Journal articles on the topic 'Wounds and injuries – Nursing'
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Al-Gharibi, Koukab A., Sajana Sharstha, and Maria A. Al-Faras. "Cost-Effectiveness of Wound Care: A concept analysis." Sultan Qaboos University Medical Journal [SQUMJ] 18, no. 4 (March 28, 2019): 433. http://dx.doi.org/10.18295/squmj.2018.18.04.002.
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This review aimed to analyse the concept of cost-effectiveness within the context of chronic wound care using Walker and Avant’s approach. The Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) and Nursing & Allied Health® (ProQuest LLC, Ann Arbor, Michigan, USA) databases were searched using a combination of keywords. A total of 18 peer-reviewed articles were identified. In wound care, defining attributes for the concept of cost-effectiveness encompassed treatments which were both effective and economical. Four antecedents were identified, including the type of wound, care setting, type of dressing and patient-related characteristics. The consequences of cost-effective wound care were patient prognosis, quality of life, the economic burden on the patient and healthcare system and cost-savings. These findings will hopefully help to standardise cost-effectiveness terminology among nursing professionals in various healthcare settings.Keywords: Cost Effectiveness; Wounds and Injuries; Healthcare Costs; Nursing; Concept Formation.
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Handayani, Estrin, and Robiul Fitri Masithoh. "A small-scale re-evaluation of the efficacy of silver sulfadiazine for burns." British Journal of Community Nursing 25, Sup12 (December 1, 2020): S34—S38. http://dx.doi.org/10.12968/bjcn.2020.25.sup12.s34.
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Burns remain one of the most common injuries contributing to an increase in trauma incidence in hospitals, particularly in developing countries. Therefore, it is essential to identify the appropriate care for these wounds. Silver sulfadiazine has been widely used for the treatment of burns, but its efficacy has not been re-evaluated in recent years. Therefore, this small-scale study aimed at re-evaluating the use of silver sulfadiazine in patients with burns at a hospital in Magelang, Indonesia. A total of seven patients with second- and third-degree burns were involved and received silver sulfadiazine for 5 months (March to July 2020). Data on their wounds were collected three times and evaluated by using the Nursing Outcomes Classification (NOC) observation method. Wound outcomes were evaluated using on the basis of wound healing by secondary intention. Silver sulfadiazine was found to be effective; 85.7% of the wound area showed granulation tissue, and 75–100% of the wound area showed epithelialisation. However, patients complained of pain during silver sulfadiazine treatment. Therefore, additional nursing interventions seem to be needed to manage burns.
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Smaropoulos, Eleftherios, and Niels AJ Cremers. "Medical grade honey for the treatment of paediatric abdominal wounds: a case series." Journal of Wound Care 29, no. 2 (February 2, 2020): 94–99. http://dx.doi.org/10.12968/jowc.2020.29.2.94.
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Objective: Children are at high risk of injuries and wounds. The application of medical grade honey is a promising approach to improving the healing of wounds of various origin and severity. However, the use of medical grade honey in young paediatric patients remains limited. The aim of this study is to show the safety, efficacy and usefulness of medical grade honey in abdominal wounds, of different causes, in paediatric patients. Method: This was a prospective, observational case series evaluating five young infants with abdominal wounds at the General Hospital in Thessaloniki. All wounds were treated in the same manner with daily medical grade honey applied to the wound area and closely monitored. Results: All treated wounds rapidly presented granulation tissue formation and underwent re-epithelialisation. Peripheral oedema and inflammation decreased upon initial application. Necrotic tissue was effectively debrided when present. Slough was removed and no signs of infection were detected, irrespective of initial wound presentations. Scar formation was minimal and the full range of motion was preserved in all cases. Conclusion: Based on this case study, medical grade honey is safe and effective in treating different abdominal wounds, including infected or dehisced wounds as well as burns. The easy application and broad applicability make medical grade honey recommendable as a first-line treatment in paediatric patients.
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Burns, Zoe, Srijesa Khasnabish, Ann C. Hurley, Mary Ellen Lindros, Diane L. Carroll, Susan Kurian, Lois Alfieri, et al. "Classification of Injurious Fall Severity in Hospitalized Adults." Journals of Gerontology: Series A 75, no. 10 (January 7, 2020): e138-e144. http://dx.doi.org/10.1093/gerona/glaa004.
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Abstract Background Many hospital systems in the United States report injurious inpatient falls using the National Database of Nursing Quality Indicators categories: None, Minor, Moderate, Major, and Death. The Major category is imprecise, including injuries ranging from a wrist fracture to potentially fatal subdural hematoma. The purpose of this project was to refine the Major injury classification to derive a valid and reliable categorization of the types and severities of Major inpatient fall-related injuries. Methods Based on published literature and ranking of injurious fall incident reports (n = 85) from a large Academic Medical Center, we divided the National Database of Nursing Quality Indicators Major category into three subcategories: Major A—injuries that caused temporary functional impairment (eg, wrist fracture), major facial injury without internal injury (eg, nasal bone fracture), or disruption of a surgical wound; Major B—injuries that caused long-term functional impairment or had the potential risk of increased mortality (eg, multiple rib fractures); and Major C—injuries that had a well-established risk of mortality (eg, hip fracture). Based on the literature and expert opinion, our research team reached consensus on an administration manual to promote accurate classification of Major injuries into one of the three subcategories. Results The team tested and validated each of the categories which resulted in excellent interrater reliability (kappa = .96). Of the Major injuries, the distribution of Major A, B, and C was 40.3%, 16.1%, and 43.6%, respectively. Conclusions These subcategories enhance the National Database of Nursing Quality Indicators categorization. Using the administration manual, trained personnel can classify injurious fall severity with excellent reliability.
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Kalinich, John F., Elizabeth A. Vane, Jose A. Centeno, Joanna M. Gaitens, Katherine S. Squibb, Melissa A. McDiarmid, and Christine E. Kasper. "Embedded Metal Fragments." Annual Review of Nursing Research 32, no. 1 (October 2014): 63–78. http://dx.doi.org/10.1891/0739-6686.32.63.
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The continued evolution of military munitions and armor on the battlefield, as well as the insurgent use of improvised explosive devices, has led to embedded fragment wounds containing metal and metal mixtures whose long-term toxicologic and carcinogenic properties are not as yet known. Advances in medical care have greatly increased the survival from these types of injuries. Standard surgical guidelines suggest leaving embedded fragments in place, thus individuals may carry these retained metal fragments for the rest of their lives. Nursing professionals will be at the forefront in caring for these wounded individuals, both immediately after the trauma and during the healing and rehabilitation process. Therefore, an understanding of the potential health effects of embedded metal fragment wounds is essential. This review will explore the history of embedded fragment wounds, current research in the field, and Department of Defense and Department of Veterans Affairs guidelines for the identification and long-term monitoring of individuals with embedded fragments.
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McNamara, Stephanie A., Penelope A. Hirt, Maximillian A. Weigelt, Sonali Nanda, Valeria de Bedout, Robert S. Kirsner, and Lawrence A. Schachner. "Traditional and advanced therapeutic modalities for wounds in the paediatric population: an evidence-based review." Journal of Wound Care 29, no. 6 (June 2, 2020): 321–34. http://dx.doi.org/10.12968/jowc.2020.29.6.321.
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Objective: Children can have non-healing wounds due to a wide range of pathologies, including epidermolysis bullosa (EB), pilonidal disease and Stevens-Johnson syndrome, with some causes being iatrogenic, including extravasation injuries and medical device-related hospital-acquired pressure ulcers. Furthermore, paediatric wounds are vastly different from adult wounds and therefore require a different treatment approach. While there are numerous types of dressings, topical remedies, and matrices with high-tier evidence to support their use in adults, evidence is scarce in the neonatal and paediatric age groups. The purpose of this review is to discuss the basic principles in paediatric wound management, as well as to present new treatment findings published in the literature to date. The benefits and risks of using different types of debridement are discussed in this review. Various topical formulations are also described, including the need to use antibiotics judiciously. Method: Databases were searched for relevant sources including Pubmed, Embase, Web of Science and DynaMed. Search terms used included ‘wound care’, ‘wound management’, ‘paediatrics’, ‘children’, ‘skin substitutes’, and ‘grafts’. Additionally, each treatment and disease entity was searched for relevant sources, including, for example: ‘Apligraf’, ‘dermagraft’, ‘Manuka honey’, ‘antibiotic’, ‘timolol’, and ‘negative pressure wound therapy’ (NPWT). Results: Amniotic membrane living skin equivalent is a cellular matrix that has been reportedly successful in treating paediatrics wounds and is currently under investigation in randomised clinical trials. Helicoll is an acellular matrix, which shows promise in children with recessive dystrophic EB. NPWT may be used as a tool to accelerate wound closure in children; however, caution must be taken due to limited evidence to support its safety and efficacy in the paediatric patient population. Integra has been reported as a useful adjunctive treatment to NPWT as both may act synergistically. Hospitalised children and neonates frequently have pressure ulcers, which is why prevention in this type of wound is paramount. Conclusion: Advancements in wound care are rapidly expanding. Various treatments for non-healing wounds in paediatric and neonatal patients have been reported, but high tier evidence in these populations is scarce. We hope to shed light on existing evidence regarding the different therapeutic modalities, from debridement techniques and dressing types to tissue substitutes and topical remedies. There have been promising results in many studies to date, but RCTs involving larger sample sizes are necessary, in order to determine the specific role these innovative agents play in paediatric wounds and to identify true safety and efficacy.
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Rockefeller, Kathleen, Barbara Silverstein, and Ninica Howard. "Getting to Zero-Lift in Washington State Nursing Homes." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 44, no. 30 (July 2000): 5–430. http://dx.doi.org/10.1177/154193120004403008.
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The huge toll caused by back and shoulder injuries among nursing home workers (nursing assistants) has been well documented. These injuries have been related primarily to tasks involving lifting and handling of the residents. There is strong evidence that reduction in load would decrease the risk of injury. “Zero-lift” programs are designed to reduce these loads and involve several components: support of management and participation of employees; acquisition of equipment; policies surrounding the use of equipment; training; and management of injuries that do occur. There appears to be a significant disparity between the availability of technology to reduce the hazards associated with handling tasks and the adoption of the technology by the industry. The challenge for nursing homes is to effectively implement programs that reduce physical loads on nursing assistants while maintaining a safe and caring environment for the residents.
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Santika, Mona, and Siska Iskandar. "ASUHAN KEPERAWATAN NYERI AKUT PADA PASIEN POST OPERASI SECTIO CAESAREA DENGAN TERAPI RELAKSASI AUTOGENIK." JURNAL KEPERAWATAN MUHAMMADIYAH BENGKULU 9, no. 1 (April 17, 2021): 17–22. http://dx.doi.org/10.36085/jkmb.v9i1.1462.
