Dissertations / Theses on the topic 'Wound care education'

Non-healing wounds can claim thousands of lives and costs billions of dollars each year, and nurse-led wound clinics are becoming necessary to fill a gap in care for patients with wounds. Even among certified wound nurses using evidence-based clinical protocols, key considerations of care are being missed. Therefore, this project was focused on developing and validating a new biofilm education module for certified or certification eligible wound care nurses. The aim of the module was to boost clinical assessment knowledge and improve patient outcomes. Benners skill acquisition model informed the development of this project. The design of the project also included a panel of expert wound care nurses using a 5-point Likert questionnaire to provide feedback on the biofilm education module, including evaluating the content, context, relevance, and use in the practice setting. Descriptive analysis provided evidence to inform the revision of the education module. Results of the Likert questionnaire ranged in mean score from 4.6 to 5.0, indicating there was strong agreement among the panel members that the education module met the objectives. The completed education module has been presented to the organization leadership for future implementation. This project supports positive social change by improving nurses' preparation to provide early clinical assessment, intervention, and definitive biofilm eradication treatments, ultimately improving patient outcomes.

Although guidelines and minimal standards for the care and documentation of wounds in home health care settings in the United States are available, there is a lack of compliance among many home health care agencies (HHAs) with regard to the accuracy of wound documentation and care of wounds. Failure to follow guidelines for wound care according to Centers for Medicare and Medicaid Services and Home Health Outcome and Assessment Information System standards could result in loss of revenue for HHAs, improper treatment of wounds, and legal ramifications. The purpose of this doctoral project was to develop and validate a staff educational module on wounds and wound documentation for an HHA. Benner's from-novice-to-expert model was the conceptual framework for understanding nurses' matriculation. The practice-focused question focused on whether a wound staff educational module increased the home health care nurse's knowledge about wounds and wound documentation. A 5-level Likert scale was used by an expert panel to validate the staff educational module. Descriptive analysis was used to evaluate the data. The results of the survey supported implementing the educational module with recommendations (overall percentage 93% [4.4]). The findings of this project contribute to social change by increasing nurses' knowledge of wound care, improving the quality of wound care, increasing reimbursement and revenue, and decreasing the cost of care for wounds.

An experimental design was employed to determine the knowledge gained through use of written Wound Healing Fact Sheets. The study sample consisted of 30 postoperative patients recruited from the accessible population of abdominal and chest surgery patients. Subjects were randomly assigned to experimental and control groups. Experimental subjects were interviewed, received the Fact Sheets and underwent knowledge testing prior to discharge and by telephone approximately one week after discharge. Control subjects did not receive the Fact Sheets but were interviewed and tested identically to the experimental group. Low equivalent reliabilities were demonstrated through use of the KR-20 for the knowledge test. Content validity was established by a panel of three experts. A t-test computed between pre and post test mean scores identified a significant difference in knowledge gained by experimental versus control subjects. Low reliability weakens the significance of this result.

