Wound management & prevention最新文献

Background: Nurses' perception of medical device-related pressure injuries (MDRPIs) may affect their performance, but there is a lack of studies in this area.

Purpose: The current study aimed to examine intensive care unit (ICU), cardiac care unit (CCU) and emergency department nurses' perception of proper prevention of MDRPIs and care for individuals with such injuries.

Methods: This descriptive study was conducted in 4 general hospitals in Iran in 2021. All nurses (N = 310) working in ICUs, CCUs and emergency departments of these facilities were invited to complete a researcher-made demographic checklist and an 11-item questionnaire to assess attitudes toward MDRPIs. The questionnaire item responses were scored from 1 (strongly agree) to 5 (strongly disagree) with the total score for the 11 items ranging from 11 to 55. A score of 11 to 25 was categorized as indicating a negative attitude toward proper prevention of MDRPIs and care for such patients; a score of 26 to 40 indicated a neutral attitude, and a score >40 indicated a positive attitude.

Results: A total of 260 nurses fulfilled the data collection tool. The response rate was 83.8%. The mean total score of attitude toward MDRPIs was 41.7. No significant relationship was observed between the total score of nurses' attitudes and their demographic variables. Of the 260 participants, 159 stated they had not received any trainings on MDRPIs at nursing schools during their education, 212 stated they had not participated in any scientific workshops on MDRPIs, and 167 described their knowledge about the prevention and care of MDRPIs as insufficient.

Conclusion: Among ICU, CCU, and emergency nurses in Iran, most had a positive attitude toward the prevention and care of MDRPIs, but steps should be taken to offer more opportunities for nurses to increase their knowledge in this area.

Background: Venous leg ulcers (VLU) require early identification and treatment to prevent further harm. Health care providers often fail to initiate evidenced-based VLU treatment promptly because of a lack of knowledge of VLU guidelines.

Purpose: To improve early treatment for patients with VLUs presenting to outpatient clinic settings.

Methods: Plan-Do-Study-Act cycles were used for this quality improvement project. Virtual education and a comprehensive clinical decision support (CDS) order set were implemented. Outcome metrics included the rate of ankle-brachial index (ABI) testing, mechanical compression therapy, and home health service referrals for patients with VLUs. The frequency with which the CDS order set was used was also measured.

Results: Forty health care providers attended the virtual education sessions among 3 outpatient clinics. There was an increase in ankle-brachial index testing from pre (n = 7; 15.9%) to post (n = 10; 18.2%) (P = .796), but there was a decline in mechanical compression therapy from pre (n = 15; 34.1%) to post (n = 4; 7.3%) (P = .002) and home health service referrals from pre (n = 11; 25%) to post (n = 9; 16.4%) (P = .322). The CDS order set was used 9 times over 13 weeks.

Conclusion: Future Plan-Do-Study-Act cycles will include completing in-person education and reducing the VLU CDS order set length. Future projects should consider these approaches when implementing evidence-based VLU guidelines.

Background: Cesarean delivery (CD) is the most frequently performed surgery. Surgical site infection (SSI) is a common complication after CD.

Purpose: To evaluate the role of complete blood count parameters in predicting the development of SSI after CD.

Methods: Patients who were hospitalized because of SSI after CD were included in the SSI group (n = 48). A control group (n = 45) was formed with healthy postpartum women who had also undergone CD. Preoperative and postoperative hemoglobin (Hb), white blood cell count (WBC), neutrophil count, lymphocyte count, platelet count (PLT), neutrophil-to-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet-large cell ratio (P-LCR) were recorded.

Results: WBC, neutrophil count, and NLR levels increased while Hb, PLT, and lymphocyte count levels decreased after CD in both the SSI and control groups. PLR increased after CD in the SSI group but remained stable in the control group. However, the difference in PLR could not predict SSI after CD.

Conclusion: Complete blood count parameters were not useful to predict SSI after CD. Larger prospective studies are needed.

Background: Chronic leg ulcers affect approximately 1% to 2% of the European population, with an increasing prevalence. The treatment of chronic wounds is a socioeconomical problem worldwide.

Purpose: The main purpose of the current investigation was to detect the etiology of leg ulcers treated in a dermatologic wound clinic from January 1, 2010, to December 31, 2019.

Methods: This retrospective observational study was performed at the Dermatologic Clinic of Spedali Civili in Brescia, Italy. The authors enrolled 465 patients with chronic leg ulcers.

Results: The 3 most represented causes of ulcers were vascular (238 patients, 51.2%), inflammatory (71 patients, 15.3%) and traumatic (43 patients, 9.3%). Altogether, a total of 13 different entities were identified as a cause of leg ulcer.

Conclusion: Vascular genesis was the most common etiology of leg ulcers in this population, even though uncommon causes were also represented. These findings are in agreement with other studies reported in the literature.

Background: Evidence about moxibustion and abdominal massage for treating constipation in older hospitalized patients is limited.

Purpose: To investigate the safety and effectiveness of moxibustion and abdominal massage in hospitalized older patients with constipation.

Methods: Hospitalized older patients (age ≥60 years) with constipation were retrospectively categorized as 2 cohorts according to whether the patients received moxibustion and abdominal massage in addition to routine nursing care. Gastrointestinal symptoms, Constipation Assessment Scale (CAS) scores, and Geriatric Depression Scale (GDS) scores were compared before and after treatment between cohorts.

Results: The 2 cohorts (n = 100 for each) had similar baseline characteristics and gastrointestinal symptoms; the control cohort and the additional intervention cohort also had similar CAS scores (7.14 ± 3.67 vs 7.48 ± 2.96, respectively), and GDS scores (>17: 31% vs 29%, respectively). Improvement in the 2 scores from baseline was observed after 2 weeks in both the control cohort and the additional intervention cohort (CAS, 5.37 ± 5.34 and 3.80 ± 4.47, respectively; GDS, >17: 28% and 15%, respectively). The cohort with additional interventions had a lower ineffective rate (defined as persistent symptoms or absence of decrease in CAS, 49% vs 32%; P = .028) but had more diarrhea (9% vs 21%; P = .017).

Conclusion: Moxibustion and abdominal massage may help relieve constipation in hospitalized elderly patients, but attention should be paid to the increased occurrence of diarrhea. More study is needed.