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Sectio Caesarea is a fragmented tissue or skin that stimulates the sensory area and stimulates the safety of sensory areas, resulting in and other neurological injuries can be a risk of infection if the opening of tissues and lack of treatment cause bacteria to enter through operating wounds. The purpose of the research aims to illustrate the acute nursing care of a post section Caesarea with autogenic relaxation therapy. Methodelogythis research is deductive with a qualitative approach and case study design with acute pain disorders in post section cesarean with autogenic relaxation therapy. The result is maternal screening indicates a scale of 3 pain, acute pain like gangstas, pain scale 3, pain that is felt constantly on the move and is impeded by mobility, activity interrupted. Vital Sign is within normal limits, the action done by performing an autogenic relaxation to treat post pain, after three days of nursing and treatment of the subject data has cooled down on both sides.Keywords: Sectio-Caesarea, nursing care, pain disorder
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Júnior, Edmar Maciel Lima, Manoel Odorico de Moraes Filho, Bruno Almeida Costa, Ana Paula Negreiros Nunes Alves, Maria Elisabete Amaral de Moraes, Alex Marques do Nascimento Uchôa, Camila Barroso Martins, et al. "Lyophilised tilapia skin as a xenograft for superficial partial thickness burns: a novel preparation and storage technique." Journal of Wound Care 29, no. 10 (October 2, 2020): 598–602. http://dx.doi.org/10.12968/jowc.2020.29.10.598.
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Despite a considerable decrease in its incidence worldwide, burns remain the fourth most common type of trauma. The majority of burns are small, with 75% of injuries treated on an outpatient basis. Tilapia skin, as a biological material, has been suggested as an option for the management of burn wounds. After good results were obtained with the use of a glycerolised version of tilapia skin in burned children and adults, it was hypothesised that similar outcomes could be achieved with the use of a lyophilised version of tilapia skin. We report the case of a 33-year-old female patient with scalds to the upper abdomen, and both breasts, arms and forearms. Involvement of 10% of total body surface area with superficial partial thickness burns was calculated. The good adherence of tilapia skin to the wound bed, a 10-day period for complete re-epithelialisation of the wounds and the absence of side effects suggested that the lyophilised version of tilapia skin is effective for burn treatment. Compared with glycerolisation, lyophilisation is thought to permit extended storage of sterile tissue and decreased costs related to distribution and transport, but further studies are needed to confirm this.
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Cunha, João Batista da, Rosimar Aparecida Alves Dutra, Geraldo Magela Salomé, and Lydia Masako Ferreira. "Sistema computacional aplicado à tecnologia móvel para avaliação e tratamento de feridas." Revista de Enfermagem UFPE on line 12, no. 5 (May 1, 2018): 1263. http://dx.doi.org/10.5205/1981-8963-v12i5a230677p1263-1272-2018.
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RESUMOObjetivo: descrever o desenvolvimento de um aplicativo móvel para a avaliação e tratamento de feridas. Método: estudo metodológico. Foi feita a pesquisa da literatura com os descritores: ferimentos e lesões; bandagens; cicatrização. Foram realizados o planejamento do conteúdo, a seleção das ferramentas do aplicativo, a definição da configuração de ambientes, ferramentas e recursos educacionais, a construção do ambiente na Internet para download e instalação do aplicativo no dispositivo móvel. Resultados: quinze artigos foram selecionados através da pesquisa da literatura. O aplicativo criado possui uma interface gráfica de fácil uso, armazena as características sociodemográficas do paciente, permite a avaliação da ferida e de fatores de risco e recomenda procedimentos terapêuticos. Conclusão: o aplicativo desenvolvido pode ter grande utilidade na prática clínica, ajudando a selecionar intervenções de enfermagem para a prevenção e tratamento de feridas, bem como na educação em enfermagem. Descritores: Aplicativos Móveis; Software; Lasers; Ferimentos e Lesões; Algortimos; Cuidados de enfermagem. ABSTRACT Objective: to describe the development of a mobile application for evaluation and treatment of wounds. Method: methodological study. Literature search was carried out with the descriptors: wounds and injuries; dressings; cicatrization. The following steps were followed: planning of content; selection of application tools; configuration of environments, tools and educational resources; building the Internet environment for downloading and installing the application on mobile devices. Results: fifteen articles were selected through literature search. The application has an easy-to-use graphical interface. It stores the patient's sociodemographic characteristics, allows assessment of the wound and risk factors and recommends therapeutic procedures. Conclusion: the application developed may be very useful in clinical practice, helping to select nursing interventions for wound prevention and treatment, as well as in nursing education. Descriptors: Mobile Applications; Software; Lasers; Wounds and injuries; Algorithms; Nursing care.RESUMENObjetivo: describir el desarrollo de un aplicativo móvil para la evaluación y tratamiento de heridas. Método: estudio metodológico. Fue hecha la investigación de la literatura con los descriptores: heridas y lesiones; vendajes; cicatrización. Fueron realizados el planeamiento del contenido, la selección de las herramientas del aplicativo, la definición de la configuración de ambientes, herramientas y recursos educacionales, la construcción del ambiente en Internet para download e instalación del aplicativo en el dispositivo móvil. Resultados: quince artículos fueron seleccionados a través de la investigación de la literatura. El aplicativo creado posee una interface gráfica de fácil uso, almacena las características sociodemográficas del paciente, permite la evaluación de la herida y de factores de riesgo y recomienda procedimientos terapéuticos. Conclusión: el aplicativo desarrollado puede tener grande utilidad en la práctica clínica, ayudando a seleccionar intervenciones de enfermería para la prevención y tratamiento de heridas, así como en la educación en enfermería. Descriptores: Aplicaciones Móviles; Programas Informáticos; Heridas y Lesiones; Evaluación.
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Díaz-Herrera, Miguel Ángel, José Ramón Martínez-Riera, José Verdú-Soriano, Raúl Miguel Capillas-Pérez, Carme Pont-García, Silvia Tenllado-Pérez, Oriol Cunillera-Puértolas, Miriam Berenguer-Pérez, and Vicente Gea-Caballero. "Multicentre Study of Chronic Wounds Point Prevalence in Primary Health Care in the Southern Metropolitan Area of Barcelona." Journal of Clinical Medicine 10, no. 4 (February 16, 2021): 797. http://dx.doi.org/10.3390/jcm10040797.
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Background: Chronic wounds give rise to major costs and resource consumption in health care systems, due to their protracted healing time. Incidence and prevalence data are scarce or nonexistent in community settings. Objective: The aim of the present epidemiological study was to analyse and determine the prevalence of chronic wounds in the community in the south of the province of Barcelona (Spain). Design: A cross-sectional, multicentre secondary data analysis study was conducted in the community (excluding nursing homes) in Barcelona between 16 April and 13 June 2013. It included 52 primary care centres that serve a total population of 1,217,564 inhabitants. Results: The observed prevalence was 0.11%. Venous ulcers presented the highest prevalence, at 0.04%, followed by pressure injuries, at 0.03%. The >74 age group presented the highest frequency of chronic wounds, accounting for 69.4% of cases. Conclusion: The results obtained are consistent with those reported in previous similar studies conducted in Spain and elsewhere. As with most studies that adjusted their variables for age and sex, we found that the prevalence of ulcers increased with age and was higher in women, except in the case of diabetic foot ulcers and ischaemic ulcers, which were more frequent in men.
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Soares, Raquel De Souza, Daianny Arrais de Oliveira da Cunha, and Patricia Dos Santos Claro Fuly. "Cuidados de enfermagem com feridas neoplásicas." Revista de Enfermagem UFPE on line 12, no. 12 (December 2, 2018): 3456. http://dx.doi.org/10.5205/1981-8963-v12i12a236438p3456-3463-2018.
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RESUMO Objetivo: discutir os cuidados de Enfermagem relacionados às feridas neoplásicas nos pacientes em cuidados paliativos. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa, com buscas nas bases de dados Cochrane, LILACS, MEDLINE, BVS e Portal CAPES, em publicações nos idiomas português, espanhol e inglês, com recorte temporal de 2012 a 2017, selecionou-se 7 artigos para a análise descritiva. Resultados: encontraram-se nos artigos selecionados as seguintes categorias de acordo com a sintomatologia abordada: Controle da dor; Controle do odor; Prevenção de hemorragias; Controle de exsudato e Aspectos psicossociais. Conclusão: norteiam-se, pelos cuidados de Enfermagem encontrados, as condutas do enfermeiro ao realizar os curativos das feridas neoplásicas. Destaca-se, no entanto, um importante aspecto que evidencia o comprometimento psicossocial que envolve o paciente com ferida neoplásica, considerando este, também, um cuidado de Enfermagem a ser realizado. Descritores: Enfermagem; Cuidados Paliativos; Ferimentos e Lesões; Neoplasias; Enfermagem Oncológica; Cuidados de Enfermagem.ABSTRACT Objective: to discuss nursing care related to neoplastic wounds in patients in palliative care. Method: this is a bibliographical study, type integrative, with searches in the databases Cochrane, LILACS, MEDLINE, VHL and Portal CAPES, in Portuguese, Spanish and English publications, with a temporal cut from 2012 to 2017, seleciounou 7 articles for the descriptive analysis. Results: the following categories were found in the selected articles according to the symptomatology: Pain control; Odor control; Prevention of bleeding; Control of exudate and psychosocial aspects. Conclusion: Nursing care is guided by nursing care when performing the dressing of neoplastic wounds. However, it is important to emphasize the psychosocial impairment that involves the patient with neoplastic wound, considering also a Nursing care to be performed. Descriptors: Nursing; Palliative Care; Wounds and Injuries; Neoplasms; Oncology Nursing; Nursing Care.RESUMEN Objetivo: discutir los cuidados de enfermería relacionados con las heridas neoplásicas en los pacientes en cuidados paliativos. Método: se trata de un estudio bibliográfico, revisión de tipo integrador, para buscar las bases de datos Cochrane, Lilacs, Medline, BVS y Portal CAPES, en publicaciones en portugués, español e Inglés, con el marco de tiempo de 2012 a 2017, seleccionado - siete artículos para el análisis descriptivo. Resultados: se encontraron en los artículos seleccionados las siguientes categorías de acuerdo con la sintomatología abordada: Control del dolor; Control del olor; Prevención de hemorragias; Control de exudado y Aspectos psicosociales. Conclusión: se orientan, por los cuidados de Enfermería encontrados, las conductas del enfermero al realizar los vendajes de las heridas neoplásicas. Se destaca, sin embargo, un importante aspecto que evidencia el compromiso psicosocial que envuelve al paciente con herida neoplásica, considerando este, también, un cuidado de Enfermería a ser realizado. Descriptores: Enfermería; Cuidados Paliativos; Heridas y Lesiones; Neoplasias; Enfermería Oncológica; Atención de Enfermería.