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Introdução: Altas taxas de infecção podem refletir a qualidade de um serviço de saúde. Considerando-se que as taxas de infecção de sítio cirúrgico (ISC) encontradas em estudos prévios no local do presente estudo variaram de 14,1% a 22%, questionou-se se a estrutura e o processo assistencial de enfermagem estariam influenciando estas taxas. Uma vez obtida esta resposta, outra indagação relacionou-se à capacidade de um programa educativo de gerar a construção de propostas ou projetos de mudanças por parte dos seus participantes, a partir e uma dinâmica que prime pela interatividade. Objetivo: Avaliar a estrutura e processo assistencial de enfermagem e um programa educativo para os enfermeiros, com o uso de estratégias educacionais interativas, para a prevenção e controle de ISC. Método: Estudo de intervenção, aprovado pelo Comitê de Ética em Pesquisa da UNIFESP sob o número 1486/07, desenvolvido em duas etapas. A primeira consistiu de um estudo observacional e de análise documental, realizado por meio de auditorias de estrutura e processo, na Unidade de Ginecologia e Setor de Oncomastologia do Hospital São Paulo (HSP), entre agosto de 2007 e março de 2008. Esta fase do estudo foi descrita no primeiro artigo que compõe o corpo desta tese. A segunda, de abordagem quali-quantitativa, foi realizada no período de outubro de 2008 a setembro de 2009 e compreende a estruturação, desenvolvimento e avaliação do projeto educacional em ambiente virtual voltado para as enfermeiras dos setores acima mencionados, para controle de ISC, baseado no Modelo Skopos e organizado a partir dos recursos do ambiente Moodle. O conjunto de dados desta etapa foi descrito nos três artigos subsequentes que compõem a tese. Resultados: A avaliação da estrutura e processo assistencial de enfermagem evidenciou que os documentos normativos estavam em consonância com o preconizado na literatura, porém, a estrutura física e os processos assistenciais dos locais pesquisados apresentavam limitações importantes com impacto negativo para o desenvolvimento dos processos assistenciais adequados à prevenção de ISC. No que se refere à estruturação e utilização de um ambiente virtual de aprendizagem na educação continuada em enfermagem, o Moodle mostrou-se valioso para estruturação de um programa educativo de enfermagem, que buscou distanciar-se do modelo de comunicação unilateral e hierárquico. A avaliação do alcance dos objetivos e da adequação dos conteúdos propostos pelo referido programa, por parte das quatro enfermeiras que participaram do processo, mostrou que as mesmas têm clareza dos benefícios e dos principais fatores limitantes atrelados aos programas educativos. E, ainda, embora novas estratégias pedagógicas, particularmente interativas, sejam bem-vindas, as profissionais preferiram os encontros presenciais para verbalização e organização das reflexões. Finalmente, a aplicação das ferramentas HFMEA® e diagrama de Ishikawa possibilitou a análise de quatro processos assistenciais de enfermagem e seus modos de falha: 1) Agendar cirurgia via Setor de Oncomastologia; 2) Fluxo de Admissão e Alta de Paciente Cirúrgico na Unidade de Internação de Ginecologia; 3) Realização de Procedimentos Cirúrgicos Ambulatoriais; 4) Retorno Ambulatorial de Pacientes Cirúrgicos. Possibilitou, ainda, a elaboração de ações de melhoria que foram iniciadas a partir das discussões realizadas no programa. Conclusões: Os resultados do estudo evidenciaram a necessidade de revisão do processo assistencial de enfermagem e adequação da estrutura, a fim de que os padrões de prevenção e controle da ISC fossem atendidos. Em relação ao programa educativo, a experiência de uso de tecnologia educacional na instituição em questão mostrou-se factível e propiciou a reflexão conjunta sobre a situação-problema vivenciada, bem como a proposta de ações para sua solução. Porém, como todo processo inovador, há uma trajetória a ser construída para que os enfermeiros habituados ao estilo expositivo, presencial e focado em objetos previamente determinados, sejam capazes de se beneficiarem de estratégias interativas, colaborativas e baseadas em projetos.
Introduction: High rates of infection can reflect low health service quality. The fact that previous studies performed at the same location of the present study found surgical site infection rates (SSI) ranging from 14.1% to 22% raised questions about the possibility of the nursing care structure and process to affect those rates. After obtaining this first answer, another question emerged, concerning the capacity of an inservice training program be able to encourage the participants, by means of an interactive dynamics, to develop proposals or projects from making changes. Objectives: To evaluate nursing care structure and process in preventing and managing SSI; and evaluate an inservice training program for nurses involved in the context of the identified problems, using interactive educational strategies aiming at the prevention and control of this complication. Method: This intervention study was approved by the UNIFESP Research Ethics Committee under register 1486/07, and was developed in two stages. The first stage consisted of and observation and analysis study, performed by means of inspections of the structure and process at the Gynecology Oncomastology Units at Hospital São Paulo (HSP), between August 2007 and March 2008. This stage was described in the first article that composes this dissertation. The second stage used a quali-quantitative approach and was performed from October 2008 to September 2009. It consisted of the structure, development, and evaluation of the educational project in a virtual environment for the Training Program at Work for nurses of the referred hospital units, in SSI control, based on the Skopos Model, and organized based on the resources of the Moodle environment. The data regarding this stage was described in the three subsequent articles that comprise the dissertation. Results: The evaluation of the nursing care structure and process showed that the normative document were in agreement with the literature; however, the physical structure and the nursing care processes of the studied locations presented important limitations, which had a negative impact on the development of adequate health care processes to prevent SSI. In terms of the structure and use of a virtual learning environment in continuing nursing education, Moodle showed to be valuable in structuring a nursing training program, which sought to stand apart from a unilateral and hierarchical communication model. The evaluation of goal achievement and content adequacy of the referred program was performed by four nurses who participated in the process. The nurses found that the program presents clear benefits and the main limiting factors associated with inservice training. In addition, although new educational strategies, particularly if interactive, are welcome, the professionals preferred in-person meetings. Finally, using the HFMEA® and the Ishikawa diagram permitted to analyze four nursing care processes and their forms of failure: 1) scheduling a surgery through the Oncomastology Unit; 2) Surgery Patient Admission and Discharge Flow at the Gynecology Hospitalization Unit; 3) Performing Outpatient Surgical Procedures; 4) Outpatient Return Appointments for Surgery Patients. In addition, it was possible to make a list of improvement actions that were initiated based on the discussions held during the training program. Conclusions: The study results evidenced the need to review the nursing care process and to make the structure adequate with a view to meet the standards for SSI prevention and control. As for the inservice training program, the experience of using educational technology at the referred institution was feasible and provided the chance for group analyses about the problematic situation, as well as the proposal of actions for its solution. However, just as any innovative process, there is a pathway to be constructed so that nurses, who are used to training programs that are expositive, performed on-site and focused on previously determined objectives become capable of benefiting from interactive, collaborative, and project-based strategies.
TEDE

