectively, and the incidence rate was 8.2/1000 person-days (95% CI: 2.4-14.2/1000 person-days). The pooled prevalence and cumulative incidence of MDRPIs were 7% (95% CI: 5.5-8.8%) and 5% (95% CI: 3.2-7.8%) respectively, and the incidence rate was 6.7/1000 person-days (95% CI, 0.11-13.4/1000 person-days). The most affected anatomical locations were the face (29.1%), ankle/foot (20.1%), and head (15.7%). Medical devices that frequently caused MDRPIs were external monitoring devices (24.5%), respiratory devices (22.8%), and supportive/securing devices (14.9%).

CONCLUSIONS

According to the current systematic review and meta-analyses, the incidence and prevalence of HAPIs and MDRPIs are moderate to high.

IMPLICATIONS

The findings suggested that healthcare providers should pay more attention to reducing HAPIs and MDRPIs and future studies should be conducted to understand their characteristics and risk factors.

Multidimensional analysis of job advertisements for medical record information managers

Objective

The rapid growth of the medical industry has resulted in a tremendous increase in medical record data, which can be utilized for hospital management, aiding in diagnosis and treatment, medical research, and other purposes. For data management and analysis, medical institutions require more qualified medical record information managers. In light of this, we conducted an analysis of the qualifications, abilities, and job emphasis of medical record information managers in order to propose training recommendations.

Materials and methods

From online job posting sites, a sample of 241 job advertisements for medical record information management positions posted by Chinese healthcare institutions were collected. We conducted word frequency and keyword co-occurrence analysis to uncover overall demands at the macro level, and job analysis to investigate job-specific disparities at the micro level. Based on content analysis and job analysis, a competency framework was designed for medical record information managers.

Results

The most frequent keywords were "code," "job experience," and "coding certification," according to the word frequency analysis. The competency framework for managers of medical record information is comprised of seven domains: essential knowledge, medical knowledge, computer expertise, problem-solving skills, leadership, innovation, and attitude and literacy. One of the fundamental skills required of medical record information managers is coordination and communication. Similarly, knowledge and skill requirements emphasize theoretical knowledge, managerial techniques, performance enhancement, and innovation development.

Conclusion

According to organization type and job differences, the most crucial feature of the job duties of medical record information managers is cross-fertilization. The findings can be utilized by various healthcare organizations for strategic talent planning, by the field of education for medical record information managers for qualification and education emphasis adjustment, and by job seekers to enhance their grasp of the profession and self-evaluation.