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Renemann, Horst H. "Rescue Mission Following the Hi-Jacking of the Lufthansa 737, “Landshut”." Journal of the World Association for Emergency and Disaster Medicine 1, no. 2 (1985): 199–200. http://dx.doi.org/10.1017/s1049023x00065584.
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At 15:15 hrs on 17 October 1977, the Lufthansa Medical Service in Frankfurt was notified about the hijacking of a 737 Boeing aircraft. At 15:30 hrs the Crisis Management Staff (CMS) asked me if I would accompany a stand-by crew on the rescue mission. The intention of the CMS was to come to an agreement with the hijackers to exchange the crew of the hijacked plane for a stand-by crew accompanied by an airline physician. I agreed. Medicines and medical equipment for the treatment of injured and sick passengers were packed by medical assistants. At 16:30 hrs highly confidential information was received from CMS—GSG 9 that the Border Patrol Special Commando led by Commander Wegner would accompany the rescue mission which would henceforth be termed “Special Mission”. The hijacked plane was to be followed and seized. It was likely that in the course of this operation an unpredictable number of burns, gunshot wounds and other serious injuries could occur. In a very short time, medical assistants packed further huge crates full of first-aid packs, Macrodex infusions, analgesics, and so forth. I asked Dr. Straub, a medical colleague, and Mr. Reiser, a nursing assistant, both employees of the Lufthansa Medical Service, to accompany me as volunteers, and they agreed. At 16:45 hrs the CMS approved the medical team and the medical equipment.
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Sperring, B., F. Wood, and A. Crocker. "The wound management of patients with partial thickness burn injuries." Journal of Wound Care 4, no. 6 (June 2, 1995): 256–58. http://dx.doi.org/10.12968/jowc.1995.4.6.256.
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Na, Ruan, and Tian Wei. "Recent perspectives of nanotechnology in burn wounds management: a review." Journal of Wound Care 30, no. 5 (May 2, 2021): 350–70. http://dx.doi.org/10.12968/jowc.2021.30.5.350.
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Objective: The burden of the management of problematic skin wounds characterised by a compromised skin barrier is growing rapidly. Almost six million patients are affected in the US alone, with an estimated market of $25 billion annually. There is an urgent requirement for efficient mechanism-based treatments and more efficacious drug delivery systems. Novel strategies are needed for faster healing by reducing infection, moisturising the wound, stimulating the healing mechanisms, speeding up wound closure and reducing scar formation. Methods: A systematic review of qualitative studies was conducted on the recent perspectives of nanotechnology in burn wounds management. Pubmed, Scopus, EMBASE, CINAHL and PsychINFO databases were all systematically searched. Authors independently rated the reporting of the qualitative studies included. A comprehensive literature search was conducted covering various resources up to 2018–2019. Traditional techniques aim to simply cover the wound without playing any active role in wound healing. However, nanotechnology-based solutions are being used to create multipurpose biomaterials, not only for regeneration and repair, but also for on-demand delivery of specific molecules. The chronic nature and associated complications of nonhealing wounds have led to the emergence of nanotechnology-based therapies that aim at facilitating the healing process and ultimately repairing the injured tissue. Conclusion: Nanotechnology-based therapy is in the forefront of next-generation therapy that is able to advance wound healing of hard-to-heal wounds. In this review, we will highlight the developed nanotechnology-based therapeutic agents and assess the viability and efficacy of each treatment. Herein we will explore the unmet needs and future directions of current technologies, while discussing promising strategies that can advance the wound-healing field
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De Freitas Martins, Thalyta Cássia, Poliana Miranda, Samanta Cristina De Almeida Pereira, and Matheus Gomes de Souza. "Tratamento Tópico para o Sangramento em Feridas Tumorais: Uma Revisão Integrativa." Saúde Coletiva (Barueri) 11, no. 66 (June 29, 2021): 6571–86. http://dx.doi.org/10.36489/saudecoletiva.2021v11i66p6571-6586.
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Objetivo: realizar uma revisão integrativa da literatura, focada na identificação e avaliação de estudos primários objetivando o controle tópico do sangramento em feridas tumorais. Métodos: foi feita pesquisa bibliográfica no período de dezembro de 2020 a janeiro de 2021 nas bases de dados Scopus, Cinahl, PubMed e Web of Science e usados os descritores wounds and injuries, hemorrhage, neoplasms e nursing e as palavras chaves symptom management, bleeding e therapeutics. Resultados: A amostra final foi composta por 06 estudos. Os delineamentos mais frequentes foram série de casos/relato de caso, com cinco estudos (83,3%), e um estudo de coorte (16,7%). Portanto, cinco estudos (83,3%) apresentaram nível de evidência 6 (fraca) e um (16,7%), nível de evidência 4 (moderada). Conclusão: recomenda-se que estudos posteriores com melhor delineamento metodológico sejam conduzidos a fim de produzir evidências mais concretas.
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Gabrovec, Branko, and Ivan Eržen. "Prevalence of violence towards nursing staff in Slovenian nursing homes." Slovenian Journal of Public Health 55, no. 3 (September 1, 2016): 212–17. http://dx.doi.org/10.1515/sjph-2016-0027.
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AbstractIntroductionThe purpose of this research was to identify the prevalence of violence towards nursing staff in Slovenian nursing homes.MethodsFor the purpose of this study, a non-experimental sampling method was employed, using a structured questionnaire as a data collection instrument (n=527). The contents of the questionnaire proved valid and reliable, with a high enough degree of internal consistency (Cronbach Alpha minimum 0.82).ResultsThe nursing staffs working in nursing homes for senior citizens are at high risk of violence. In the last year, the employees were most often faced with verbal violence (71.7%), physical violence (63.8%) and sexual violence (35.5%). 35.5% of employees suffered injuries at their working place. During aggressive outbursts of nursing home residents, employees particularly experience vulnerability, fear and insecurity.ConclusionThere is a need for a comprehensive approach to tackle workplace violence. Some psychiatric health care facilities have already introduced certain measures in this field, and reduction of workplace violence proves that it is possible to reduce aggressive outbursts of patients. After conducting further quantitative research, which would expose detailed characteristics and the background of such violence, it would be sensible to develop similar measures in the field of health care in nursing homes.
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Blankenship, RD, LA Clegg, and DT Powell. "Postarteriographic pressure dressings: two types." Critical Care Nurse 11, no. 5 (May 1, 1991): 92–96. http://dx.doi.org/10.4037/ccn1991.11.5.92.
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Is there a difference in the numbers of tape injuries, hematomas, and recurrent bleeding episodes associated with the postarteriographic wound between the standard pressure dressing and the pelvic-girdle-type pressure dressing? The answers to these questions can be important to critical care nursing practices.
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., Sonia, Sukhbir Singh, Brijender Singh, Satpal Singh, Anil Khurana, and Ramesh Verma. "Study of knowledge, attitude and practice among nurses regarding needle stick and sharp item injuries." International Journal Of Community Medicine And Public Health 6, no. 5 (April 27, 2019): 2064. http://dx.doi.org/10.18203/2394-6040.ijcmph20191819.
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Background: Needle stick injuries are an important occupational hazard for nursing personnel as they form an important mechanism for transmission of blood borne pathogens. A needle stick injury (NSI) is defined as an accidental skin-penetrating stab wound from a hollow-bore needle (or any sharp) containing another person’s blood or body fluid. Sharp injury (SI) is defined as a skin-penetrating stab wound caused by sharp instruments & accidents in a medical setting.Methods: The study is hospital based cross-sectional descriptive in PGIMS Rohtak. The study was designed towards achievement of all objectives. The study was carried out from 14 June 2016 to 13 August 2016.Results: Majority (6%) of sample were in the age group of 20-25 years and (31%) in age group of 26-30 years. Majority of sample (98.5%) were female. Majority of sample (90%) were GNM, (6.5%) were B.Sc Nursing, (1.5%) was M.sc Nursing. Majority of sample (91.5%) were married.Conclusions: The study identified the presence of suboptimal practices that put both staff nurses and patients at significant risk of contracting occupational infections.
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Borille, Denise. "Dressing Wounds: Considerations on Trauma Theory and Life Writing in Vera Brittain’s Testament of Youth." Journal of English Language and Literature 3, no. 2 (April 30, 2015): 259–62. http://dx.doi.org/10.17722/jell.v3i2.55.
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This paper aims at analyzing how the trauma inflicted by the First World War is described by Vera Brittain in her autobiographical novel Testament of Youth (1933). The author, who shares many features in common with Virginia Woolf – regarding witnessing and writing about trauma – also lost her loved ones to the War: her fiancé, Roland Leighton, her brother, Edward Brittain, and her friend, Victor Richardson.For Vera Brittain and some of her contemporaries, nursing became a woman‟s experience of taking part in the male-dominated realm of the First War. From treating wounds to listening to injured soldiers‟ talks, First War nurses grasped the geographies of men‟s bodies and minds, something regarded as “improper” by most parents whose daughters were born between the late Victorian and early Edwardian ages. Nursing was the closest a woman could get to the battleground in those days; in Brittain‟s case, for instance, the only safe way to see Roland again. V.A.D. nursing also allowed many women to evolve from tactile experience to the subjective activity of writing about the War, and Brittain‟s Testament of Youth may be regarded as one of its best examples.What may account for the title Testament of Youth is the thought Brittain kept that writing about the distress she and her contemporaries felt due to war would probably have an impact on coming generations. She leaves a “testament” of a terrible incident that would more likely recede; yet, she acknowledges that, whatever may happen, it would never surpass the impact that the First War had on her generation of young women, who were deprived of the innocence of their youth.
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Tatomir, Jovanka. "Procedure zdravstvene nege pacijenta sa opekotinskom traumom / Procedures health care of the patient with burns trauma." SESTRINSKI ŽURNAL 3, no. 1 (November 1, 2016): 48. http://dx.doi.org/10.7251/sez0116048t.