Unintentional injuries are the leading cause of death for children aged 5-19 Twenty-two million children are injured each year and approximately one quarter of these injuries occur on school premises. Schools must provide nursing services to children who attend school, but ratios of registered nurses to students is higher than the 1:750 recommended ratio. Current school teachers believe pre-service teachers should be trained in emergency care in teacher training programs. Yet, no research has been conducted to evaluate pre-service teachers’ knowledge and attitudes toward emergency care. The purpose of the study was to investigate pre-service teachers’ knowledge of and attitude toward emergency care in the school setting. A cross sectional group-comparison survey design was used. A 40-item questionnaire was administered to pre-service elementary teachers at Ball State University located in Muncie, IN. The questionnaire consisted of questions from “Emergencies in the school setting: Are public school teachers adequately trained to respond?” and Urban public school teachers’ attitudes and perceptions of the effectiveness of CPR and automated external defibrillators. Sub-group comparisons were made using bivariate and multivariate analyses of similar demographic, attitude, and knowledge questions. Findings indicated that pre-service teachers have a positive attitude toward emergency care, low levels of knowledge about emergency care, and a low level of willingness to provide emergency care in schools. In addition, when comparing pre-service teachers who had received emergency care training to those who did not, a statistically significant difference was found in their knowledge about emergency care. Emergency care training has limited influence on pre-service teachers’ attitudes and willingness to provide care.
Department of Physiology and Health Science