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The burns are tissue damage caused under the influence of pathogenic amounts of heat, chemicals, electricity or radiation of different bodies.Etiological factors generally can be divided into four groups: thermal, chemical, electrical and radiation burns.Tissue damage is directly related to high temperature and length of exposure to harmful agents. The higher the temperature and longer works, the damage was more severe. Etiologic agents can cause minor injuries in the form of erythema of the skin, and severe destruction of body parts or the whole organism. System changes occur and are particularly pronounced in severely burned patients. These are patients with more than 25% body surface area burned, regardless of the depth, electrical burns, subdermal burns over 10% of body surface area burned with associated lung injuries, fractures, contusions, wounds, diseases previously. The burns are the most serious violations of the organism due to the involvement of almost all organs and systems. Extensive burns are therefore called and burns disease.The treatment of burned patients conducted team with a multidisciplinary approach. The nurse is an integral part of the team. The treatment of burns consists of first aid, general medical and surgical treatment. Prophylactic antibiotic therapy is applied in extensive burns. The main aim of local treatment of the disposal of burned area.Nursing care of the patient with burns trauma is of particular importance for the outcome of the treatment and prevention of complications. Nursing process involves numerous and complex medical-technical intervention, such as: continuous monitoring of vital functions; daily dressing wounds, with the absolute application of the principles of aseptic techniques; taking laboratory analysis; placement of a urinary catheter connected to a closed drainage system, to be followed hour diuresis; placement central venous catheter, peripheral venous catheters; taking blood cultures and urine culture with the aim of diagnosis of septic states.
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Lane, Cheryl A., Cynthia Selleck, Yuying Chen, and Ying Tang. "The Impact of Smoking and Smoking Cessation on Wound Healing in Spinal Cord–Injured Patients With Pressure Injuries." Journal of Wound, Ostomy and Continence Nursing 43, no. 5 (2016): 483–87. http://dx.doi.org/10.1097/won.0000000000000260.
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Kolacz, Nicole M., Mark T. Jaroch, Monica L. Bear, and Rosanna F. Hess. "The Effect of Burns & Wounds (B&W)/Burdock Leaf Therapy on Burn-Injured Amish Patients." Journal of Holistic Nursing 32, no. 4 (March 25, 2014): 327–40. http://dx.doi.org/10.1177/0898010114525683.
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Purpose: The purposes of this pilot study were to measure pain associated with dressing changes, assess the presence of infection, and document healing times of burn-injured Amish in central Ohio using an herbal therapy consisting of Burns and Wounds™ ointment (B&W) and burdock ( Arctium ssp.) leaves. B&W contains honey, lanolin, olive oil, wheat germ oil, marshmallow root, Aloe vera gel, wormwood, comfrey root, white oak bark, lobelia inflata, vegetable glycerin, bees wax, and myrrh. Design: A prospective, case series design guided the study within a community-based participatory research framework. Methods: Amish burn dressers provided burn care. Registered nurses monitored each case and documented findings. Pain scores were noted and burns were inspected for infection during dressing changes; healing times were measured from day of burn to complete closure of the skin. All cases were photographed. Results: Between October 2011 and May 2013, five Amish were enrolled. All had first- and second-degree burns. B&W/burdock leaf dressing changes caused minimal or no pain; none of the burns became infected, and healing times averaged less than 14 days. Conclusion and Implications: The use of this herbal remedy appears to be an acceptable alternative to conventional burn care for these types of burns. The trauma of dressing changes was virtually nonexistent. Nurses working in communities with Amish residents should be aware of this herbal-based method of burn care and monitor its use when feasible.
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Schroeder, Jessica, and Verna Sitzer. "Nursing Care Guidelines for Reducing Hospital-Acquired Nasogastric Tube–Related Pressure Injuries." Critical Care Nurse 39, no. 6 (December 1, 2019): 54–63. http://dx.doi.org/10.4037/ccn2019872.
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Background Nurses certified in wound, ostomy, and continence monitored an increasing incidence of hospital-acquired pressure injury of the nares due to medical devices, specifically nasogastric tubes, in a metropolitan hospital. A majority of these pressure injuries occurred in patients in the intensive care unit. The organization lacked formal guidelines for preventing such injuries. Objective To decrease the incidence of nasogastric tube–related hospital-acquired pressure injury. Methods The organization’s process improvement model, comprising steps to define, measure, analyze, improve, and control, guided the project. The incidence rate of nasogastric tube–related hospital-acquired pressure injury before the intervention was determined for calendar year 2015 and compared with data obtained after the intervention, for calendar year 2016. An interprofessional team created, implemented, and evaluated the effectiveness of evidence-based guidelines and surveillance strategies for preventing nasogastric tube–related hospital-acquired pressure injury. The team implemented guidelines using the simple mnemonic “CLEAN”: correct tube position, stabilize tube, evaluate area under/near tube, alleviate pressure, note date and time. Results The incidence rate of nasogastric tube–related hospital-acquired pressure injury (0.13 per 1000 patient days in 2015) decreased 100% (0.0 per 1000 patient days in 2016) after the guidelines were implemented in the organization. This rate was sustained for a full year, after which it increased slightly because temporary and new staff lacked knowledge of the guidelines. Conclusions The creation and implementation of clear and specific guidelines for assessing and securing nasogastric tubes successfully reduced nasogastric tube–related hospital-acquired pressure injury.
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Levin, Pamela F., Jeanne Beauchamp Hewitt, and Susan Terry Misner. "Workplace Violence." AAOHN Journal 44, no. 7 (July 1996): 326–31. http://dx.doi.org/10.1177/216507999604400703.
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Homicide is the leading cause of fatal occupational injuries for women and accounts for 39% of all fatal injuries for women at work. Using medical examiner and coroner reports, this study analyzed female workplace homicides in three counties within metropolitan Chicago from 1984 to 1990. These workplace homicides were compared to non-workplace homicides of women. There were 1,354 female homicides; of the 17 workplace homicides, all occurred in Cook County. The annual rate of female occupational homicides was higher (1.5/105) for Cook County, while for the metropolitan Chicago area (Cook, DuPage, and Lake counties) it was 1.19/105. Black women experienced a higher workplace homicide rate (2.3/105) than white women (1.2/105). Most of these occupational homicides occurred in retail trade, predominately in eating and drinking establishments; robbery was a frequent occurrence, and the women often worked alone. Only three medical examiner reports cited a known assailant. The leading cause of death was from gunshot wounds. Workplace homicides were similar to non-workplace homicides in relation to age, race, and cause of death. Identified risk factors associated with workplace homicides, as well as non-fatal assaults, should be used to develop effective preventive measures. A national standard for general workplace security also is needed.
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Yari, Abazar, Fatemeh Heidari, Sanaz Joulai Veijouye, and Maliheh Nobakht. "Hair follicle stem cells promote cutaneous wound healing through the SDF-1α/CXCR4 axis: an animal model." Journal of Wound Care 29, no. 9 (September 2, 2020): 526–36. http://dx.doi.org/10.12968/jowc.2020.29.9.526.
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Objective: An appropriate source of adult stem cells for therapeutic use is stem cells deriving from the hair follicle bulge. Following injury, ischaemic tissues produce a variety of cytokines and growth factors that are essential for tissue repair. This study sought to investigate the temporal effects of hair follicle bulge stem cells (HFSCs) on cutaneous wound healing in rats using the SDF-1α/CXCR4 axis. Method: HFSCs obtained from rat vibrissa, labeled with DiI and then special markers, were detected using flow cytometry. The animals were divided into five groups: control (non-treated, n=18), sham (PBS, n=18), AMD (treated with AMD3100, n=18), HFSC + AMD (treated with HFSCs + AMD3100, n=18) and HFSC (treated with HFSCs, n=18). A full-thickness excisional wound model was created and DiI-labeled HFSCs were injected around the wound bed. Wound healing was recorded with digital photographs. The animals were sacrificed 3, 7 and 14 days after the surgery and were used for histological (H&E, Masson's trichrome staining) and molecular (ELISA and q-PCR) assays. Results: The flow cytometry results demonstrated that HFSCs were CD34-positive, nestin-positive, but Kr15-negative. The morphological analysis of the HFSC-treated wounds showed accelerated wound closure. The histological analysis of the photomicrographs exhibited more re-epithelialisation and dermal structural regeneration in the HFSC-treated wounds compared with the control group. In the HFSC + AMD group, the histological parameters improved on the same days, but showed a significant decrease compared with the HFSC group in all the days assayed. In the AMD group, there was a significant reduction in the noted parameters. qRT-PCR and ELISA showed a high expression level of SDF-1α, CXCR4 and VEGFR-2 in the HFSC-treated wounded skin tissue, but the expression of CXCR4 and VEGFR-2 showed a significant reduction in the HFSC + AMD group compared with the HFSC group. Conclusions: Based on the findings of this study, HFSC transplantation affects wound closure parameters and the expression of SDF-1α and CXCR4. As the SDF-1α expression level increases in the injured area, the HFSCs contribute to wound repair through the SDF-1α/CXCR4 axis. This result is extremely valuable because it raises the possibility of wounds healed by isolating autologous HFSCs from the patient.
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Collier, Mark. "Minimising pain and medical adhesive related skin injuries in vulnerable patients." British Journal of Nursing 28, no. 15 (August 8, 2019): S26—S32. http://dx.doi.org/10.12968/bjon.2019.28.15.s26.
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The skin is the largest and one of the most important organs of the body and as such it is essential that skin integrity is maintained to preserve normal body functions as much as possible at all times. Health professionals must endeavour to minimise any pain and trauma likely to be encountered by their patients through the use of a variety of medical products and devices that are designed to adhere to the skin, especially as the use of dermatological and wound-management products in particular, that incorporate adhesives to help keep them secure and in place, has grown in line with the increasingly ageing population and changing demographics throughout the UK. This article reviews the literature related to the causes of medical-adhesive-related skin injuries (MARSIs) and the reported patient effects, in particular pain and skin trauma and highlight some ‘at-risk’ patient groups and potential actions to minimise risk. A sterile silicone medical adhesive remover—Appeel Sterile—is introduced and the clinical benefits highlighted through the discussion of clinical evidence and case studies undertaken on a range of patients with varied aetiologies.
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Ho, Weiguang, Christopher D. Jones, Daniel Widdowson, and Hilal Bahia. "Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience." Journal of Wound Care 28, no. 11 (November 2, 2019): 758–61. http://dx.doi.org/10.12968/jowc.2019.28.11.758.
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Objective: It is widely accepted that the early debridement of burns improves outcome. There is increasing evidence that enzymatic debridement is an effective technique for removal of full-thickness and deep-dermal burns, reducing blood loss and often the need for autologous skin grafting by avoiding over excision of the burn. We aim to highlight the potential use of this form of debridement as an alternative to surgical management in patients with electronic cigarette (e-cigarette)-associated flame burn injuries. Methods: This case series presents the use of Nexobrid (MediWound Ltd, Israel), a non-surgical, bromelain-based enzymatic debridement technique, in patients with deep partial-thickness burns (range: 1–3% total body surface area), avoiding the need for autologous skin grafting. Results: Burn wounds in two patients healed within 14 days without complications or the need for further surgical intervention. Another patient required further dressings after discharge but failed to attend follow-up appointments. These results are comparable with those reported by others using conservative management of e-cigarette burns. Conclusion: The authors wish to raise awareness of the potential for a combination of thermal and chemical burns related to e-cigarette explosions. Chemical burns should be excluded by pH testing of the burn wound. From our experience, small e-cigarette-associated flame burns can be considered for management with enzymatic debridement.