Throughout the last forty years, policy and practice in Early Childhood Education and Care (ECEC) in England has increasingly demanded a strong and reciprocal partnership with parents. Family policy has become intertwined with ECEC policy with the drive to instil a standardised model of good parenting to facilitate the eradication of child poverty. As a result, ECEC practitioners have a responsibility to support good parenting; however, a uniform model of parenting does not reflect the socio-economic and cultural constructs of contemporary family life. The personal and professional roles of caring for babies and young children are naturally closely aligned, and many ECEC practitioners are parents themselves. This study investigated this perception, and asked the question: ‘How might ECEC practitioners’ experiences of mothering influence and inform their working practice with parents?’ The research offers a psychosocial theoretical framework that embraces social theory alongside concepts from science that address the nature of close relationships. Seven mother practitioners, working in a range of professional roles within the ECEC sector, responded to in-depth e-mail interviews to describe their personal experiences of mothering and how these were translated in their professional roles with parents. By applying a constructivist grounded theory method of analysis, the findings highlighted the participants’ mothering of their own children to be a natural and instinctive process highly influenced by their social and cultural worlds. Such a view conflicts with political rhetoric that supports a uniform model of good parenting. An empathetic approach was used when supporting parents, and through attentive listening, mother practitioners were able to combine personal experience with their professional theoretical knowledge and experience to tailor support and meet the needs of families. The thesis concludes that the mother practitioners placed an intrinsic value on being a parent within their working roles, when combined with professional knowledge and experience facilitated empathetic relationships with parents. The study suggests that recognition is needed of the value of personal experiences, which can be capitalised upon more in ECEC policy and practice in order to respect contemporary constructs of family. Suggestions for further professional development, research and dissemination of the research findings are offered.

This study aimed to determine health promotion needs of physically disabled youth with spinal cord injury. The study specifically explored health-related behaviours with reference to participation in physical activity and substance usage, factors that influenced these behaviours and major issues that needed to be targeted in health promotion.

The hand is one of the most complex of all of the anatomical structures in the human body. It has been found that hand injuries are among the most frequent injuries that occur to the body, predominantly during industrial activities. It has therefore been concluded that more research is needed into protective factors, such as glove use. The design features of a glove emphasise either protection or performance. There is often a trade-off between increased safety and performance capability when donning gloves. It has been determined that gloves which are fitted and comfortable for the worker may provide the best compromise between protective functions and decreased performance. This investigation aimed to assess the influence of glove fit on the performance attributes of industrial tasks, as well as on the responses of the human operator. Glove fit was analysed as 35 male participants donned three different glove sizes during each test, including a best-fitting glove, a glove one size smaller than best-fitting, and a glove one size larger than best-fitting. For each glove size, gloves of two differing materials were tested, namely nitrile and neoprene. A barehanded condition was also tested, totalling seven gloved/barehanded conditions for each test. The seven conditions were assessed in a laboratory setting in a battery of tests. This consisted of components of task performance, including maximum pulling and pushing force, maximum torque, precision of force, tactility, speed and accuracy and dexterity. The performance responses were recorded, as well as participants’ perceptual responses using the Rating of Perceived Exertion scale, and muscle activity. Six muscles were selected: Flexor Digitorum Superficialis, Flexor Pollicus Longus, Extensor Carpi Ulnaris, Extensor Carpi Radialis, Flexor Carpi Ulnaris and Flexor Carpi Radialis. The results revealed that glove fit does affect certain spects of performance, and influences human operator responses for selected task components. Furthermore, discrepancies were distinguished between orking barehanded and working with an optimally fitted glove. There was also a glove material effect established. Overall, it was found that muscle activity when exerting maximum force in a pushing and pulling direction was optimal with the nitrile glove material. Maximum torque performance was enhanced with the use of a best-fitting glove, as compared with an ill-fitting glove or barehanded work. Force precision was preferable when barehanded, as opposed to the tactility task which rendered optimal results with a best-fitting glove. The same was found for speed and accuracy results, as glove fit appeared to have no effect on performance, but performance was improved when participants were barehanded. Dexterity performance was the most conclusively influenced by the conditions, resulting in barehanded performance being optimal. However, should a glove be necessary for a given task, an optimally-fitted glove which is of a thinner material would be recommended. It is necessary to distinguish the performance components of a task within industry and select the most appropriate glove for optimal performance and the least risk of overexertion.