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Vieira, Chrystiany Plácido de Brito, Daniella Mendes Pinheiro, Maria Helena Barros Araújo Luz, Telma Maria Evangelista de Araújo, and Elaine Maria Leite Rangel Andrade. "Wound care technologies used by nurses / Tecnologias utilizadas por enfermeiros no tratamento de feridas / Tecnologías utilizadas por enfermeros en el tratamiento de heridas." Revista de Enfermagem da UFPI 6, no. 1 (March 1, 2017): 65. http://dx.doi.org/10.26694/reufpi.v6i1.5852.
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Objetivo: analisar evidências científicas sobre as tecnologias utilizadas por enfermeiros no tratamento de feridas. Metodologia: revisão integrativa realizada nas bases de dados Cumulative Index to Nursing and Allied Health Literature, Scopus e Web of Science, por meio dos descritores não controlados woundsand injuries, woundhealing, nursing e technologicaldevelopment. Resultados: foram analisados 13 artigos, dos quais 8 (61,5%) utilizaram tecnologia dura, 4 (30,8%) leve-duras e 1 (7,7%) leve, sendo que entre as duras o uso de coberturas foi o que mais se destacou, seguido de sistema de medição digital e biomarcadores. Conclusão: a Enfermagem tem utilizado, na maioria dos casos, a tecnologia dura como estratégia facilitadora para o tratamento de feridas, devendo ser estimulado o uso e desenvolvimento das consideradas leves e, principalmente, leve-duras.
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Matthews, Marc R., Emily Helmick, Christopher Mellon, Danielle Thornburg, Areta Kowal-Vern, William H. Tettelbach, and Kevin N. Foster. "552 Limb Salvage: Amputations Prevented with Dehydrated Human Amnion/Chorion Membrane Allografts (dHACM) Used in Combination with Decellularized Human Collagen Matrix (dHCM)." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S124—S125. http://dx.doi.org/10.1093/jbcr/irab032.202.
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Abstract Introduction Burn and traumatic limb injuries with exposed bone/tendon typically require surgical flaps or amputations for healing. Some burn patients are not candidates for these invasive techniques. Placental amniotic membrane has been used as a wound dressing for more than 100 years and may offer an alternative to flaps and/or amputations. Processed dehydrated human amnion/chorion membrane (dHACM), from human placental tissue, contains type 1 human collagen as well as non-viable cells and 285 identified regulatory proteins including growth factors, chemokines, cytokines, metalloproteinases, and other tissue growth and inflammatory mediators. dHACM has been successfully used as a dressing for wound ulcers, burns, donor sites, & surgical debridement. This study reports the use of dHCAM as a limb salvage tool in four patients with severe injuries. Methods This is a retrospective case series of patients suffering severe lower extremity injury with bone/tendon exposure that had applied dHACM/dHCM over or packed (depending on wound depth), then covered with 3% bismuth tribromophenate petrolatum dressing & glycerol/ hydroxyethylcellulose lubricant. Negative pressure wound therapy (NPWT) was initiated; wound re-evaluation occurred in seven days. dHACM/dHCM was reapplied if required (bone still exposed). Results There were 3 males and 1 female with three burns and one NSTI. The mean±sd (median) age was 58±23 (61) years; % total burn surface area 3±3 (2); length of hospital stay 48±30 (40) days; number of tangential excisions & debridements 6.5±1 (6.5); days from admission to product application 49±47 (34) and discharge 24±19 (19) days; negative pressure wound therapy (NPWT) 53±6 (56) days. All four patients continued treatment upon discharge with clinic visits and home NPWT. All recovered with good results and no complications. Treatment may be continued with NPWT therapy at home or in a skilled nursing facility. Patients healed after two to three dHACM/dHCM applications and did not require leg or foot amputations. Conclusions In select limb salvage cases, dHACM/HCM may be a promising alternative to extremity amputations, tissue transfer flaps or other techniques for secondary intention healing of wounds with bone/tendon exposure.
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Seczynska, Bozena, Ilona Nowak, Aurelia Sega, Maria Kozka, Michael Wodkowski, Wieslaw KrÓlikowski, and Wojciech Szczeklik. "Supportive Therapy for a Patient With Toxic Epidermal Necrolysis Undergoing Plasmapheresis." Critical Care Nurse 33, no. 4 (August 1, 2013): 26–38. http://dx.doi.org/10.4037/ccn2013555.
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A patient with severe toxic epidermal necrolysis underwent 2 cycles of therapeutic plasma exchange and received specialized wound care for widespread skin damage of more than 80% of his body surface area. Extensive involvement of mucous membranes, including the conjunctivas and the oropharyngeal cavity, and damage of his genitourinary organs required meticulous wound care. Daily care of injuries of tissues affected only in the most severe cases of toxic epidermal necrolysis was provided by an experienced intensive care unit nursing team. A meticulous supportive therapy regimen was a major contributing factor to this patient’s remission.
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Wynn, Matthew. "Deep tissue injury: a narrative review on the aetiology of a controversial wound." British Journal of Nursing 30, no. 5 (March 11, 2021): S32—S37. http://dx.doi.org/10.12968/bjon.2021.30.5.s32.
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Deep tissue injuries (DTIs) were added to pressure ulcer grading systems in 2009. Since then, they have been associated with the same aetiological processes as other forms of pressure injury (PI). This is despite notable clinical differences in their presentation along with variations in natural history that suggest they are the consequence of processes distinct from those that cause other PIs. Understanding the aetiology of DTIs is essential to guide prevention and treatment in addition to ensuring healthcare governance processes deeply tied to pressure injury are effective and efficient. Current understanding of the aetiology of DTI has significant gaps, with several key challenges impeding progress in this area of PI research, including inconsistent reporting by healthcare services and the limitations of animal and computer models in addition to the ethical barriers to conducting studies on human subjects. Synthesis of early studies with studies undertaken before 2009 is also limited by the variety in definitions of DTI used before that published by the European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance in 2009. To date, few prospective clinical studies have been conducted. This article presents a narrative review on the clinical and animal study evidence indicating contemporary understanding of DTI.
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Mihdawi, Maha, Rasmieh Al-Amer, Rima Darwish, Sue Randall, and Tareq Afaneh. "The Influence of Nursing Work Environment on Patient Safety." Workplace Health & Safety 68, no. 8 (March 20, 2020): 384–90. http://dx.doi.org/10.1177/2165079920901533.
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Background: Patient safety has been a concern over the past two decades. The value of nurses and their work environment in relation to patient safety has been acknowledged by studies and international organizations. This study aimed to examine the relationship between patient safety practices and the nursing work environment. Methods: In total, 570 registered nurses were invited from the inpatient units in public and private hospitals. Perceived patient safety was evaluated using the Overall Perceptions of Patient Safety subscale from the Hospital Survey of Patient Safety Culture (HSPSC). The nursing work environment was assessed using the Practice Environment Scale of the Nursing Work Index (PES-NWI). Findings: Of the 350 of 570 (64.6%) nurses surveyed, 35.2% (125) reported positive levels of perceived patient safety. Staffing and resource adequacy, professional communication style, and nurses’ participation in hospital quality improvement activities were associated with higher levels of perceived patient safety. Conclusion/Application to Practice: This study provided empirical results about perceived patient safety culture in relation to nursing work environment. It is paramount to focus on specific dimensions of the nursing work environment, such as staffing and resource adequacy, nurses’ participation and advancement, and communication style to improve the quality of care provided to patients. Hospitals are considered one of the most hazardous places compared with industries. Policy makers would help reduce injuries, save resources, and build a culture of safety when taking into consideration the importance of the nursing work environment in relation to patient safety.
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Faucher, Nathalie, Martine Barateau, Franck Hentz, Philippe Michel, Sylvie Meaume, Chantal Rousseaux, Marc Marty, Marc le Fort, and Benoit Nicolas. "Use of multilayer silicone foam dressings as adjuvant therapy to prevent pressure injuries." Journal of Wound Care 30, no. 9 (September 2, 2021): 712–21. http://dx.doi.org/10.12968/jowc.2021.30.9.712.
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Despite progress in the prevention of pressure injuries (PIs), they remain a challenging public health problem because of their frequency and morbidity. Protection of the skin by multilayer silicone foam dressings may be an adjuvant measure to prevent PIs in high-risk patients. Despite the available clinical data and published recommendations on this measure, caregivers face difficulties in identifying patients who would benefit from this adjuvant measure. The objective of this work was to define the profiles of high-risk patients who would benefit optimally from this measure in combination with basic preventive procedures. This consensual expert opinion was drawn up using two methods: the Nominal Group Technique with eight medical and paramedical experts, and the Delphi process with 16 experts. The bases for this expert consensual opinion were a formal search and analysis of the published literature regarding evidence on the prevention of PIs using multilayer silicone foam dressings. The consensual expert opinion reported here addresses five proposals mostly intended to define patients who would benefit from the use of a multilayer silicone foam dressing (≥4 layers) to prevent PIs (sacrum and heels).
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Schmidt, Patricia, and Elizabeth A. Mann-Salinas. "Evolution of Burn Management in the U.S. Military: Impact on Nursing." Annual Review of Nursing Research 32, no. 1 (October 2014): 25–39. http://dx.doi.org/10.1891/0739-6686.32.25.
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As the only burn center in the Department of Defense, the U.S. Army Institute of Surgical Research is the primary location for care of service members with burn injuries. The combat operations in Iraq and Afghanistan during the past decade have caused an increase in burn patients. As a result of this increased need, advancements in care were developed. The speed and precision of transporting patients from the battlefield to the burn center has improved over previous conflicts. Technological advancements to support treating complications of burn wound healing were leveraged and are now integrated into daily practice. Clinical decision support systems were developed and deployed at the burn center as well as to combat support hospitals in combat zones. Technology advancements in rehabilitation have allowed more service members to return to active duty or live productive civilian lives. All of these advancements were developed in a patient-centered, interdisciplinary environment where the nurses are integrated throughout the research process and clinical practice with the end goal of healing combat burns in mind.