Introdução: o Programa ATLS foi desenvolvido nos EUA na década de 70, visando estabelecer um método padronizado para avaliação e tratamento iniciais dos pacientes vítimas de trauma pelos médicos que trabalham nas unidades de emergência. Hoje, apesar do sucesso e de sua ampla disseminação internacional, os benefícios do Programa em relação à modificação dos índices de mortalidade das vítimas de trauma ainda não foram largamente comprovados. Objetivos: o objetivo deste estudo é avaliar a efetividade do Programa ATLS no atendimento do traumatizado em cidade de pequeno porte do Brasil, analisando seu impacto sobre os índices de mortalidade, sobre o tempo de internação e sobre a realização de determinados procedimentos diagnósticos e terapêuticos. Métodos: no período compreendido entre 01 de Janeiro de 2003 e 31 de Dezembro de 2005, foram analisados 240 pacientes, vítimas de trauma, atendidos em hospital universitário de cidade de pequeno porte no Brasil, com RTS \"Revised Trauma Score\" - Escore Revisado de Trauma <6,62, subdivididos em duas amostras: grupo pré-ATLS (120 pacientes) - quando não havia protocolo específico para atendimento ao trauma, e grupo pós-ATLS (120 pacientes) - após a implantação do programa. Resultados: Houve diferença estatisticamente significativa na mortalidade, com redução média de 17% no grupo pós-ATLS. Também foi constatado, no grupo pós-ATLS, aumento estatisticamente significativo da mortalidade após 24 horas da chegada do paciente ao hospital. Quanto ao tempo de internação, não houve diferença estatisticamente significativa entre os grupos. Conclusão: a implantação do programa ATLS reduziu o índice de mortalidade global atestando efetividade no atendimento ao trauma.
Introduction: the ATLS Program was developed in U.S.A. in the decade of 70, aiming to provide a standardized method for initial evaluation and management of the trauma patient for the doctors that work at the emergency room. Today, despite the success and of its ample international dissemination, the impact of the benefits of the Program on trauma care has not been wide scientifically proven. Objectives: the objective of this study is to analyze the effectiveness of the ATLS Program in the management of trauma patients in a small size city of Brasil, studying the real impact on the mortality index, the time of hospital stay and the accomplishment of determined diagnostic and therapeutic procedures. Methods: starting on January 01, 2003 and ending on December 31, 2005, 240 trauma victims were studied at the university hospital of a small size city of Brasil, with RTS (Revised Trauma Score) < 6.62, subdivided in two samples: group pre-ATLS (120 patients) - when there was no specific protocol for trauma care, and group post-ATLS (120 patients) - after the implementation of the program. Results: It had statistical significant difference in mortality, with average reduction of 17% in the group post-ATLS. Also it was evidenced, in the group after-ATLS, statistical significant increase of mortality after 24 hours of the arrival of the patient to the hospital. Concerning the length of hospital stay, there was no statistical significant difference between the groups. Conclusion: the implementation of the ATLS program reduced the index of global mortality certifying effectiveness in the management of the trauma patient.

碩士
中國醫藥大學
護理學系碩士班
98
Aim: The purpose of study is to explore the effectiveness of wound self-care program for emergency traumatic patient in Taiwan. Methods: The study is a quasi-experimental design by using two groups posttest. Random sampling was used to recruit participants in emergency department at a level one medical center hospital in a central district of Taiwan. A total of 178 participants were recruited, 89 participants in each groups. A 20-minuet of Wound Self-care Health Education was given in the experimental group. The health program included the oral description, demonstration, practice of wound care, education sheet, and resources of wound self-care while regular service was given in control group . A questionnaire was used to evaluate the effectiveness of the program after 2-3 days as patient followed up in the out-patient department. Results: After Wound Self-care Program, the knowledge, skills of wounds self-care, the satisfaction of health education in experimental group are better than the control group (p <.05). Wound infection rate in experimental group (9%) is lower than control group (20.2%), and statistically significant (p <.05). Education, age, wound with foreign body are significantly correlate with wound infection (p <.05). Age is related to the knowledge of wound self-care (p <.05). Wound with foreign body and the location of wound relate with skills of wound self-care (p <.05). The knowledge and skills of wounds self-care, and the satisfaction of health education are positive related to each other, revealing the better care knowledge, better care skills, and better satisfaction. Skills of wounds self-care and wound with foreign body are the major predictors of wound infection. Conclusions: The Wound Self-care Health Education could increase the knowledge and skill of wound self-care, satisfaction of health care education, and reduce the rate of wound infection. Wound care requites technical knowledge, thus, practical demonstration of teaching and practice is more effectiveness for patient’s wound self-care. A appropriated health resources with cartoon illustrations and mnemonics care process can improve the patients’ motivation and self-care effectiveness.