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Dwivedi, Mukesh Kumar, Amit Kumar Bhagat, Rajeshwar Nath Srivastava, Amita Jain, Kavita Baghel, and Saloni Raj. "Expression of MMP-8 in Pressure Injuries in Spinal Cord Injury Patients Managed by Negative Pressure Wound Therapy or Conventional Wound Care." Journal of Wound, Ostomy and Continence Nursing 44, no. 4 (2017): 343–49. http://dx.doi.org/10.1097/won.0000000000000333.
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Rodrigues dos Santos, Antonio Adriano, Ana Beatriz De Almeida Medeiros, Maria Julia Guimarães de Oliveira Soares, and Marta Miriam Lopes Costa. "Observation of dressing technique performed by professionals of nursing in a public hospital." Revista de Enfermagem UFPE on line 4, no. 3 (June 30, 2010): 1357. http://dx.doi.org/10.5205/reuol.928-8485-2-le.0403201003.
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ABSTRACTObjectives: to know how professionals of nursing are performing the dressing technique, to observe the use of technical principles in the accomplishment of the procedure and to identify the use of materials appropriated for execution of the technical procedure. Method: this is about an exploratory study, from quantitative approach, with a sample composed by 14 professionals. Data had been collected through a half-structuralized questionnaire. Is has been approved by the Ethics Commitee from Health Sciences Center of Federal University of Paraíba/UFPB and by the Ethics Commitee of the Lauro Wanderley University Hospital, under the protocol number 011/09, considering the Resolution 196/96 of the National Research Ethics Committee with human. Results: the most participants were female and they had less than five years of performance in the treatment of wounds; the practical of hygienic cleaning of the hands is not made in the correct way for the majority of them; the materials and coverings had been used in adequate way. Conclusion: the dressing technique is not made, for the majority of the nursing professionals, in agreement with what studied literature recommend. Descriptors: nursing; wounds and injuries; therapeutics.RESUMOObjetivos: conhecer como profissionais de enfermagem estão realizando a técnica de curativo, observar a utilização dos princípios técnicos na realização do procedimento e identificar a utilização de materiais adequados para execução do procedimento técnico. Método: trata-se de um estudo exploratório, de abordagem quantitativa, com amostra de 14 profissionais de enfermagem. Os dados foram coletados com um roteiro semi-estruturado, após aprovação pelo Comitê de Ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba/UFPB, Campus I e pelo Comitê de Ética do Hospital Universitário Lauro Wanderley, sob protocolo 011/09, considerando a Resolução 196/96 da Comissão Nacional de Ética em Pesquisa com Seres Humanos. Resultados: a maioria dos participantes era do sexo feminino e tinham menos de cinco anos de atuação no tratamento de feridas; a prática de higienização das mãos não é feita da maneira correta pela maioria deles; os materiais e coberturas foram utilizados de maneira adequada. Conclusão: a técnica de curativo não é feita, pela maioria dos profissionais de enfermagem, em concordância com o que a literatura pesquisada recomenda. Descritores: enfermagem; ferimentos e lesões; terapêutica.RESUMENObjetivos: conocer cómo las enfermeras están haciendo la técnica de curativo, observar el uso de los principios técnicos en la realización del procedimiento e identificar el uso de materiales adecuados para la aplicación del procedimiento técnico. Método: estudio exploratório, enfoque cuantitativo con una muestra de 14 profesionales. Los datos fueron recogidos entre marzo y junio 2009 a través de un cuestionario semi-estructurado. Este estudio fue aprobado por el Comité de Ética del Centro de Ciencias de la Salud, Universidad Federal de Paraíba, y por el Comité de Ética del Hospital Universitario Lauro Wanderley, con el número de protocolo siguiente: 011/09, teniendo en cuenta la resolución 196/96 de la Comisión Nacional de Ética en Pesquisa. Resultados: la mayoría de los participantes eran mujeres y tenían menos de cinco años de experiencia en el cuidado de heridas; la práctica de lavarse las manos no se hace de la manera correcta por la mayoría de ellos; los materiales y coberturas fueran usados correctamente. Conclusión: la técnica de curativo no se hace por la mayoría de los profesionales de enfermería, de acuerdo con lo que la literatura recomienda. Descriptores: enfermería; heridas y lesiones; terapéutica.
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Hooper, Jim, and William Charney. "Creation of a Safety Culture: Reducing Workplace Injuries in a Rural Hospital Setting." AAOHN Journal 53, no. 9 (September 2005): 394–98. http://dx.doi.org/10.1177/216507990505300905.
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A newly organized employee safety program, with an 11–step design, has been introduced at Valley General Hospital in Monroe, Washington, with the intention of changing the “culture of safety.” A 1–year report of the results indicates that the overall incidence of injury claims, lost-time injuries, and needlestick injuries were reduced after the program was implemented and timely reporting of claims within 24 hours was increased. The hypothesis, that by creating more visibility for the employee safety program a decrease in injury rates would occur, was confirmed.
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Ying, Wenjie, Jinglei Tan, Caiqiang Chen, Tao Sun, Shuangshuang Wang, and MingShi Zhang. "Biofabrication of silver nanoparticles and its application for development of wound dressing system in nursing care for burn injuries in children." Journal of Drug Delivery Science and Technology 54 (December 2019): 101236. http://dx.doi.org/10.1016/j.jddst.2019.101236.
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Grayson, Deborah, Ann Marie Dale, Paula Bohr, Laurie Wolf, and Bradley Evanoff. "Ergonomic Evaluation: Part of a Treatment Protocol for Musculoskeletal Injuries." AAOHN Journal 53, no. 10 (October 2005): 450–57. http://dx.doi.org/10.1177/216507990505301006.
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Ergonomic analyses and interventions are used as primary prevention methods to reduce physical stressors in the workplace and to prevent work-related musculoskeletal disorders (WMSDs). These methods can also be used for the treatment of injured employees. In this study, 103 employees with WMSDs resulting in more than 5 days away from usual work received an ergonomic evaluation which consisted of observation of usual work tasks, recommendations to minimize identified stressors, and case coordination. The goal of the intervention was to make simple job changes that would assist employees to return safely to usual job duties. The process for implementing this protocol for health care, airline, and university employees is described. The results show that after ergonomic evaluations were performed, the majority of recommendations were fully or partially (89%) implemented. Behavior changes were more likely to occur than administrative and equipment changes (p < .001). Occupational health nurses can use a similar program to enhance treatment plans for clients with WMSDs.
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Bettencourt, Amanda P., Matthew D. McHugh, Douglas M. Sloane, and Linda H. Aiken. "Nurse Staffing, the Clinical Work Environment, and Burn Patient Mortality." Journal of Burn Care & Research 41, no. 4 (April 13, 2020): 796–802. http://dx.doi.org/10.1093/jbcr/iraa061.
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Abstract The complexity of modern burn care requires an integrated team of specialty providers working together to achieve the best possible outcome for each burn survivor. Nurses are central to many aspects of a burn survivor’s care, including physiologic monitoring, fluid resuscitation, pain management, infection prevention, complex wound care, and rehabilitation. Research suggests that in general, hospital nursing resources, defined as nurse staffing and the quality of the work environment, relate to patient mortality. Still, the relationship between those resources and burn mortality has not been previously examined. This study used a multivariable risk-adjusted regression model and a linked, cross-sectional claims database of more than 14,000 adults (≥18 years) thermal burn patients admitted to 653 hospitals to evaluate these relationships. Hospital nursing resources were independently reported by more than 29,000 bedside nurses working in the study hospitals. In the high burn patient-volume hospitals (≥100/y) that care for the most severe burn injuries, each additional patient added to a nurse’s workload is associated with 30% higher odds of mortality (P < .05, 95% CI: 1.02–1.94), and improving the work environment is associated with 28% lower odds of death (P < .05, 95% CI: 0.07–0.99). Nursing resources are vital in the care of burn patients and are a critical, yet previously omitted, variable in the evaluation of burn outcomes. Attention to nurse staffing and improvement to the nurse work environment is warranted to promote optimal recovery for burn survivors. Given the influence of nursing on mortality, future research evaluating burn patient outcomes should account for nursing resources.
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Hasjim, Bima J., Areg Grigorian, Catherine M. Kuza, Sebastian Schubl, Cristobal Barrios, Theresa L. Chin, and Jeffry Nahmias. "Ground-Level Falls at Skilled Nursing Facilities Are Associated With More Serious Lower Extremity Injuries Compared With Home." International Journal of Lower Extremity Wounds 19, no. 2 (September 9, 2019): 190–96. http://dx.doi.org/10.1177/1534734619870393.
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Ground-level falls (GLFs) are the number one cause of injury and death in the older adult population. We compared injury profiles of GLFs at SNFs to those at homes, hypothesizing that GLFs at SNFs would lead to higher risks for serious (AIS ≥ 3) traumatic brain injury (TBI) and lower extremity (LE) injuries compared to GLFs at home. The 2015-2016 Trauma Quality Improvement Program was used to compare patients sustaining GLFs at home and SNFs. From 15,873 patients sustaining GLFs, 14,306 (90.1%) occurred at home while 1,567 (9.9%) at SNFs. More patients with GLFs at SNFs were female, older, and had greater incidence of congestive heart failure, end-stage renal disease, and dementia ( p < 0.001) compared to those at home. Although, GLF SNF patients had lower injury severity scores (9 vs. 10, p < 0.001) and incidence for TBI (28.0% vs 33.4%, p < 0.001), they had a higher rate of femur fractures (55.1% vs. 38.9%, p < 0.001). After controlling for female, end stage renal disease, smoking, dementia, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, and stroke, patients falling at SNFs had an increased risk of sustaining serious LE injury AIS (OR 1.64, p < 0.001), but not serious TBI AIS (OR 0.89, p = 0.073). In conclusion, compared to GLFs at home, those at SNFs have a higher risk for serious LE injury, with femur fractures being the most common. However, GLFs at SNFs and homes had no significant difference in risk for serious TBI. Future studies are warranted to evaluate preventative measures to reduce LE injuries at SNFs.
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Medeiros, Ana Beatriz de Almeida, Maria Julia Guimarães de Oliveira Soares, Marta Miriam Lopes Costa, Antonio Adriano Rodrigues dos Santos, Gilson De Vasconcelos Torres, and Felismina Rosa Parreira Mendes. "Dressing techniques: practice of nursing academics an institution of higher education." Revista de Enfermagem UFPE on line 5, no. 2 (March 26, 2011): 379. http://dx.doi.org/10.5205/reuol.1718-11976-1-le.05spe201110.