碩士
國立臺北護理健康大學
護理研究所
107
Background: According to the statistics by the Ministry of Health and Welfare (MOHW), the number of patients with orthopedic disease accounts for 31.3% of the total patient number of inpatients and outpatients combined; among which, bone fracture accounts for 18.5%. An external fixator is one of the treatments for bone fracture. In the past decade, the infection rate of using external fixator was between 5-15%, which was mainly due to improper care after returning home from surgery. As we live in an era of information development, diversified health care educational videos are now offered by the health care system. Not only can it be used for repeatedly educational purposes, but is also cost effective for hospitals and enhances satisfaction and convenience for the patients’ families. The work load of clinical care has increased as medical system becomes more complicated than before. Therefore, health care educational videos are being developed to replace the traditional health education instructions for the patients’ benefit. Purpose: The purpose of this research is to discuss the effectiveness of the Interactive Multimedia Education Program (IMEP) on patients returning home from external fixation treatment, in terms of the controlling of wound care, pain, infection rate and anxiety. Method: Adopting the randomized controlled trial research design, the trial was conducted in a regional university hospital located in northern Taiwan. The subjects for the trial were patients under external fixation treatment, who are randomly assigned to experiment and control groups. Patients in the experiment group are taught with traditional health education while also watching Interactive Multimedia Education Program videos. Traditional health education is conducted in an one-on-one format by the researcher, with the demonstrations and responds to the demonstration as feedback. The health education video has a total playback time of 15 minutes, inclusive of 5 interactive questions on wound care knowledge instructed by the researcher. Finally, the patients are provided the QR Code to the health education video before they return home. The control group is given traditional health education solely, with nurses handing out A4 double sided health education sheets and conducting health education teaching through verbal education, teaching patients about wound dressing procedures. The tool for this research is a structured survey, with its content including demographic attributes (social demography and relevant medical information), external fixation cognitive scale for home-use and visual analog and situational anxiety scale, which are tested 2 days, 7 days, 14 days, 28-42 days after the surgery for the comparison on the efficacy of both experiment group and control group on the aspects of would care knowledge, pain level, infection rate and situational anxiety. Results: Generally, patients under external fixation treatment showed significant difference on the results of efficacy after taking the IMEP. In terms of wound care knowledge, the experiment group outscored the control group on average during the post-test, with an increasing score of 0.48 after each post-test. In terms of pain level, significant difference was found between the 14th day after the fourth post-test and on the 42nd day after the fifth post-test, showing that the experiment group has lower pain level than the control group on average, with a decreasing score of 0.87 for both groups after each post-test; Judging by the wound type on both groups the 2nd day and the 14th day after the surgery, a significant difference was shown, the experiment group has more dried wound that the control group, while more skin redness appeared in the control group than the experiment group; In terms of infection rate, both group saw no significant difference, total number of patients infected in the experiment group and control group was 1:2, with a total infection rate of 4.76%. As for anxiety, both groups taking the IMEP showed significant difference in each post-test, with the experiment group scoring lower than the control group, decreasing 2.3 by score for each post-test. Conclusion: IMEP is an easy, conductible educational method with theoretical basis, applicable to health education of all ages and disease types. Confirmed by this research, the IMEP promotes wound care knowledge, reduces wound pain, results in dried wound and lowers anxiety level for patients under external fixation treatment. Therefore, it is recommended for clinical care workers to apply for health education purposes, in order to enhance medical care proficiency.

Wound care is an important part of the daily work of nurses in all facilities like hospitals, institutes for long-term patients, social care institutions, or ambulances. In recent years, the treatment of wounds puts more and more emphasis on modern methods, mainly in the Czech Republic (CR) and Ireland. As already mentioned, nursing is constantly evolving, and possibilities for wound treatment are wide. Our aim will be to compare the ways and methods of wound treatment in three different countries. We will focus on the General Nurse, as a nursing care provider. In the theoretical part, the work was focused on characteristic of wounds, their distribution, general healing as well as concrete treatment in the countries concerned, specifically according to the competence of nurses. A major part was devoted to the education of nurses The main purpose of the research was focused on the way nurses treat wounds in Namibia, Ireland and the Czech Republic. Based on the research subject the following research questions and goals were set: Identify and describe how nurses treat wounds in the selected countries. How are wounds healed in Namibia, Ireland and the Czech Republic? How is the wound care in Namibia, Ireland and the Czech Republic? What kind of education does a nurse have to have in the countries concerned, in connection with the wound care? For the empirical part of the thesis, a qualitative approach was selected. A semi-structured interview with nurses from the selected countries was used. Further records of the wound treatment were used. These were obtained during the internship in Namibia, a personal visit to Ireland and my experience during my studies in the Czech Republic. Respondents were recruited by purposive sampling, the condition of which was wound care requiring hospital treatment. The interviews were conducted using a range of questions addressing nurses in those countries during their working hours and if needed, supplementing the required information via Skype. The research sample consisted of nine respondents - nurses from Namibia, Ireland and the Czech Republic and then records of the wound treatment of 9 patients from Namibia, the Czech Republic and Ireland were drawn. The countries have their competencies relating to this issue. In Ireland, Czech Republic there is a re-bandaging nurse, who creates a nursing plan and, if needed, consults everything with the physician. In Namibia, due to lack of nurses and physicians, only competences of local nurses which they acquired during their university studies, are sufficient. These competences lead to decisions and choice of care and wound treatment. In the Czech Republic, nurses shall consult the healing process and the course of treatment with the physician. In the area of education of nurses from the surveyed countries in connection with wound care the research investigation showed that university education is required in Namibia, in the Czech Republic as well as in Ireland. The third mentioned research question related to methods of care with clients suffering from acute or chronic wounds. Wound care in Namibia, Ireland, and in the Czech Republic does not differ in some specific procedures; however, in most cases it is very different. In severe cases of wounds, for many patients it is an unforgettable memory, which requires a professional approach, consisting of knowledge and experience. The nurse provides a unique support to the patient, education is therefore very important and unconditional in order to enable the patient coping with the situation. The results of this thesis can serve as information and study material to other grades of the surgical block and for further research on a similar topic.

碩士
中臺科技大學
護理系碩士班
106
The purpose of this study was to investigate the effectiveness of wound dressing change knowledge, self-efficacy and state-trait anxiety Inventory for SICU registered nurses by multimedia teaching. In this study, one single group was designed as pre-test and post-test by convenient sample.The registered nurses in SICU of a medical center in midland Taiwan were recruited.The date collection were conducted from October to November.Total 55 questionnaires were valid ,and 96.5% of all was completed. After completing to fill in the consent,the researcher conducted the pretest for SICU subjects.Then, multimedia teaching about wound changing dressing was performed .One month later the subjects receired the post-test. The data collected were statistically analyzed by using SPSS 20.0 package software as inferential statistics, including Chi-square test , Wilcoxon signed-rank test and, Mann-Whitney U test and regression analysis . In this study, we found that multimedia teaching intervention related with high score of the general surgical wound dressing knowledge and situational anxiety, trait anxiety with low score. The scores in post-test of wound dressing self-efficacy were lower. After intervention in multimedia teaching, significant differences in the scores of dressing change self-efficacy and trait anxiety was found in the staffs with level N0 nurses without wound education. According to the results of the study, nursing attendants receive training in wound education improve their knowledge of the wound dressing, self-efficacy and situational characteristics. The results of this study stressed the educational strategy for new caregivers who need to implement a multimedia approach to wound dressing change. Therefore, the strategies of new nursing education and training should include the wound dressing multimedia teaching in future. It is not only enhance the integrity of the postoperative wound care, but also improve the nursing skills, ensure the patient's quality of care, and enhance the ability of nursing care.