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ABSTRACTObjectives: to know how academics of nursing are performing the dressing technique, to observe the use of technical principles in the accomplishment of the procedure and to identify the use of materials appropriated for execution of the technical procedure. Method: exploratory study, from quantitative approach, with a sample composed by 24 academics. Data had been collected through a half-structuralized questionnaire. Is has been approved by the Ethics Commitee from Health Sciences Center of Federal University of Paraíba and by the Ethics Commitee from Lauro Wanderley University Hospital, under the protocol number 011/09, considering the resolution 196/96 of the National Research Ethics Commitee. Results: the most participants were female; the practical of hygienic cleaning of the hands is not made in the correct way for the majority of them; the materials and coverings had been used in adequate way. Conclusion: the dressing technique is not made, for the majority of the nursing academics, in agreement with what studied literature recommend. Descriptors: nursing; wounds and injuries; therapeutics.RESUMOObjetivos: conhecer como acadêmicos de enfermagem estão realizando a técnica de curativo, observar a utilização dos princípios técnicos na realização do procedimento e identificar a utilização de materiais adequados para execução do procedimento técnico. Método: estudo exploratório, abordagem quantitativa, com amostra composta por 24 acadêmicos. Os dados foram coletados através de um roteiro semi-estruturado. Estudo aprovado pelo Comitê de Ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba e pelo Comitê de Ética do Hospital Universitário Lauro Wanderley, sob o seguinte número de protocolo: 011/09. Considerando a Resolução 196/96 da Comissão Nacional de Ética em Pesquisa. Resultados: a maioria dos participantes era do sexo feminino; a prática de higienização das mãos é feita da maneira correta pela maioria deles; os materiais e coberturas foram utilizados de maneira adequada. Conclusão: a técnica de curativo é feita, pela maioria dos acadêmicos de enfermagem, em concordância com o que a literatura pesquisada recomenda. Descritores: enfermagem; ferimentos e lesões; terapêutica.RESUMENObjetivos: conocer cómo las académicos están haciendo la técnica de curativo, observar el uso de los principios técnicos en la realización del procedimiento e identificar el uso de materiales adecuados para la aplicación del procedimiento técnico. Método: estudio exploratório, enfoque cuantitativo con una muestra de 24 académicos. Los datos fueron recogidos através de un cuestionario semi-estructurado. Este estudio fue aprobado por el Comité de Ética del Centro de Ciencias de la Salud, Universidad Federal de Paraíba, y por el Comité de Ética del Hospital Universitario Lauro Wanderley, con el número de protocolo siguiente: 011/09, teniendo en cuenta la resolución 196/96 de la Comisión Nacional de Ética en Pesquisa. Resultados: la mayoría de los participantes eran mujeres; la práctica de lavarse las manos se hace de la manera correcta por la mayoría de ellos; los materiales y coberturas fueran usados correctamente. Conclusión: la técnica de curativo se hace por la mayoría de los académicos de enfermería, de acuerdo con lo que la literatura recomienda. Descriptores: enfermería; heridas y lesiones; terapêutica.
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Frederico, Giovana Andrade, Flávia Cristiane Kochraiber, Danila Cristina Paquier Sala, Anderson Da Silva Rosa, and Mônica Antar Gamba. "Integralidade no cuidado de enfermagem às pessoas com úlceras cutâneas." Revista de Enfermagem UFPE on line 12, no. 7 (July 3, 2018): 1997. http://dx.doi.org/10.5205/1981-8963-v12i7a234800p1997-2011-2018.
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RESUMOObjetivo: analisar a assistência de Enfermagem às pessoas com úlceras cutâneas sob a perspectiva da adoção do cuidado integral. Método: revisão integrativa, com busca nas bases de dados MEDLINE, LILACS, BDENF e na biblioteca virtual SciELO, de artigos publicados entre 2009 a 2016, com a adoção do conceito de integralidade e com os descritores integralidade e úlceras cutâneas. Após a leitura dos artigos, efetuaram-se a extração e a análise dos dados. Resultados: identificaram-se 11 estudos originais e duas revisões que destacam a perspectiva da integralidade dicotomizada com temas centrados nos conhecimentos para a prevenção e a recuperação tópica das lesões, cuidados com a ferida, descrição de fluxos de cuidado, acesso ao serviço, processo de trabalho da equipe e a percepção dos usuários sob o enfoque da especialidade. Conclusão: há uma lacuna em estudos que mostrem a valorização do modelo a se adotar na atenção básica utilizando o referencial teórico de integralidade na área de cuidados às pessoas com úlceras cutâneas, o que pode dificultar a adesão e a resolutividade nessa linha de cuidado. Descritores: Ferimentos e Lesões; Doença Crônica; Cicatrização; Assistência Integral à Saúde; Saúde Pública; Enfermagem. ABSTRACT Objective: to analyze Nursing care for people with skin ulcers from the perspective of adopting integral care. Method: integrative review, with search in the MEDLINE, LILACS, BDENF databases and in the SciELO virtual library, of articles published between 2009 and 2016, with the adoption of the concept of integrality and with the descriptors comprehensiveness and cutaneous ulcers. After reading the articles, the data were extracted and analyzed. Results: we identified 11 original studies and two reviews that highlight the perspective of dichotomized completeness with knowledge-centered themes for the prevention and topical recovery of injuries, wound care, description of care flows, and access to the service, process of work of the team and the perception of the users under the focus of the specialty. Conclusion: there is a gap in studies that show the value of the model to be adopted in basic care using the theoretical reference of integrality in the area of care for people with skin ulcers, which may hinder adherence and resolution in this care line. Descritores: Wounds and Injuries; Chronic Disease; Wound Healing; Comprehensive Health Care; Public Health; Nursing. RESUMEN Objetivo: analizar la asistencia de Enfermería a las personas con úlceras cutáneas bajo la perspectiva de la adopción del cuidado integral. Método: la revisión integrativa, con búsqueda en las bases de datos MEDLINE, LILACS, BDENF y en la biblioteca virtual SciELO, de artículos publicados entre 2009 a 2016, con la adopción del concepto de integralidad y con los descriptores integralidad y úlceras cutáneas. Después de la lectura de los artículos, se efectuó la extracción y la análisis de los datos. Resultados: se identificaron 11 estudios originales y dos revisiones, que destacan la perspectiva de la integralidad dicotomizada con temas centrados en los conocimientos para la prevención y la recuperación tópica de las lesiones, descripción cuidados con la herida, descripción de flujos de cuidado, acceso al servicio, proceso de trabajo del equipo y la percepción de los usuarios, bajo el enfoque de la especialidad. Conclusión: hay una lacuna en estudios que muestren la valorización del modelo a adoptar en la atención básica utilizando el referencial teórico de integralidad en el área de cuidados a las personas con úlceras cutáneas, lo que puede dificultar la adhesión y la resolución en esta línea de cuidado. Descritores: Heridas y Lesiones; Enfermedad Crónica; Cicatrización de Heridas; Atención Integral de Salud; Salud Pública; Enfermería.
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Cunha, Diequison Rite da, Rosimar Aparecida Alves Dutra, Geraldo Magela Salomé, and Lydia Masako Ferreira. "Construção de um aplicativo multimídia em plataforma móvel para tratamento de feridas com laserterapia." Revista de Enfermagem UFPE on line 12, no. 5 (May 1, 2018): 1241. http://dx.doi.org/10.5205/1981-8963-v12i5a230676p1241-1249-2018.
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RESUMOObjetivo: descrever o desenvolvimento de um aplicativo móvel para tratamento de feridas com laserterapia. Método: estudo metodológico, desenvolvido entre abril e setembro de 2017, envolvendo revisão da literatura, planejamento e produção do conteúdo didático, definição da estrutura de navegação e construção de um ambiente para download e instalação do aplicativo em dispositivos móveis. Resultados: quinze artigos, dois livros e uma dissertação foram selecionados a partir de pesquisa da literatura. O aplicativo desenvolvido registra as características sociodemográficas do paciente e, a partir dos dados de avaliação da ferida e de fatores de risco obtidos pelo profissional de saúde, propõe os parâmetros a serem utilizados em laserterapia. Conclusão: o aplicativo desenvolvido tem potencial de utilização na prática clínica, podendo auxiliar na seleção de parâmetros de laserterapia no tratamento de feridas, bem como na educação em enfermagem. Descritores: Aplicativos Móveis; Software; Lasers; Ferimentos e Lesões; Avaliação; Algoritmos.ABSTRACT Objective: to describe the development of a mobile application for treatment of wounds with laser therapy. Method: this is a methodological study, developed between April and September 2017, involving literature review, planning and production of didactic content, definition of the navigation structure, and construction of an environment for downloading and installing the application on mobile devices. Results: fifteen articles, two books, and one dissertation were selected from literature research. The developed application registers the sociodemographic characteristics of the patient, and from the data of evaluation of the wound and of risk factors obtained by the health professional, the parameters to be used in laser therapy were propose. Conclusion: the developed application has potential for use in clinical practice, and may help in the selection of laser therapy parameters in wound treatment, as well as in nursing education. Descriptors: Mobile Applications; Software; Lasers; Wounds and Injuries, Evaluation; Algorithms.RESUMEN Objetivo: describir el desarrollo de un aplicativo móvil para tratamiento de heridas con terapia de laser. Método: estudio metodológico, desarrollado entre abril y setiembre de 2017, envolviendo revisión de la literatura, planeamiento y producción del contenido didáctico, definición de la estructura de navegación, y construcción de un ambiente para download e instalación del aplicativo en dispositivos móviles. Resultados: quince artículos, dos libros y una disertación fueron seleccionados a partir de investigación de la literatura. El aplicativo desarrollado registra las características sociodemográficas del paciente, y a partir de los datos de evaluación de la herida y de factores de riesgo obtenidos por el profesional de salud, proponen los parámetros a ser utilizados en laserterapia. Conclusión: el aplicativo desarrollado tiene potencial de utilización en la práctica clínica, pudiendo auxiliar en la selección de parámetros de laserterapia en el tratamiento de heridas, así como en la educación en enfermería. Descriptores: Aplicaciones Móviles; Programas Informáticos; Rayos Láser; Heridas y Lesiones, Evaluación, Algoritmos.
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Santos, Aline Caroline, Rosimar Aparecida Alves Dutra, Geraldo Magela Salomé, and Lydia Masako Ferreira. "Construção e confiabilidade interna de um algoritmo para escolha da limpeza e terapia tópica em feridas." Revista de Enfermagem UFPE on line 12, no. 5 (May 1, 2018): 1250. http://dx.doi.org/10.5205/1981-8963-v12i5a230675p1250-1262-2018.