碩士
國立臺北護理健康大學
醫護教育研究所
105
The objective of this study was to examine the training needs of the chronic wound care ability for the nursing students. A cross-sectional design was used. Data were collected using a self administered questionnaire— job capability assessment tool, and the CVI was 0.925 . The sample consisted of purposeful sampling from the first-year students of the 2-year Bachelor degree program in a techology college. A total of 125 valid questionnaires were obtained.The response rate was 84.5%. The research findings reveal that (1) incorrect rate of the chronic wound care ability learning-prerequisite was 48% and the chronic wound care ability learning-prerequisite have to be strengthened. (2) The passing rate of chronic wound care ability was 88% and the chronic wound care ability could be improve by the training program. (3) The correct rate of the chronic wound care ability items were less than 60%, which includes 6 chronic wound care ability learning-prerequisite items and 2 chronic wound care ability items. The chronic wound care program needs to put these items into the nursing student training course. The study was evaluated the correct rate of the chronic wound care ability for the freshman of nursing students. These results could be used as a reference to the nursing teachers to know how to arrangement the teaching resources and learning strategies.

碩士
輔英科技大學
護理系碩士班
105
Background: Wound care is a major stress to patients or their primary caregivers no matter what their size of wound may be. Knowledge and skills of wound care would affect their willing and determination to perform the wound care as well as affect their self-care ability on wound care after discharge. Many patients and their primary caregivers are afraid of performing wound care incorrectly and lead to developing anxiety which, in turn, affects the learning outcome of wound care. Thus, the purpose of this study was to explore the effects of patient education applications (APP) on self-care of wound before discharging from the hospital. Aims: This research used the self-regulation theory to design patient education on wound care with Mobile Applications in comparison of routine patient education on knowledge, skills and anxiety of on wound care. Research Methods: A single-blinded experimental research design was used. The study recruited patients from the Department of Plastic Surgery at a Medical Center Hospital in Southern Taiwan. A total of 70 participants were randomized to each group for 35 people, the control group receiving the oral patient education and the experimental group receiving patient education using mobile applications. Both groups collected data using “Wound Care Knowledge Scale,” “Wound Care Skills Scale,” “State Trait Anxiety Inventory,” “Visual Analogue Scale” and “Heart Rate Variability” at three phases, including before the intervention (T1), after 3 times of intervention (T2), and before discharge from hospital (T3). The SPSS 22.0 for Windows was used for statistics analyses. Results: The major findings indicated that the scores of knowledge and skills on wound care were improved after receiving patient education for both the experimental and control group. The findings revealed that both oral education and education Applications (APP) had a positive effect on the knowledge and skills of the Wound Care. The change degree of knowledge, skills and anxiety of wound care for experimental group was significantly improved than the control group (p < .05). Conclusion: The Mobile Applications (APP) for patient education has promoted the knowledge, skills on the Wound Care and reduced the anxiety of wound care which can not only serves as the individual nursing education but also provide as a reference for nurses when planning the patient education in clinical settings. In recent years, the popularity of smart healthcare and mobile devices has helped us develop and design the interactive healthcare platform to provide the quality and ability of a continuing care after discharging from the hospital for patients and reduce the numbers of return visits and rates of unexpected readmission.