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RESUMOObjetivo: descrever a construção e validação de um algoritmo com indicações de procedimentos para a limpeza e terapia tópica de feridas. Método: estudo analítico, prospectivo, descritivo com respaldo de revisão da literatura. Para a construção do algoritmo, foi realizada uma pesquisa nas bases de dados das Ciências da Saúde. Trinta profissionais de saúde participaram como juízes na validação do algoritmo, respondendo a um questionário via e-mail. Resultados: os juízes consideraram que o algoritmo apresenta informações capazes de apoiar a decisão do profissional na escolha da técnica de limpeza da ferida e na conduta terapêutica. A análise estatística mostrou que as questões relacionadas à construção e validação do algoritmo apresentavam excelente confiabilidade, com alfa de Cronbach de 0,962. Conclusão: a versão validada do algoritmo construído com base na literatura e validado por profissionais de saúde mostrou confiabilidade estatística para a indicação da limpeza e da terapia tópica em feridas. Descritores: Algoritmos; Avaliação em Enfermagem; Cicatrização; Ferimentos e Lesões; Cuidados de Enfermagem; Protocolo clínico. ABSTRACT Objective: to describe the construction and validation of an algorithm with indications of procedures for cleaning and topical wound therapy. Method: this is an analytical, prospective, descriptive study supported by literature review. For the construction of the algorithm, a research was carried out with Health Sciences databases. Thirty health professionals participated as judges in the validation of the algorithm, responding to a questionnaire via e-mail. Results: the judges considered that the algorithm presents information capable of supporting the decision of the professional in the choice of the wound cleaning technique and the therapy. The statistical analysis showed that the issues related to the construction and validation of the algorithm presented excellent reliability, with Cronbach's alpha of 0.962. Conclusion: The validated version of the algorithm based on the literature and validated by health professionals showed statistical reliability for the indication of cleanliness and topical wound therapy. Descriptors: Algorithms; Nursing Assessment; Wound Healing; Wounds and Injuries; Nursing Care.RESUMEN Objetivo: describir la construcción y validación de un algoritmo con indicaciones de procedimientos para la limpieza y terapia tópica de heridas. Método: estudio analítico, prospectivo, descriptivo con respaldo de revisión de la literatura. Para la construcción del algoritmo, fue realizada una investigación junto a bases de datos de las Ciencias de la Salud. Treinta profesionales de salud participaron como jueces en la validación del algoritmo, respondiendo a un cuestionario vía e-mail. Resultados: los jueces consideraron que el algoritmo presenta informaciones capaces de apoyar la decisión del profesional en la elección de la técnica de limpieza de la herida y en la conducta terapéutica. El análisis estadístico mostró que las preguntas relacionadas a la construcción y validación del algoritmo presentaban excelente confiabilidad, con alfa de Cronbach de 0,962. Conclusión: la versión validada del algoritmo construido con base en la literatura y validado por profesionales de salud mostró confiabilidad estadística para la indicación de la limpieza y de la terapia tópica en heridas. Descriptores: Algoritmos; Evaluación en Enfermería; Cicatrización de Heridas; Heridas y Lesiones; Atención de Enfermería.
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Lernevall, L. S. T., A. L. Moi, E. Gjengedal, and P. Dreyer. "Staff Members’ Experience of Providing Parental Support in a National Burn Centre." Open Nursing Journal 13, no. 1 (December 31, 2019): 211–19. http://dx.doi.org/10.2174/1874434601913010211.
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Background Paediatric burn injuries affect not only the child but the whole family, especially the parents. Knowledge of how parents are affected psychologically has increased, but there is an ongoing dearth of literature on parental support while hospitalised. There is also very little documentation of the ways in which burn staff members support parents. Objectives To explore staff members’ lived experiences of supporting parents with children hospitalised at a burn centre due to a burn injury. Methods Four focus group interviews were conducted in 2017 with a total of 21 staff members at the National Burn Centre in Norway. Seven different burn staff professions participated. Data were analysed using a Ricoeur-inspired method for text analysis and managed using NVivo 12Plus. Results Four themes were identified in the treatment trajectory: creating a safe, secure and trusting environment from the moment parents enter the burn centre; helping parents deal with feelings of guilt; helping parents navigate in their daily routines while continuing to be a mother or father; and gradually involving parents in wound treatment as preparation for discharge. Conclusion Staff must carefully consider their verbal and non-verbal (body) language and how to approach parents from the very moment they enter the burn ward. Most parents are affected by feelings of guilt and these feelings must be addressed and processed. During the treatment trajectory, parents are guided to participate in the daily care of their child and are gradually assisted in taking over the wound treatment prior to discharge.
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Kammin, Vitina M., Kristine Eckert, Paula Alem, Margaret A. Dimler, Vitina M. Kammin, and Michael Marano. "585 Preventing Occipital Pressure Injuries in Patients Admitted to the Burn ICU." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S134—S135. http://dx.doi.org/10.1093/jbcr/iraa024.211.
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Abstract Introduction Occipital pressure injuries (OPI) are categorized as pressure injuries on the occipital bone caused by pressure, shearing, or friction. Patients with significant burns are at a greater risk of developing these types of injuries due to increased fluid volume from resuscitation, decreased tissue perfusion, immobility, edema and length of stay. The rate of OPI in the BICU was 4.3 in 2016; this led to a comprehensive program to reduce/eliminate these injuries. Methods Early identification of at-risk patients and implementation of prevention strategies was conducted. Best practices were reviewed and the following interventions were put into place: on admission, all patients with facial burns, (intubated or not), were given a small size fluidized positioner pillow. The pillow was to be positioned with a defined divot in the center and not flattened (which is the way they were currently being utilized). The fluidized pillow must go into the hydrotherapy room with the patient and the patient’s head turned and repositioned every 2 hours. The use of a moisture-wicking fabric was utilized over the fluidized positioner pillow to prevent maceration. Nursing staff and burn technicians were educated as to practice changes; wound care nurses were available for educational support. In addition, in 2017, the Burn ICU instituted a 2 RN skin check daily for all patients in the hydrotherapy room once all dressings were removed. This tank room “time out” was instituted for early identification of areas of potential skin breakdown. Results Implementation of these protocols has significantly decreased the occurrence of OPI in the BICU. Since implementation, the rate of OPI in 2017, 2018 and Q1 and Q2 of 2019 has been 0%. The application of the fluidized positioner pillow, tank room “time-out” and staff education has greatly decreased the occurrence of OPI in the BICU. Conclusions Patients sustaining large surface area burns and/or full-thickness burns to the head and neck are susceptible to the development of OPI. The utilization of a fluidized positioner pillow in conjunction with improved assessment and identification using a 2 RN “time out” skin assessment daily, has led to a decrease in OPI in our BICU. Applicability of Research to Practice The utilization of the fluidized positioner pillow in conjunction with the described interventions can lead to a decrease in occipital HAPI and improve patient outcomes.
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Klein, Céline, Plancq Marie-Christine, François Deroussen, Elodie Haraux, and Richard Gouron. "Treatment options for soft tissue defects in severe foot trauma in children." Journal of Wound Care 30, no. 6 (June 2, 2021): 432–38. http://dx.doi.org/10.12968/jowc.2021.30.6.432.
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Objective: Severe foot trauma in children is a therapeutic challenge, with presence of devitalised and soiled distal tissues. Several reconstruction and covering procedures can be applied, including artificial dermis (AD), negative pressure wound therapy (NPWT), fasciocutaneous flaps and free flaps. Here, we have developed and evaluated an algorithm for treating severe foot injuries with skin defects in children Method: Paediatric cases of severe foot injury treated over a 16-year period were retrospectively reviewed. Characteristics of the injuries, surgical procedures, complications and the modified Kitaoka score (clinical and functional rating score of the ankle and foot) were recorded. Results: A total of 18 children were included. The mean age at the time of injury was four years and 10 months (range: 1–11 years). The mean follow-up period was 6.2 years. Of the children, 13 presented with an amputation (12 partial foot amputations and one whole ankle and foot). The skin defect was combined with tendon exposure in nine cases, and/or bone and cartilage in seven cases, and heel damage in two cases. A flap was implemented in eight cases, of which one failed. NPWT was used in 13 patients (for an average of 21 days) and was combined with AD in six patients. The mean modified Kitaoka score was 68 (range: 55–80). Additional surgery during the follow-up period was required in seven patients (dorsal skin retraction, a thick flap, osteoma, trophic ulcer or ankle deviation). Conclusion: Our algorithm suggests different therapeutic strategies for skin coverage and healing, depending on the size of the lesion and the exposed structures, and seems to offer good results. These procedures should be combined with NPWT to optimise these results (improved healing, reduced infections, decreased skin defects and enhanced granulation tissue) and so should be used more frequently.
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Holbert, Maleea Denise, Roy M. Kimble, Mark Chatfield, and Bronwyn R. Griffin. "Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burn injuries: a prospective randomised controlled trial." BMJ Open 11, no. 1 (January 2021): e039981. http://dx.doi.org/10.1136/bmjopen-2020-039981.
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ObjectiveTo compare the effectiveness of two acute burn dressings, Burnaid hydrogel dressing and plasticised polyvinylchloride film, on reducing acute pain scores in paediatric burn patients following appropriate first aid.DesignSingle-centre, superiority, two-arm, parallel-group, prospective randomised controlled trial.Participants and settingPaediatric patients (aged ≤16) presenting to the Emergency Department at the Queensland Children’s Hospital, Brisbane, Australia, with an acute thermal burn were approached for participation in the trial from September 2017–September 2018.InterventionsPatients were randomised to receive either (1) Burnaid hydrogel dressing (intervention) or (2) plasticised polyvinylchloride film (Control) as an acute burn dressing.Primary and secondary outcomesObservational pain scores from nursing staff assessed 5 min post application of the randomised dressing, measured using the Face Legs Activity Cry and Consolability Scale was the primary outcome. Repeated measures of pain, stress and re-epithelialisation were also collected at follow-up dressing changes until 95% wound re-epithelialisation occurred.ResultsSeventy-two children were recruited and randomised (n=37 intervention; n=35 control). No significant between-group differences in nursing (mean difference: −0.1, 95% CI −0.7 to 0.5, p=0.72) or caregiver (MD: 1, 95% CI −8 to 11, p=0.78) observational pain scores were identified. Moreover, no significant differences in child self-report pain (MD: 0.3, 95% CI −1.7 to 2.2, p=0.78), heart rate (MD: −3, 95% CI −11 to 5, p=0.41), temperature (MD: 0.6, 95% CI −0.13 to 0.24, p=0.53), stress (geometric mean ratio: 1.53, 95% CI 0.93 to 2.53, p=0.10), or re-epithelialisation rates (MD: −1, 95% CI −3 to 1, p=0.26) were identified between the two groups.ConclusionsA clear benefit of Burnaid hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burns was not identified in this investigation.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617001274369).